Objective To search，evaluate and integrate relevant evidence on the management of eating behaviors in patients with anorexia nervosa（AN） at home and abroad，so as to provide references for clinical practice. Methods We systematically searched the domestic and foreign databases to collect the evidence on the management of eating behaviors in patients with AN，including clinical decisions，recommended practice，evidence summaries，clinical practice guidelines，systematic reviews and expert consensuses. The time for the retrieval is from the inception of databases until February 2022.There were 3 researchers who evaluated the quality of the literature，and extracted and summarized the evidence based on this subject. Results A total of 16 articles were included，including 2 clinical decisions，2 evidence summaries，9 guidelines，and 3 systematic reviews.Totally 26 pieces from 6 aspects of evidence were summarized，including multidisciplinary team，management goals，assessment，management practice，psychotherapy and health education. Conclusion This study summarizes the best evidence for the management of eating behaviors in patients with AN. In the follow-up process of evidence transformation，specific clinical situations in China should be considered to select evidence in a targeted manner，in order to standardize the eating behaviors of patients and improve their clinical outcomes.
Objective To assess the status and analyze the causes of low intake dehydration in elderly patients with cancer at admission，and to provide references for early clinical recognition and prompt intervention. Methods From March 2021 to March 2022，elderly patients with cancer who had been hospitalized within 24 h in a tertiary A hospital in Tianjin were selected by convenience sampling method. The occurrence of low intake dehydration was judged by the calculated plasma osmolality，and the patients were divided into a normal group and a dehydrated group according to the plasma osmolality values，and the influencing factors for the occurrence of low intake dehydration in elderly patients with cancer were screened by logistic regression analysis. Results Among 706 elderly patients with cancer，the incidence of low intake dehydration during admission was 60.91%. Logistic regression analysis showed that comorbid cognitive impairment（OR=2.018），comorbid swallowing disorder（OR=1.611），Barthel score≤60 points（OR=2.572），serum albumin<35 g/L（OR=2.698） and duration of illness>6 months（OR=2.905） were influencing factors of low intake dehydration（P<0.05）. Conclusion Elderly cancer patients who have a high incidence of low intake dehydration on admission and comorbid cognitive impairment，comorbid swallowing disorders，Barthel score≤60 points，serum albumin<35 g/L and duration of illness>6 months are more likely to develop low intake dehydration，and nursing staff should pay close attention to high-risk patients to identify and plan suitable interventions early to reduce the incidence of low intake dehydration.
Objective In order to construct a non-artificial airway care scheme for the prevention of stroke-associated pneumonia and to provide references for effectively preventing stroke-associated pneumonia. Methods A group was set up to preliminarily formulate a non-artificial airway management program based on literature research and clinical experience. Through 2 rounds of expert consultations，the items were modified and the final scheme was determined. Results The return rates of questionnaires in 2 rounds were 88.24% and 100%，respectively. The expert authority coefficient is 0.940. After the second round of expert consultation，the variation coefficients of importance and feasibility of each item were 0-0.224 and 0-0.245，and the Kendall harmony coefficients were 0.139 and 0.241，respectively，with statistically significant differences（P<0.001）.The final scheme consists of 4 first-level items with risk assessment，dietary management，respiratory management，and oral health management，16 second-level items and 54 third-level items. Conclusion Experts have a high degree of enthusiasm and authority，and their opinions are well coordinated. The non-artificial airway care scheme constructed in this study for the prevention of stroke-associated pneumonia is reliable，specific and practical.
Objective To translate the English version of Perioperative Thirst Discomfort Scale （PTDS） into Chinese,and to test the reliability and validity of the Chinese version of PTDS. Methods The English version of PTDS was translated into Chinese and back translated and modified for cultural adaptation according to the guidelines. A convenience sample of 316 perioperative patients at 4 tertiary hospitals in Fujian was investigated by the Chinese version of PTDS,in order to test its reliability and validity. Results The Cronbach’s α of the Chinese PTDS was 0.813; both the scale-level content validity index and the item-level content validity index were 1.Factor analysis showed 2 factors explaining 64.312% of the total variance. The score of PTDS was significantly associated with the thirst intensity score（r=0.681,P<0.001）. Conclusion The Chinese version of PTDS has been proved to be reliable and valid.It can be used for measuring thirst discomfort in perioperative patients.
