The Rainbow Model of Integrated Care（RMIC） is a new conceptual framework that integrates primary care principles，integrated care characteristics，and a triple aim framework based on the Rainbow Model，which helps researchers better understand the concept of integrated care from a primary care perspective and thus scientifically conduct integrated care practice programs. This paper reviews the emergence and development of RMIC，its conceptual framework，and its application in integrated care，with the aim of providing a guiding basis for improving the quality of integrated care and positively transforming the health care delivery model in China.
Objective To search，evaluate，and summarize the best evidence of insertion and maintenance of mini-midline in adult patients，in order to provide a solid evidence-based foundation for establishing clinical standardized and safe utilization of mini-midline. Methods We systematically searched UpToDate，BMJ Best Practice，Guideline International Network，National Guideline Clearinghouse，Joanna Briggs Institute，National Institute for Health and Care Excellence，Centers for Disease Control and Prevention，Scottish Intercollegiate Guidelines Network，Canadian Medical Association：Clinical Practice Guideline，Registered Nurses’ Association of Ontario，Intravenous Nurses Society，Cochrane Library，PubMed，CINAHL，Embase，Web of Science，Yimaitong，China National Knowledge Infrastructure，Wanfang Database，and China Biomedical Literature Database. It includes clinical practice guidelines，expert consensuses，evidence summaries，systematic reviews，meta-analyses，and best practice on mini-midline insertion and maintenance. The search period covered January 2013 to May 2023. 2 researchers independently evaluated the literature quality and extracted the literature that met the standards. The evidence was graded using the JBI evidence pre-grading system（2014），and the extracted evidence was classified and summarized by themes. Results A total of 10 pieces of the literature were involved，including 6 guidelines，2 expert consensuses，and 2 systematic reviews. This study summarized 20 pieces of best evidence in relation to the following 4 themes：indications and contraindications for mini-midline，catheter insertion，catheter maintenance and catheter removal. Conclusion The study comprehensively and scientifically summarizes the best evidence regarding the insertion and maintenance of mini-midline. We recommend that clinical practitioners integrate this evidence into their practice，while considering individual patient preferences and medical contexts. This approach，in line with the principle of individualization，will contribute to enhancing the standardization and safety of mini-midline use in clinical settings.
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.
As an independent scientific knowledge system，nursing science is gradually improving its unique philosophical views，domains，theories and research in the field of nursing. Theory is widely used in clinical practice，nursing education and nursing research as the guiding framework and substantive content. This study introduces the definitions，connotations，and research methods of theoretical derivation strategy，summarizes the application scope of derivation strategies at home and abroad，and analyzes its role in improving the development of nursing disciplines，aiming to increase nursing researchers’ understanding of derivation strategy，stimulate research interests，and promote the application of derivation strategy in the field of nursing in China.
Objective To construct a lifestyle management scheme for infertile women with polycystic ovary syndrome（PCOS） during outpatient medical treatment，and to evaluate its clinical effects. Methods Based on the evidence summary and qualitative interviews，a lifestyle management scheme for infertile women with PCOS during medical treatment was constructed. The infertile women at childbearing age with PCOS from the health management center and reproductive medicine center of a tertiary A hospital in Nanjing were recruited through convenience sampling. 27 patients who visited the above mentioned 2 centers from September 15 to 30，2021 were recruited in an experimental group successively，while another 27 patients who visited there from February 15 to 28，2021 were recruited in a control group successively. Next，the lifestyle management scheme was implemented in the experimental group in 9 key steps，including evaluation，screening，status analysis，formulation of body mass management objectives，diet management，exercise management，behavior management，health guidance，and evaluation. Meanwhile，27 patients in the control group were given the routine healthy lifestyle guidance. After 3 months，the figure of BMI，insulin resistance index，serum testosterone，anxiety，depression and quality of life of the 2 groups were analysed. Results After the intervention，the BMI of the experimental group was 24.43±2.99，which was lower than （26.48±3.49） in the control group. The insulin resistance index was 2.42±0.98，which was lower than 3.52±0.97 in the control group. The level of testosterone was（0.55±0.19） ng/ml，which was lower than（1.20±0.42） ng/ml in the control group. The anxiety level was（5.73±2.13） and the depression level was（5.12±2.66），which were lower than（9.40±2.36） and（10.60±2.58） of the control group. The score of disease-related quality of life was（140.38±7.25），which was higher than（115.56±7.99） of the control group，and the differences were statistically significant （P<0.05）. Conclusion The implementation of the lifestyle management scheme for infertile women with PCOS during medical treatment is conducive to adjust patients’ endocrine and metabolic status，alleviate their anxiety and depression and improve quality of life.
