Objective To explore the effect of a mobile health intervention model based on self-determination theory on subthreshold depression in breast cancer patients. Methods By convenience sampling method，74 patients with breast cancer subthreshold depression who received chemotherapy in the breast department of a tertiary hospital in Guangxi from July 2021 to August 2022 were selected as the research subjects. According to the order of admission time，the patients admitted from February 2022 to August 2022 were taken as an experimental group，and the patients admitted from July 2021 to January 2022 were taken as a control group，with 37 cases in each group. On the basis of routine nursing，the experimental group implemented a mobile health intervention model based on self-determination theory. The control group received routine nursing，with every 21 days for 1 cycle and a total of 4 cycles of intervention. Before and after the intervention，the Centre for Epidemiological Studies Depression Scale（CES-D），Hamilton Rating Scale for Depression（HAMD-17），Basic Psychological Needs Satisfaction Scale（BPNS） and Functional Assessment of Cancer Therapy-Breast（FACT-B） were used to evaluate the intervention effect. Results 34 patients in the experimental group and 36 patients in the control group completed the study. After intervention，the CES-D score and HAMD-17 score of the 2 groups were lower than those before intervention（P<0.05）；the CES-D score and HAMD-17 score of the experimental group were lower than those of the control group，and the difference was statistically significant（t=7.748，P<0.001；t=8.150，P<0.001）. The BPNS scores of the 2 groups were higher than those before the intervention，and the BPNS score of the experimental group was significantly higher than that of the control group（t=-6.534，P<0.001）. The scores of FACT-B in the 2 groups were higher than those before the intervention，and the scores of FACT-B in the experimental group were significantly higher than those in the control group（t=-4.579，P<0.001）. Conclusion The mobile health intervention model based on self-determination theory can improve the subthreshold depression，self-determination and quality of life of breast cancer patients.
Objective To evaluate and summarize the best evidence for ultrasound-guided nasointestinal tube placement in adult critically ill patients，and to provide references for clinical practice. Methods The relevant evidence of ultrasound-guided nasointestinal feeding tube placement in adult critically ill patients was systematically searched from domestic and foreign databases and websites，including guidelines，expert consensuses，clinical decision-making，evidence summaries and systematic reviews，and the search time limit is from the establishment of the databases to June，2022. There were 2 researchers who independently assessed the quality of the literature and identified the level of evidence. Results A total of 22 articles were included，including 5 guidelines，6 expert consensuses，1 group standard，2 clinical decision-making，3 evidence summaries and 5 systematic reviews. 26 pieces of evidence were summarized from 5 themes：clinical situation，assessment，preparation，key points of catheterization，and nursing essentials. Conclusion The best evidence of ultrasound-guided nasointestinal tube placement in adult critically ill patients was summarized to provide evidence-based references for the implementation of bedside ultrasound-guided nasointestinal feeding tube placement and ensure patient safety.
This paper mainly reviews the construction，characteristics，and application of the risk prediction models of venous thromboembolism among trauma patients. We also analyze and compare the characteristics of the models and application effects，so as to provide a reference for the selection of venous thromboembolism risk prediction models among trauma patients for clinical nurses.
Objective To investigate the status and analyze the influencing factors of cognitive function for older people in 30 nursing homes nationally，so as to provide references for the formulation of interventions to improve the cognitive function. Methods The cross-sectional study design was conducted in our study. The convenience sampling method was used to choose older people in 30 nursing homes from east，central，south，north，northwest and southwest for investigation from January to September in 2022 by a general information questionnaire，Mini-Mental State Examination and Short Physical Performance Battery. Logistic regression analysis was used to explore the influencing factors of cognitive function. Results A total of 2 242 older people were investigated. There were 1 006（44.9%） older people with impaired cognitive function. Multivariate logistic regression analysis showed that age，children，long-term medication，regular exercise，self-reported social support as well as hearing impairment and physical performance were the influencing factors（P<0.05）. Conclusion The cognitive function of older people in nursing homes needs to be improved. The older people with advanced age，childless，long-term medication，irregular exercise，lack of social support，hearing impairment and impaired physical performance should be paid more attention. The early interventions should be conducted to improve cognitive function.