Objective To construct a nursing plan for the quality of bowel preparation of diabetic patients,and to explore effects of its application. Methods The Delphi expert consultation method was used to construct a nursing plan for the intestinal preparation of diabetic patients. The plan includes 4 times of intestinal preparation intervention,5 key points of intestinal preparation intervention and 15 guiding contents of nursing intervention. 300 patients who underwent colonoscopy in the digestive endoscopy center of a tertiary general hospital in Fujian Province from August 2020 to January 2021 were selected as the research subjects,using the experimental research method. The research participants are grouped in chronological order,and finally 150 cases were included in the actual research subject control group and 150 cases in the experimental group. The control group was given regular bowel preparation guidance,and the experimental group used diabetic colonoscopy on the basis of routine care. The adequacy rate of bowel preparation,the detection rate of adenoma,the compliance of bowel preparation and the occurrence of adverse reactions of the 2 groups were compared. Results The bowel preparation adequacy rate,colon adenoma detection rate,and bowel preparation compliance ratio of the experimental group were all higher than those of the control group（P<0.05）. The number of cases of nausea,abdominal distension and hypoglycemia in bowel preparation in the experimental group were Less than it in the control group（P<0.05）. Conclusion The application of the intestinal preparation nursing intervention program for diabetic patients can effectively improve the bowel preparation adequacy rate,the detection rate of polyps,and the compliance of intestinal preparation;reduce the occurrence of adverse reactions during the intestinal preparation process,and alleviate the intestinal preparation of patients.
To summarize the nursing care of fecal microbiota transplantation in a patient complicated with pulmonary infection and pseudomembranous colitis after radical resection of rectal cancer. The main contents of nursing are as follows. The first stage is to prevent the aggravation of infection,including the observation and management of ileostomy and ostomy fluid,respiratory function exercise,early functional exercise,nutritional support,and disease observation. The second stage is the care of fecal microbiota transplantation,including preparation for transplantation,the key points of nursing during transplantation,and nursing after transplantation. After careful nursing,the patient has recovered and discharged from the hospital. After 6-month follow-up,the ileostomy fluid was controlled at a normal level of 560-1 050 ml/d,with the enhanced self-care ability and the improved symptoms of anxiety and depression,and the quality of life was improved.
Objective To search,evaluate and summarize the best evidence for thrombosis prevention of arteriovenous fistula（AVF） in hemodialysis patients,and to provide references for improving the long-term survival rate of autologous AVF. Methods According to the guidance of evidence-based nursing methods,we searched BMJ Best Clinical Practice,UpToDate,JBI Library,Cochrane Library,DynaMed,Agency for Healthcare Research and Quality and other guideline databases,National Kidney Foundation and other professional associations,PubMed and other comprehensive databases for the related studies on the prevention of autologous AVF thrombosis in hemodialysis patients. The evidence-based team extracted,summarized and evaluated the evidence. Results A total of 14 pieces of the literature were included through literature search,including 5 clinical decisions,6 guidelines,2 expert consensuses,and 1 systematic evaluation. Totally 34 pieces of evidence were selected,including assessment,monitoring and screening,standardized use of AVF,personnel qualification and training,health education,and intradialytic hypotension management,based on evidence-based evidence extraction and opinions of clinical professionals. Conclusion This study summarizes the best evidence for AVF thrombosis prevention and provides a reference for medical staff in dialysis centers. Through the clinical application of evidence,we can make the monitoring and maintenance of autologous arteriovenous fistula work better,and the quality of nursing care can be improved.
In recent years,the method of distraction based on virtual reality（VR） technology has gradually been applied to the management of children’s operational pain. This paper reviews the application status of VR technology in children’s procedural pain,including the concept of VR technology and procedural pain,and the application methods and effects of VR technology in reducing children’s procedural pain. The shortcomings and prospects of VR technology in alleviating children’s procedural pain are also introduced in order to provide guidance for clinical practice.