Objective To analyze the current situation of nursing needs and services for the aged in Sichuan province，so as to provide references for improving and standardizing nursing needs assessment and services for the aged. Methods The data of geriatric nursing needs assessment carried out by Sichuan Provincial Health Commission were used. The elderly aged 65 years and over were selected as the research subjects. The ability classification of the elderly，the number of geriatric syndromes，the level of nursing needs，whether to provide nursing services，and the items of nursing services were included in the descriptive analysis. Results A total of 1 272 896 elderly people were enrolled，of which 962 607（75.62%） were in 0 grade（good ability）. The number of cases of geriatric syndromes were 0-2，which accounted for the majority. A total of 310 289 elderly people had different degrees of nursing needs，and 129 097 elderly people were provided with nursing services by nursing staff，accounting for 41.6%. The highest proportion of the 4 types of nursing services were safety protection and guidance，health education，psychological communication and counseling，and traditional Chinese medicine diet care. Conclusion The nursing needs level of the elderly in the community is mainly intact，and the number of geriatric syndrome projects is mostly 0~2. The supply of nursing services for the elderly with nursing needs is seriously insufficient，and the supply of nursing services for the elderly needs to be standardized and improved.
To summarize the nursing experience of a patient with diabetic nephropathy who underwent xenogeneic islet transplantation after kidney transplantation. The key points of nursing mainly include：establishing a multidisciplinary diagnosis and treatment team before surgery，improving relevant examinations and preparations，and ensuring the safety of surgery；postoperative dynamic anticoagulant therapy and bleeding observation and nursing to prevent rejection and infection. The goal-oriented blood glucose management was implemented in the whole process，and systematic health education and personalized psychological nursing were carried out.After careful specialized nursing，the patient recovered on the 26th day of hospitalization and was discharged from hospital. Up to now，the patient has completely separated from exogenous insulin treatment.
Objective The purpose is to translate the Hematology Information Needs Questionnaire（HINQ） into Chinese，and to test its reliability and validity. Methods The cross-cultural adaption guide of Beaton was used to translate the scale. The reliability and validity of the HINQ were tested through a survey of 362 patients with hematologic neoplasms in a tertiary specialized hospital in Tianjin by convenience sampling from October to December 2021. Results 345 valid questionnaires were collected. The Chinese version of the scale included 7 dimensions of disease（with 10 items），treatment（with 19 items），etiology（with 3 items），sleep and physical changes（with 6 items），self-care（with 7 items），medical tests and prognosis（with 11 items），psycho-social aspect（with 6 items），with a total of 62 items. In exploratory factor analysis，the cumulative variance contribution of 7 common factors was 73.963%. The item-level content validity index of the Chinese HINQ is 0.830~1.000，the scale-level content validity index is 0.949；Cronbach’s α coefficient for the overall scale was 0.986，and the Cronbach’s α coefficients of each dimension ranged from 0.903~0.976； the test-retest reliability of the total scale was 0.896，and the split half reliability coefficient was 0.917. Conclusion The scale has good reliability and validity，and it can be used as an assessment tool for the information needs of patients with hematologic neoplasms.
Objective To explore the effect of cognition-early warning intervention on the cognitive behavior of patients with delayed treatment of diabetes in rural areas,in order to improve their treatment compliance. Methods Rural patients with delayed treatment of diabetes in Datong District,Daqing City,in Heilongjiang Province and Luannan County,Tangshan City,in Hebei Province were conveniently selected as the research subjects from October 2019 to January 2020. According to the random number table method,6 villages were divided into an experimental group and a control group,with 63 cases in each group. The experimental group was given the cognition-early warning intervention for 2 weeks,and the control group was given routine health education. The general demographic data of patients with delayed treatment of diabetes in rural areas were obtained through a general data questionnaire;the cognitive behavior scale of delayed treatment of diabetes in rural areas,medication compliance questionnaire and diabetes management self-efficacy scale were used to evaluate the cognitive behavior,medication compliance and self-efficacy scores of subjects before and after intervention;fasting glucose results were collected by venous blood collection. Results A total of 60 samples were included in the experimental group and the control group respectively. Before intervention,general demographic data,cognitive scores,medication compliance scores and diabetes management self-efficacy scores were comparable between the 2 groups. After intervention,the cognitive behavioral scores and medication compliance scores of the experimental group were higher than these of the control group and these before intervention,and the difference was statistically significant（P<0.05）. The scores of diabetes management self-efficacy in experimental group were higher than these of the control group,with statistical significance（P<0.05）. The self-efficacy score of diabetes management in experimental group was slightly higher than before intervention. Fasting blood glucose level in the experimental group was better than in the control group after intervention,with statistical significance（P<0.05）. Conclusion Cognition-early warning intervention can improve the cognitive and behavioral level of patients with delayed treatment of diabetes in rural areas,and contribute to the standardized treatment of patients with delayed treatment of diabetes in rural areas.