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 search，evaluate，and summarize the best evidence of endotracheal tube cuff management in adult ICU patients，and to provide a reference for clinical practice and standard formulation. Methods We searched UpToDate，BMJ Best Practice，Guidelines International Network（GIN），National Guideline Clearinghouse（NGC），Joanna Briggs Institute（JBI），Cochrane Library，PubMed，Embase，Web of Science，CINAHL，National Institute for Health and Care Excellence（NICE），China Clinical Guidelines Library，Yimaitong，Wanfang Database，China Biology Medicine（CBM），CNKI on artificial airway endotracheal tube cuff management in ICU adult patients，including clinical decision-making，guidelines，systematic reviews and expert consensuses published from January 2012 to February 2022. There were 4 researchers who evaluated the quality of the included articles and 2 researchers extracted evidence from the articles that met the quality standards. Results A total of 22 articles were included，including 3 clinical decision-makings，7 guidelines，3 expert consensuses，and 9 systematic reviews. 29 pieces of best evidence were summarized，including artificial airway evaluation，endotracheal tube cuff selection，cuff inflating method，cuff inflating time，cuff pressure regulation，cuff leakage evaluation，removal of secretions from the cuff，and cuff leakage test. Conclusion The best evidence of artificial airway endotracheal tube cuff management in ICU adult patients provides evidence-based evidence for clinical healthcare professionals. Scientific management of artificial airway endotracheal tube cuffs in ICU adults helps to reduce the incidence of ventilator-associated pneumonia.
The nursing experience of a patient undergoing emergency coronary artery bypass grafting in the period of targeted drug therapy after lobectomy. The patient，who was complicated with multiple drug-resistant bacterial infections and other lesions，had acute myocardial infarction during the targeted drug therapy. The main points of nursing include the assessment and care of cardiac function，proper measures of excessive drainage fluid，protection and rehabilitation of lung function，prevention and control of infection，protection of liver and kidney function，targeted psychological care and health education to help him build confidence in overcoming disease. After the comprehensive management of a multidisciplinary team，tracheal intubation was removed 38 hours after surgery，and the patient was discharged 15 days after emergency operation.
Objective To investigate the status and influencing factors of dysphagia in elderly patients with chronic obstructive pulmonary disease（COPD）. Methods A total of 1 268 elderly patients with COPD hospitalized in the respiratory department of 13 general hospitals in Ningxia were selected by convenience sampling method from April 2019 to August 2020. Patients were investigated by the general information questionnaire，the Water Swallowing Test，Modified Medical Research Council Dyspnea Scale，Activities of Daily Living，the Geriatric Depression Scale，the Mini Nutritional Assessment-Short Form，COPD Assessment Test Scale，the FRAIL debilitation assessment scale. Logistic regression analysis was performed to analyze the influencing factors of dysphagia in COPD patients with statistically significant variables. Results The incidence of dysphagia in elderly COPD patients was 20.39%. Logistic regression analysis showed that smoking status，tooth loss，feeding attention，feeding position，PaCO2，dyspnea，nutritional status and COPD severity were the influential factors of dysphagia（P<0.05）. Conclusion The incidence of dysphagia in elderly COPD patients is higher. COPD patients with severe disease，high degree of dyspnea，high PaCO2，long-term smoking，number of missing teeth≥6，malnutrition，not paying attention to eating，and semi-recumbent position have a higher risk of dysphagia. Clinical medical staff can formulate relevant intervention measures according to the influencing factors to prevent the occurrence of dysphagia.
Objective To investigate the incidence and influencing factors of dysmobility syndrome（DMS） in maintenance hemodialysis（MHD） patients，and to provide theoretical bases for clinical prevention. Methods Data of MHD patients with the age of over 45 years and dialysis time of over 3 months were collected from a hemodialysis center of a Shanghai hospital from September to December 2020. Dual-energy X-ray absorptiometry，body composition analyzer and dynamometer were used to measure human parameters. Logistic regression model was used to analyze the independent influencing factors. Results The overall incidence of DMS in MHD patients was 48.6%（71 cases）. Logistic regression identified that patients with and without DMS were statistically different（P<0.05）in MIS（OR=3.344），concentric obesity（OR=3.932），knee extension strength/weight（OR=5.772），phase angle（OR=6.206），history of cerebrovascular（OR=3.855），cardiovascular（OR=3.431） disease and anemia（OR=0.188）. Conclusion The incidence of DMS in middle-aged and elderly MHD patients was high. MIS≥8，concentric obesity，low knee extensor muscle strength/weight and phase angle，history of anemia，cerebrovascular and cardiovascular disease are influencing factors of DMS in MHD patients. Health staff should evaluate influencing factors early to decrease the incidence of DMS.
