Objective To construct a telemedicine-based home care program for hospice patients that will provide a reference for hospice telemedicine-based home care practices. Methods Using the Supportive Care Model as a theoretical guide，a preliminary telemedicine-based home care program for hospice patients was developed based on literature research combined with qualitative interviews. 2 rounds of expert consultation were conducted in March 2023 to solicit their opinions and revise the proposal to form the final draft. In April 2023，9 patients who were about to be discharged from the palliative care ward of a cancer hospital in Hunan Province，were selected for the preliminary application of the program by the convenience sampling method；the number of cases of adverse events and the Telemedicine Satisfaction Questionnaire were used for the effectiveness of the program. Results A total of 16 experts completed 2 rounds of consultation，and the coefficient of expert authority was 0.928. The effective questionnaire recovery rates of the 2 rounds of consultation were 94.12% and 100%；the expert opinion submission rates were 100% and 25.00%；the coefficients of variation of item scores were 0.05~0.18 and 0~0.16. The coefficients of Kendall harmony in 2 rounds were 0.093 and 0.210（P<0.001）. The constructed final program included 4 dimensions of symptom management，daily life care，psycho-spiritual care and social information support，and a total of 17 modules such as pain management，dyspnea management，gastrointestinal symptom management and cough management，which covering 37 specific items. No adverse events occurred during the application and the score of care satisfaction was（60.22±7.41），which indicated a high level of satisfaction. Conclusion The program constructed in this study is scientific，relevant and feasible，and can provide guidance for healthcare professionals in conducting hospice telemedicine-based home care practices.

Objective To evaluate the effectiveness of the shared medical appointments (SMA) in the management of type 2 diabetes mellitus (T2DM) and its impact on self-management behavior and efficacy and quality of life led by specialist nurses. Methods 30 patients with T2DM going to the endocrine clinic of a hospital from September to December 2020 were selected to participate in the SMA. The body mass index,Summary of Diabetes Self-care Activities (SDSCA) scale and Diabetes Management Self-efficacy Scale (DMSES) and Diabetes Specific Quality of Life (DSQL) scale were compared before the intervention and 3 months after the intervention. Results After 3 months of intervention,there was no statistical significance in the control rate of blood glucose compared with that before intervention (P=0.310). Waist circumference,total cholesterol and triglycerides of the patients after the intervention were significantly lower than those before the intervention (P<0.05). The total scores and the score of each dimension (diet,foot care) in SDSCA,and the DMSES score after the intervention were higher than those before (P<0.05). After the intervention,the total scores of DSQL and the scores of physiological dimension,psychological dimension and social relationship dimension were significantly lower than those before the intervention (P<0.05). Conclusion The SMA can effectively improve the waist circumference,total cholesterol and triglycerides of diabetic patients,improve the self-management ability,self-management efficiency,and the quality of life of patients with type 2 diabetes.

Objective To figure out the relationship between lymphedema status and symptoms among breast cancer survivors. Methods Convenient and purposive sampling methods were used to recruit 224 participants who underwent axillary lymph node dissection. Circumferential limb measurement was used to confirm the lymphedema diagnosis and make sure the lymphedema status ； Breast Cancer and Lymphedema Symptom Experience Index （ BCLESEI ） was used to assess the symptoms experienced by breast cancer survivors. Results Among all 224 participants ，94 （ 42.0% ） of cases had no lymphedema ， while 46 （ 20.5% ） developed mild lymphedema and 84 （ 37.5% ） developed severe lymphedema. Significant differences in scores of symptom experience were found among groups （ P=0.017 ）； significant differences were found in the rate of arm swelling ， arm heaviness ， arm fatigue ， arm tightness ， arm firmness ， limited arm movement ， limited elbow movement and limited wrist movement between non鄄lymphedema group and mildlymphedema group. Conclusion Symptoms can exist in the early stage of lymphedema ， and number and severity of symptoms ， distress of symptoms will increase as the lymphedema aggravates ； symptom assessment may contribute to the early detection of lymphedema and guide the intervention.