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 establish a consensus on perioperative urospesis nursing of patients with intracavitary surgery for urinary tract calculi. Methods A consensus developing group was established,and the first edition of the "Expert consensus on perioperative urosepsis nursing of patients with intracavitary surgery for urinary tract calculi"（hereinafter referred to as the "consensus"） was formed after a large amount of literature review and collation,online expert consultation and group discussion. Domestic medical experts from urology,minimally invasive operating rooms and intensive care units were invited to discuss and revise the "consensus" for 2 rounds,and then peer review was conducted,and finally the "consensus" was completed. Results The final version of the "consensus" comprises 3 major sections,namely the preoperative,intraoperative and postoperative,which covers high-risk factors,prevention,identification,condition monitoring and nursing intervention,with a total of 21 items. The positive coefficients for the 2 rounds of consultations were 100%. The coefficients of judgment,familiarity and authority in the 2 rounds of consultations were 0.975,0.960 and 0.968,respectively. In the 2 rounds of expert consultations,the importance assignments of each items were（4.847±0.304） and（4.888±0.212）,and the overall Kendall’s coefficients were 0.232 and 0.287,respectively. Conclusion The "consensus" integrates the suggestions of multidisciplinary experts with a certain degree of practicality,representativeness and scientificity. It can provide guidance for clinical nursing practice of patients with perioperative urosepsis of intracavitary surgery for urinary tract calculi.
Objective To explore the potential categories and influencing factors of psychological resilience in primary brain tumor patients. Methods A convenient sampling method was used to select 237 primary brain tumor patients hospitalized in the Neurosurgery Department of a tertiary hospital in Kunming,Yunnan Province from December 2020 to August 2021. General information questionnaire,Resilience Scale-14（RS-14）,Medical Coping Modes Questionnaire（MCMQ） and Perceived Social Support Scale（PSSS） were conducted for investigation. Latent class analysis （LCA） was used to explore the potential categories of psychological resilience among patients with primary brain tumor. Single factor analysis,analysis of variance and ordinal and multinomial logistic regression analysis were used to identify the factors associated with the potential categories of psychological resilience. Results A total of 226 returned questionnaires were valid,resulting an effective response rate of 95.4%. Based on the analysis of potential categories,the psychological resilience of patients with primary brain tumor was divided into 3 potential categories,namely low level group （27.4%）,medium-high fluctuation group（30.1%） and high level group（42.5%）. The result of ordinal and multinomial logistic regression analysis showed that the score of PSSS（OR=1.045,P<0.001）,facing dimension（OR=1.102,P=0.016） and yield dimension（OR=0.865,P=0.013） in MCMQ,and rural residence （OR=0.437,P=0.049） were the influencing factors of the potential categories of psychological resilience. Conclusion Patients with primary brain tumor have obvious differences in characteristics by psychological resilience. More awareness and interventions from healthcare providers based on characteristics of different types of patients and influencing factors are needed,in order to promote the psychological resilience.
Objective To investigate the status and factors associated with fear of progression in recipients of renal transplantation. Methods By using the convenient sampling method,221 recipients of renal transplantations were selected from February to June 2021 in a tertiary hospital in Changsha. General information questionnaire,Fear of Progression Questionnaire-Short Form,Positive Psychological Capital Questionnaire,Brief Illness Perception Questionnaire,Distress Disclosure Index were used to conduct the investigation. Results The score of fear of progression of recipients of renal transplantation was (28.13±7.87) ;51 cases (23.08%) were≥34 points;the positive psychological capital score was (124.05±21.06) ;the illness perception score was (37.67±11.10) ;the distress disclosure score was (36.09±8.98). Multiple linear regression analysis showed that illness perception and positive psychological capital were the influencing factors of fear of progression (P<0.05),which explained 35.3% of the total variation. Conclusion The incidence of fear of progression in recipients of renal transplantation is high,which is generally in the middle level. Clinicians should pay attention to the psychological status of renal transplant recipients,and reduce recipients’ illness perception,enhance patients’ positive psychological capital,and reduce their fear of disease progression.