Objective To comprehensively retrieve and analyze the relevant evidence of non-pharmacological interventions in promoting the recovery of gastrointestinal function after gastrointestinal malignant tumor surgery,and to summarize the best evidence. Methods According to the 6S model of evidence-based resources,computerized search in websites and databases such as UpToDate,Cochrane clinical answers,National Guideline Clearing house,the National Institute for Health and Care Excellence,New Zealand Guidelines Group,Yimaitong,Cochrane Library,PubMed,CNKI,Wanfang Data,VIP,was conducted to collect relevant clinical decisions,guidelines,expert consensuses,evidence summaries,and systematic reviews on non-pharmaceutical interventions in promoting gastrointestinal function recovery after gastrointestinal malignant tumor surgery. 3 researchers evaluated the quality of the included literature independently,and combined the professional judgment to standardize the literature information extraction. Results A total of 15 articles were included,including 4 articles on clinical decision-making,1 guideline,3 expert consensuses,and 7 systematic reviews. 12 pieces of the best evidence were formed,including topics such as multimodal intervention,preventive gastrointestinal decompression,early postoperative activities,chewing gum,drinking coffee,and acupuncture therapy. Conclusion Medical staff can follow the best evidence to formulate intervention programs to promote the recovery of gastrointestinal function for patients with gastrointestinal malignant tumors after surgery,and promote evidence-based practice.
Objective To construct a platform of post-hospital health management for mothers and infants based on “Internet +”,and to provide corresponding evidence. Methods The post-hospital health management for mothers and infants based on “Internet+” included 2 parts：①Patient APP included service items page and personal information page,supporting personal information registration,previous health file query,team selection and appointment,service evaluation,etc;②Medical APP included personal work station,appointment service application display and consultation communication interface,supporting medical staff registration,viewing appointment services,and consultation. Data from January 25 to August 31,2021 were collected,including the use of platform,online medical team-patient interaction,and maternal satisfaction with the platform. Results The platform has served 990 mothers,and the repeated use rate was 38.28%（379/990）. The consultation content covers many aspects of maternal and child care during the puerperium period,of which a total of 42 cases were solved by medical and nursing staff （4.24%）;251（25.36%） problems were solved off regular working hours. Conclusion Post-hospital health management platform for mothers and infants based on “Internet +” is convenient,efficient and professional,and it works well. Solving maternal and infant problems in a timely,professional and efficient manner,it improves the participation of mothers and meets their diversified health needs.
Objective To systematically evaluate the safety and effectiveness of enteral nutrition in patients with prone ventilation,and to provide references for clinical decision-making. Methods CNKI,WanFang,VIP,SinoMed,PubMed,Embase,Cochrane Library,Web of Science,Clinic trials were searched for randomized controlled trials,quasi-experimental studies and cohort studies about the safety and efficacy of enteral nutrition in patients with prone ventilation published from inception to January 2021. There were 2 reviewers who screened the literature according to the inclusion and exclusion criteria,extracted data,and assessed the quality of included studies indepen-dently. Meta-analysis was conducted by RevMan 5.4. Results Finally,9 articles are included,with a total of 461 patients. The results of meta-analysis showed that compared with patients with supine position,there was no statistical significance for patients with enteral nutrition during prone position in the incidence of high gastric residual volume[OR=0.89,95%CI（0.57,1.38）,P=0.60],the incidence of vomiting or reflux[RR=1.15,95%CI（0.89,1.48）,P=0.29],ventilator associated pneumonia[RR=1.18,95%CI（0.77,1.81）,P=0.44],enteral nutrition interruption rate[RR=1.42,95%CI（0.90,2.24）,P=0.13],length of stay in ICU[MD=-0.63,95%CI（-5.94,4.68）,P=0.82]. Conclusion Enteral nutrition in prone patients had no significant effect on the incidence of high gastric residual volume,vomiting or regurgitation,ventilator-associated pneumonia,enteral nutrition interruption,or length of ICU stay. However,the quality of the included literature is limited,and more high-quality clinical studies are needed for further validation in the future.