Objective To explore the risk factors of Post-Intense Care Syndrome-Cognitive Impairment（PICS-CI） in critically ill patients,and to build their risk prediction model. Methods A total of 481 ICU patients from 2 Level A tertiary hospitals in Fujian Province were selected,and divided into a cognitive impairment group（n=215） and a non-cognitive impairment group（n=266） according to their cognitive score of 7 days after being transferred out of ICU. The demography,disease,treatment,physiological and laboratory indicators between the 2 groups were compared;the risk factors of PICS-CI were screened out,and Logistic regression was used to establish a risk prediction model. 118 patients from another 4 hospitals were selected to verify the model prediction. Results Age（OR=1.035）,delirium（OR=10.488）,sepsis（OR=1.925）,propofol dose（OR=1.098）,sleep disorder（OR=0.932） are the independent risk factors of PICS-CI. These 5 factors are used to construct a prediction model,which was internally verified by the modeling group. The calibration curve of the calibration chart is close to the ideal curve;the area under the ROC curve is 0.838;the risk prediction value 0.521 corresponding to the maximum Youden index is the best value;the prediction critical value is 50 points. The external verification shows that the calibration curve of the calibration chart is near the ideal curve,and the area under the ROC curve drawn is 0.797. Conclusion The PICS-CI prediction model constructed in this study shows good prediction efficiency. ICU patients with scores≥50 should receive close attention and early interventions in early stage.
Objective Combined with physical and mental characteristics of children,we developed health education game software for children with type 1 diabetes,so as to provide references for health education of children with chronic diseases. Methods The health education software for children with type 1 diabetes was developed in the form of games with questions and answers. It is convenient to select children with type 1 diabetes admitted to Department of Endocrinology in our hospital from November 2017 to April 2019 as research subjects. According to the time of admission,they are allocated into an experimental group and a control group,with 16 cases in each group. In the experimental group,game software was used for health education;the control group received traditional health education. Before and after the implementation,the knowledge of disease theory of children,satisfaction of children and parents and satisfaction of nurses were compared. Results The theoretical test score of the experimental group was significantly higher than that of the control group（P<0.05）. 87.5% of the children and their parents thought that the game software was novel and easily acceptable for children,and it could stimulate their willingness to learn actively,which was helpful for children to learn disease knowledge. Satisfaction of nurses with all dimensions of software was high,and the overall satisfaction was 94.67%. Conclusion The software is convenient,professional,practical,interesting and easily acceptable for children. Through the application of game software,we can improve health education mode for children by improving their learning participation and theoretical knowledge level.
Objective To understand the status of the bowel preparation quality of outpatients with colonoscopy. To analyze the effect of interval time from the completion of bowel preparation to the start of colonoscopy on the quality of bowel preparation. Methods Demographic and clinical data of outpatients undergoing colonoscopy at digestive endoscopy center of 3 general hospitals in Fuzhou from April 2019 to September 2019 were collected.Chi-square test was used to screen the factors with statistical significance on the bowel preparation quality（P<0.10）. After statistical method of propensity value matching was used to eliminate the confounding factors,the differences in bowel preparation quality between different interval groups（divided into（2,3] h、（3,4] h、（4,5] h、（5,6] h、（6,7] h、（7,8] h、（8,∞） h） were compared by variance analysis. Results A total of 401 patients were enrolled in the study. After matching of 401 samples with propensity value matching,316 new samples were generated and the influence of confounding factors was excluded by test. Compared the data with analysis of variance,the quality of bowel preparation was different in different interval time groups.The quality of bowel preparation in group of（2,3] h was significantly better than groups of（4,5] h and（6,7] h. The quality of bowel preparation in group of（3,4] h was significantly greater than（6,7] h. There was no significant difference between 2 groups of（2,3] h and（3,4] h. There was no significant difference between any 2 groups in（4,5] h,（6,7] h,（7,8] h,（8,∞） h. Conclusion The quality of bowel preparation can be maintained at an optimal state of cleanliness within 2~4 hours between the completion of bowel preparation and the start of colonoscopy.
Objective To investigate the knowledge and attitude of ICU physicians and nurses on physical environment in ICU setting and to explore the influencing factors.Methods A self-made questionnaire was used to survey 487 physicians and nurses from 8 tertiary hospitals and 14 secondary hospitals in Fujian Province.Results The ICU physicians and nurses’ knowledge and attitude scores were （33.25±7.14） and （42.17±3.26）. Multiple regre-ssion analysis showed that educational background and level of hospitals were influencing factors for knowledge scores for physical environment in ICU medical staffs（P<0.01）. Job title,position and level of hospitals were influencing factors for attitude score for physical environment in ICU medical staffs（P<0.01）.Conclusion ICU physicians and nurses took a positive attitude about physical environment,while the level of knowledge should be improved.