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.
To summarize the multidisciplinary treatment and nursing experience of 6 children with severe collective chlorine poisoning. The hospital set up a multidisciplinary rescue team,implemented lung ventilation protection strategies,conducted airway management,eye care and targeted psychological care. The specialized care ensured the treatment effects of children with severe chlorine poisoning. All of the 6 children in this group were cured and discharged.
Objective To systematically review body image experience of patients with head and neck cancer（HNC） and to provide healthcare professionals with foundations to develop interventions. Methods Qualitative studies on body image experience of HNC patients,published by December 2020,were searched in English and Chinese databases,including PubMed,Web of Science,Embase,Cochrane Library,PsyINFO,CINAHL,CNKI,Wanfang,VIP and CBM. The quality of included studies were evaluated by Joanna Briggs Institute Critical Appraisal Tool for qualitative studies. Results A total of 9 eligible studies were included. Based on the similarities of the extracted 44 findings,we concluded 7 new categories and further synthesized 3 integrated themes,including serious impact of body image change on HNC patients,various influencing factors of body image experience in HNC patients,and different coping strategies of body image issues in HNC patients. Conclusion Body image is a critical issue in HNC patients. To deal with this issue,more awareness and interventions should be given from healthcare professionals. Family supports are encouraged,with a balance with patients’ autonomy. More appropriate social and cultural attention to the body image issues in HNC patients are needed.
Objective To evaluate and summarize the best evidence of exercise instructions for breast cancer-related lymphedema,and to provide references for clinical practice. Methods We searched BMJ Best Practice,UpToDate,Cochrane Library,Joanna Briggs Institute（JBI） Library,JBI Clinical Online Network of Evidence for Care and Therapeutics（JBI CONNECT+）,National Institute for Health and Clinical Excellence（NICE）,National Guideline Clearinghouse（NGC）,Guideline International Network（GIN）,Scottish Intercollegiate Guidelines Network（SIGN）,National Comprehensive Cancer Network（NCCN）,Registered Nurses’ Association of Ontario（RNAO）,National Lymphedema Network（NLN）,International Society of Lymphology（ISL）,PubMed,CINAHL,Embase,Web of Science,Physiotherapy Evidence Database,China Guideline Clearinghouse,CNKI,Wanfang Database,CBM and VIP Database to collect guidelines,expert consensuses,evidence summaries and systematic reviews on exercise for patients with breast cancer-related lymphedema. The retrieval period was from the inception of databases to July 2019. 2 researchers with evidence-based nursing background assessed the quality of the literature independently and identified the level of evidence. Results A total of 19 articles were incorporated,including 1 clinical decision,1 clinical practice recommendation,1 evidence summary,5 guidelines,3 expert consensuses,8 systematic reviews. A total of 23 pieces of best evidence including 8 dimensions were summarized,namely contraindication,pre-exercise assessment,pre-exercise test,exercise intensity,safety,exercise program,announcements and health education related exercise. Conclusion Exercise interventions can alleviate symptoms of lymphedema. Clinical staff should consider patients’ opinions and provide personalized exercise programs for patients with breast cancer-related lymphedema according to the clinical situation,in order to further improve effectiveness of the exercise and quality of life of patients.
Objective To compare the effects of three nursing methods in preventing neck skin injury of tracheotomy patients.Methods A total of 168 cases of tracheotomy patients were randomly divided into 3 groups with 56 cases in each group：the liner gauze(Group I),the hydrocolloid dressing(Group Ⅱ),and the liner foam dressing(Group Ⅲ). The incidence of neck skin injury,the service length of liner dressing,the time of dressing replacement,the difficulty of dressing replacement,and average cost were compared in three groups,and the effects of three nursing methods in preventing neck skin injury in tracheotomy patients were evaluated.Results There were 13 cases,5 cases,and 1 case of skin injury in group Ⅰ~Ⅲ,respectively. There was significant difference in the incidence and severity of skin injury among three groups (P<0.05). The service length of liner dressing from low to high was Group Ⅰ,Group Ⅱ and Group Ⅲ,respectively. The time spent in replacing dressing from low to high was Group Ⅲ,Group Ⅰ and Group Ⅱ,respectively. The difficulty of replacing dressing from low to high was Group Ⅲ,Group Ⅰ and Group Ⅱ,respectively. The average cost from low to high was Group I,Group II and Group III,respectively.Conclusion Foam dressing can effectively prevent neck skin injury in patients underwent tracheotomy,and it has long length of service,short replacement time,is easier to operate,and more suitable for patients with tracheotomy,but economic cost is slightly higher.