Objective To investigate the influencing factors of enterostomy patients’ usage intention of Internet diagnosis and treatment services within the theoretical framework of Unified Theory of Acceptance and Use of Technology and Dual-Factor Model. Methods Using a convenience sampling method，310 enterostomy patients were recruited from 3 tertiary hospitals in Hefei city from March to September 2021. The general data questionnaire，m-eHEALS Scale and the questionnaire on the usage intention of the Internet diagnosis and treatment services of enterostomy patients were used for investigation. Structural equation model was constructed to analyze the influencing factors. Results The score for usage intention was（3.37±1.31），with the performance expectation of （4.08±0.76），effort expectation of （3.11±1.33），social influence of （3.66±1.02），facilitating conditions of （3.80±1.06），trust of（4.06±0.58），resistance to change of（3.07±1.29），and ehealth literacy of（2.53±1.07）. The results of the structural equation model show that social impact，effort expectation，and ehealth literacy have positive effects on the usage intention，with effect values of 0.251，0.230 and 0.082，respectively. Resistance to changes negatively affects the usage intention，and the effect value was -0.506（P<0.05）. Conclusion The level of usage intention of Internet diagnosis and treatment service of enterostomy patients is in the middle of the upper. Resistance to changes，social influences，effort expectations，and ehealth literacy are the key factors affecting usage intention of enterostomy patients. To enhance patients’ usage intention of Internet diagnosis and treatment.
Objective To investigate the relationship between the changes of blood pressure and palmar swelling during radial artery compression in patients with radial artery percutaneous coronary intervention (PCI). Methods The patients who underwent radial artery PCI in the coronary heart disease unit of a tertiary general hospital in Nanchang from May 2018 to December 2020 were selected as the study subjects. The general data and the related indexes of decompression were analyzed retrospectively,and the blood pressure fluctuation during radial artery compression was described. Univariate regression analysis was used to analyze the influencing factors of palmar swelling on the operative side,and the blood pressure during radial artery compression was divided into nodes. The effects of different blood pressure on operative side palm swelling were analyzed by stratification,and the corresponding range of blood pressure at the highest risk of operation side palm swelling was further analyzed by trend regression. Results A total of 788 patients with radial artery PCI were included. Based on the analysis of patients’ baseline data,it was found that history of diabetes,history of hypertension,signs of heart failure and high average systolic blood pressure during radial artery compression were the risk factors of operative palmar swelling. However,multivariate stratified analysis of risk factors showed that systolic blood pressure ≥130 mmHg during radial artery compression increased the risk of ipsilateral palm swelling in patients with diabetic history (OR=1.09,P<0.001). In patients with or without heart failure signs and hypertension history,when the systolic blood pressure during radial artery compression was more than 130 mmHg,the 2 groups increased the risk of palmar swelling on the operative side. Furthermore,trend regression analysis showed that the average systolic blood pressure during radial artery compression was between 130 and 149 mmHg. Every 10 mmHg increase in systolic blood pressure had increased the risk of palmar swelling by 3.52 times[95%CI (1.37,13.22) ]. Conclusion During the period of radial artery compression,the average systolic blood pressure of patients is 130-149 mmHg,and the risk of palmar swelling on the operative side is the highest. It is suggested that clinical nurses should comprehensively consider the changes of systolic blood pressure when formulating the prevention plan for complications of palmar swelling on the operative side.
Objective To evaluate the effect of discharge preparation service in patients with chronic obstructive pulmonary disease (COPD) through meta-analysis. Methods A systematic search of PubMed,Cochrane Library,Web of Science,CINAHL,Embase,OVID,CNKI,CBM and Wanfang database was carried out to collect randomized controlled trials(RCTs) on discharge preparation service for COPD patients from inception to March 2021. Literature screening,information extraction and quality evaluation were conducted by 2 reviewers,and RevMan 5.2 software was adopted for meta-analysis. Results A total of 14 RCTs with 2 023 patients were finally included. The results showed that discharge preparation services reduced readmission rates [OR=0.62,95%CI(0.48,0.80),Z=3.69,P<0.001],the number of readmissions [MD=-0.57,95%CI(-0.96,-0.19),Z=2.94,P=0.003] and length of stay [MD=-1.77,95%CI (-2.78,-0.76),Z=3.42,P<0.001],and improved MMRC [MD=-0.39,95%CI(-0.70,-0.09),Z=2.56,P=0.010]. There was no significant difference in quality of life by the SGRQ [MD=-3.27,95%CI(-7.57,1.03),Z=1.49,P=0.140]. The quality of life was improved by the SOLDQ [MD=49.38,95%CI(43.11,55.65),Z=15.43,P<0.001]. There was no significant difference in reducing mortality [OR=0.90,95%CI(0.61,1.34),Z=0.50,P=0.620]. Conclusion Discharge pre-paration service can effectively reduce the readmission rate,the number of readmissions and length of stay,and improve MMRC in patients with COPD,but the impact on mortality and quality of life is still uncertain,and high-quality research is still needed for further demonstration.
