Objective To conduct a meta-synthesis of the experience of dementia patients and their relatives in advance care planning（ACP） and provide evidence-based guidance for the development and implementation of ACP in dementia patients. Methods 8 databases（Web of science,PubMed,EBSCO,The Cochrane Library,Embase,CNKI,CBM,Wan Fang） were included to retrieve the literature on the experience of dementia patients and their relatives about ACP intervention from inception until August 2021. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. Meta-aggregation was used to conduct the synthesis. Results 41 findings were extracted from 11 qualified studies and they were integrated into 9 categories. 4 synthesis results were summarized,including attitude of dementia patients and their families to participate in ACP,the perceived benefits of dementia patients and their families to participate in ACP,the perceived barriers of dementia patients and their families to participate in ACP,and the perceived reactions of dementia patients and their families to participate in ACP. Conclusion The successful implementation of ACP requires continuous focus on the attitude of dementia patients and their families for participation. At the same time,facing the difficulties of dementia patients participating in ACP,we should alleviate the negative influence of family members’ participation and attach importance to patient preferences and enrich the content and form of ACP to promote the development and improvement of ACP.

Objective To explore distinct trajectories of psychological distress on breast cancer patients from diagnosis to early survivorship,and to investigate whether sociodemographic factors,disease related factors,and personality characteristics can predict trajectories of psychological distress. Methods A prospective study was conducted. Breast cancer patients,who met inclusion and exclusion criteria,were followed up at 6 different timepoints,namely before surgery（T1）,before chemotherapy（T2）,after first chemotherapy（T3）,middle of chemotherapy（T4）,end of chemotherapy（T5）,and 2 months after chemotherapy（T6）. General information,personality,and psychological distress of patients were evaluated. Growth mixture modeling was used to identify trajectory patterns of psychological distress. Logistic regression was used to identify predictors of psychological distress trajectories. Results 3 distinct trajectories were identified and named as “high-stable distress group”“decreasing distress group” and “low-stable distress group”,accounting for 5.3%,57.2%,37.5%,respectively. Occupation（χ²=6.508,P=0.089）,income（χ²=5.237,P=0.073）,and personality（χ²=40.382,P<0.001） have effects on distress trajectories. But only personality was identified in Logistic regression as an independent predictor of psychological distress trajectories. Conclusion Breast cancer patients showed various psychological distress trajectories patterns from diagnosis to early survivorship. Most patients experienced low distress and had good adjustment following cancer diagnosis. Patients who belonged to depressive temperament were more likely to experience high-stable distress and should be given more attention.

Objective The aim of this study was to develop and construct a core competence index system for specialized nursing of pulmonary rehabilitation,which can provide references for the training and management of pulmonary rehabilitation nurses. Methods Literature review,group discussion and expert consultation were used to establish the index of the core competence for specialist nurses of pulmonary rehabilitation,and the analytic hierarchy process was adopted to confirm the weight of each indicator. Results This study employed a two-round Delphi method with recruitment of 26 nursing experts,and the effective recovery rate was 100%. The results of Ca（judgment coefficient）,Cs（familiarity coefficient） and Cr（authority coefficient） are 0.938,0.846 and 0.901,respectively. Besides,the Kendall coefficients of the two rounds were 0.108~0.227 and 0.126~0.264 respectively,which were statistically significant（P<0.001）. Finally,the core competence index for specialist nurses of pulmonary rehabilitation was formed,including 8 first-level indicators,30 second-level indicators and 113 third-level indicators. Conclusion The reliability and practical significance of the newly developed core competence index were relatively high,which could provide references for the training,examination,evaluation and accreditation of pulmonary rehabilitation nurses.

Objective To investigate the current status of cognition and attitude of community residents for advance care planning（ACP） in Zhengzhou and its influencing factors. Methods A multi-stage random sampling was used through a questionnaire survey on 342 residents from 4 communities in Zhengzhou. The factors influencing positive attitude of community residents were analyzed by logistic regression. Results The cognition of community residents to ACP in Zhengzhou was scored 0~5 [0（0,1）];the total score of attitude is 15~62 [40（26,49）]. Logistic regression analysis showed that age,the previous experience of caring for family or friends in hospital and the experience of family or friends receiving life support treatment were the influencing factors of positive attitude of community residents to ACP in Zhengzhou（P<0.05）. Conclusion The cognition of community residents to ACP is at a low level,while the overall attitude is positive. Senior residents,residents with experience of caring for relatives and friends in hospitals and experience of family or friends receiving life-sustaining treatment have a more positive attitude towards ACP. Health care workers should work with relevant organizations to promote the popularization and acceptance of ACP,and should also provide targeted education and services for different groups in order to promote ACP.

Objective To standardize an expert consensus on pulmonary rehabilitation nursing of chronic respiratory diseases. Methods On the basis of literature review,5 experts were interviewed and 19 experts were consulted to establish the primary and secondary themes. 10 nursing experts in this field were invited to conduct peer review on the draft consensus to modify and improve the consensus content. Results After expert consultations,14 first-level themes and 40 second-level themes were established. The value of Ca（judgment coefficient）,Cs（familiarity coefficient） and Cr（authority coefficient） were 0.895,0.839 and 0.867,which indicated the expert consultation have high authority and credibility. The Kendall coefficients of first-round expert consultation were 0.121 and 0.151,and they were 0.205 and 0.149 in the second round（P<0.05）. In the first-round expert consultation,the coefficients of variation of the first and second themes were 0.197 and 0.200,and in the second round,they were 0.202 and 0.237. They were all less than 0.25,indicating that the expert’s judgment results were relatively consistent. Conclusion As this consensus was developed based on 19 clinical nursing professionals from across the country,it is scientific and authoritative. This consensus can not only benefit to clinical nursing practice,but also lay the foundation for the development of guideline,and it still needs further theoretical and empirical research verification.