Objective To explore the application effects of bedside wheelchair seating in patients with severe acute pancreatitis and acute respiratory distress syndrome undergoing mechanical ventilation.Methods Semi-experimental research method was used. We set up a management team for bedside wheelchair sitting,and implemented early activities using bedside wheelchair seating. A total of 30 patients were selected as the experimental group between March 2016 and July 2018,and were treated with beside wheelchair seating. A total of 28 patients were selected as the control group between January 2014 and February 2016,and received routine treatment. The incidence of ICU acquired debilitation,the length of mechanical ventilation,the length of stay in ICU,the oxygenation index before withdrawing tracheal tube(30 min from the ventilator),and the incidence of adverse events in two groups were compared.Results The incidence of ICU acquired debilitation in the experimental group and in the control group was 26.60% (8 cases) and 57.14% (16 cases),and the difference was statistically significant(P<0.05);the length of mechanical ventilation was (5.94±1.05) d and (8.47±1.45) d,the length of stay in ICU was (7.11±0.99) d,(9.93±2.06) d,and the differences were statistically significant(P<0.05). The oxygenation index was (294.20± 21.18) mmHg and(290.96±27.36) mmHg without statistically significant difference(P>0.05);the incidence of adverse events was 3.30% (1 case)and 0.00% (0 cases),respectively,and the difference was not statistically significant(P>0.05).Conclusion The bedside wheelchair sitting can effectively help patients to prevent the occurrence of ICU acquired debilitation,shorten the length of mechanical ventilation and stay in ICU. It is safe and effective,and has good clinical application value.
Objective To explore the application value and effect of infrared thermometer in temperature monitoring of post-sterilization.Methods By using the infrared thermometer to test the cooling influencing factors,the time required for the cooling of the five types of sterilization packages,and the relationship between the cooling temperature and the wet package to obtain the reference data,and finally compare the incidence of wet packets and clinical satisfaction before and after the actual application of it.Results The difference in cooling rate between different placement floors,different packaging materials,different contents,different weight and volume of surgical bags after sterilization and unloading was statistically significant（P<0.05）. The time difference between the five types of sterilization bags cooled to room temperature was statistically significant（P<0.05）. The incidence of wet packs in cotton-packed surgical instruments at different cooling temperatures was statistically significant（P<0.05）. The difference in the incidence of wet packs before and after the application of the infrared thermometer was statistically significant（P<0.05）. The difference of times the sterilizer’s hand touching the sterilization package was statistically significant（P<0.05）.Conclusion Through the application of infrared thermometer for temperature monitoring,it can provide objective and accurate judgment for the migration and distribution of articles after sterilization,it also can effectively reduce the occurrence of wet packets and the risk of frequent exposure to pollution,so it has good application value and effect.
Objective To investigate the current status of the curriculum for doctoral education in nursing in China,which will provide a reference for further optimizing the curriculum design for doctoral nursing education. Methods This research adopted questionnaire survey to investigate the curricula of doctoral education in nursing in 26 schools of nursing. Results The curricula of doctoral education in nursing varied in design,most of which included the common courses,specialized courses and elective courses. Among those 26 schools of nursing,the average number of courses was 15.42. The minimum academic credits of each school were different widely,and the average was 21.29. The main contents of curricula included political education,basic theories,research methodology,research direction,latest development,and academic writing. However,the specialized course on nursing was relatively less,with only 2.38 courses were offered averagely,and nine schools of nursing had not offered such kind of courses yet. Conclusion The current doctoral education in nursing in China has not established curriculum system with nursing science features,and lacked standards for setting up core courses of nursing. Great importance should be attached on constructing nursing specialized courses,and determine rational number and proportion of academic credits. Meanwhile,relevant administrative departments of education should also clarify the core courses,so as to further optimize the curriculum design of doctoral education in nursing.