Objective To observe and evaluate the effect of self-designed shoulder exercise in patients with limited shoulder joint movement after the implantation of an arm infusion port.Methods 116 inpatients with limited shoulder joint movement after the implantation of the arm port were selected by oncology nurses of a tertiary hospital using convenience sampling method from October to December 2019. By the random number table method,the patients were randomly divided into an experimental group（59 cases）and a control group（57 cases）. The experimental group received shoulder exercise for 3 months,while the control group received ball gripping exercise for the same time period. The total score of shoulder joint function,the score of each sub-group,the occurrence of thrombus and tube blockage in the arm infusion port were compared between the 2 groups before and after the exercise for 3 months.Results 3 months after the exercise,there was no statistically significant difference between the experimental group and the control group in the total scores before the exercise（P>0.05）,while there was statistically significant difference in the total scores after the exercise（P<0.05）. The shoulder joint movement,activity ability of daily life and muscle strength scores in the experimental group were higher than those in the control group with statistically significant differences（P<0.05）. A month after the exercise,the incidences of catheter-related thrombosis and tube blockage in the experimental group were lower than those in the control group,and the differences between the 2 groups were statistically significant（P<0.05）. During the whole exercise period,the total incidence of catheter-related thrombosis and blockage in the experimental group was lower than it in the control group with statistically significant differences（P<0.05）.Conclusion Shoulder joint exercise is helpful to improve the limitation of shoulder joint movement in patients with the arm infusion port,to reduce the incidences of thrombus and blockage of the arm infusion port,and it is worthy of clinical promotion.
Objective To construct a core competence indicator system for baccalaureate student midwives in China and to guide competency-based midwifery education. Methods Literature review,open-ended questionnaires and Behavioral Event Interview（BEI） with 21 clinical midwives were undertaken,followed by 2 rounds of Delphi technique with experts evaluation to identify the weight of each indicator. Results The response rates of 2 rounds were both 100%. The authority coefficients of experts in 2 rounds were 0.905 and 0.950 respectively,with coordination coefficients of 0.254 and 0.228 respectively（P<0.001）. The indicator system consisted of 4 dimensions including professional knowledge,skills,attitudes and behaviors,along with 30 competencies. Conclusion The core competence indicator system is scientific and reliable,which can provide a reference for revolution of competency-based higher education of midwifery in China.
Objective To develop a Gout Patient Self-management Scale and to test its reliability and validity. Methods Based on self-management theory,literature review and semi-structured interview,the provisional Gout Patient Self-management Assessment Scale was formed by Delphi technique and pilot investigation. Totally 260 gout patients were recruited to perform the item analysis for the provisional scale. Other 317 gout patients were investigated to test the reliability and validity of the final scale. Results The Gout Patient Self-management Assessment Scale consisted of 41 items in 4 dimensions. The Cronbach’s α coefficient of the total scale was 0.962;split-half reliability coefficient was 0.842;2-week test-retest reliability was 0.904. 4 common factors were extracted by exploratory analysis and the cumulative variance contribution rate was 60.779%. The content validity index（S-CVI） of the total scale was 0.905. Conclusion The Gout Patient Self-management Assessment Scale is a reliable and valid scale for measuring the self-management ability of gout patients.
After discontinuation of oral anticoagulants,venous thromboembolism in patients with high recurrence rates seriously affects the quality of life. This paper reviews the recurrence of venous thromboembolism prediction model from the applicable people,predict performance and evaluation indexes published abroad in recent years. This review summarizes the current research status at home and abroad for recurrence of venous thromboembolism in China,aiming to provide references for the construction and use of prediction model.
Objective To describe the dynamic change of exercise compliance after discharge and health belief among patients underwent hip arthroplasty at different stages and explore the correlation. Methods A prospective study was employed. Convenience sampling was used to recruit 195 cases of patients underwent hip arthroplasty,and the self-designed questionnaire of exercise compliance and new Health Belief Scale were used for investigation. Results At 1,3,6 months after arthroplasty,patients’ exercise compliance was at moderate level and showed a descending trend. The rates of exercise compliance were（62.60±11.87）%,（57.47±11.16）%,（52.67±10.33）%,respectively. Patients’ health belief scores were（153.72±17.60）,（151.01±14.53）,（150.05±12.83）,respectively,which were above the average and showed a descending trend. Exercise compliance after discharge was correlated with health belief（r=0.354~0.491,P<0.01）. Conclusion Higher level of patients’ health belief was related to better exercise compliance after discharge. Medical staff should provide corresponding appropriate intervention for patients based on defects in their health belief to improve exercise compliance after discharge.
Objective To understand caring experience of main caregivers of elderly patients with type 2 diabetes in Hui ethnic group,and to provide reference for nursing program suitable for Hui culture. Methods Fifteen main caregivers of elderly patients with type 2 diabetes mellitus of Hui ethnic group were interviewed by semi-structured in-depth interviews. Results Four themes were extracted：experience of love,heavy burden of elderly and female caregivers,influence of Hui culture and living customs on diseases,and gratitude and expectation of social support system. Eight sub-themes：perspective from husband and wife：gratitude,caring as a practice;perspective from children：feeding back,love feedback;neglect of own health in elderly caregivers;more devotion from women;unique view of life and death,sadness no longer as the main theme;conflicts between customs and health;gratitude to the country,lighter burden for seeing a doctor;low rate of disease awareness,and desire to receive professional care support. Conclusion The perceived burden of main caregivers of elderly patients with type 2 diabetes mellitus in Hui ethnic group is not heavy.The elderly and female caregivers have heavy burden of care. Caring experience and behaviors are influenced by Hui culture and customs. Main caregivers have inadequate disease related knowledge,traditional culture and healthy eating habits have conflicts,and nursing support in line with cultural characteristics is appreciated.
Objective To investigate the status of post-traumatic stress disorder （PTSD） and social support in amputated patients at different time points,and to analyze the trajectory of change and relationship between them,so as to provide a scientific theoretical basis for psychological nursing of patients.Methods Forty-seven patients with amputation were selected by convenience sampling. The general information questionnaire,Social Support Scaling Questionnaire and Post-traumatic Stress Checklist-Civilian Version（PCL-C） were used to investigate and analyze the patients on the 3rd day,28th day,84th day,and 168th day after amputation.Results The detection rates of PTSD at four time points were 42.59%,51.06%,53.19% and 38.30%,respectively. The scales of PCL-C in 3rd day,28th day and 84th day showed an upward trend,with a significant decrease at 168th day（P<0.05）. The positive social support at four time points was always higher than the negative social support（P<0.05）,and both positive social support and negative social support were decreasing（P<0.05）. PTSD was negatively correlated with the positive social support at all time points,and positively correlated with the negative social support at all time points. There was a significant negative correlation between positive social support and negative social support.Conclusion The positive rate of PTSD among amputated patients is relatively high and patients bear a higher level of negative social support. The more negative social support patients perceive,the less positive social support they have,and the more likely they show PTSD symptoms.
Objective To evaluate the quality and analyze content of existing clinical practice guidelines related to fall prevention in the elderly,and to provide reference for developing clinical practice guidelines suitable for domestic health care settings.Methods National Guideline Clearinghouse（NGC）,Guidelines International Network（GIN）,National Institute for Health and Clinical Excellence（NICE）,Scottish Intercollegiate Guidelines Network（SIGN）,Registered Nurses Association of Ontario（RNAO）,Joanna Briggs Institute（JBI）,PubMed,Embase,CINAHL,CNKI,Wanfang,and CBM were searched to collect clinical practice guidelines related to fall prevention. Guidelines meeting inclusion criteria were evaluated using AGREE II instrument and content was analyzed.Results A total of 13 clinical practice guidelines were included,2 were grade A recommendation,9 were grade B recommendation and 2 were grade C recommendation. The 6 domains with highest scores were scope and purpose（96.01%）,clarity（81.34%）,participants（64.24%）,eligibility（51.60%）,applicability（51.28%）,independence（44.44%）. Finally 7 themes including 27 items were extracted by content analysis.Conclusion Overall,the quality of existing clinical practice guidelines related to fall prevention in the elderly is not good that should be improved in eligibility,applicabilty and editorial independence,the contents of the guidelines are extensive but need to be further improved.
