Objective In this research，we constructed a skin care program for radiodermatitis in breast cancer patients and explore its clinical application effect. Methods The skin care program for radiodermatitis of breast cancer patients was constructed by the evidence summary and expert meeting. By the convenient sampling method，the patients admitted from July 2022 to September 2022 were selected as the control group for routine nursing，and the patients admitted from October 2022 to December 2022 were selected as the intervention group. The severity of radiodermatitis and quality of life of patients were compared between the 2 groups. Results The Radiation-Induced Skin Reaction Assesment Scale score of the intervention group was（4.63 ± 2.12） after intervention，which was lower than （9.88 ± 2.35） of the control group. After intervention，ou. Results determined by RTOG showed that 16 patients in the control group had grade Ⅰ dermatitis（66.7%）；8 patients had grade Ⅱ dermatitis（33.3%）；22 patients in the intervention group had grade Ⅰ dermatitis（91.7%），and 2 patients in the intervention group had grade Ⅱ dermatitis（8.33%）. The score of quality of life after intervention was（102.04±18.20） in the intervention group and（78.29±13.18） in the control group. The differences were statistically significant（P<0.001）. Conclusion The skin care program for radiodermatitis can effectively reduce the severity of radiodermatitis of breast cancer patients，and the quality of life of breast cancer patients during radiotherapy can be effectively improved.

Objective To compile an Assessment Scale of Aspiration Risk for Nasal Feeding Patients,and to test its reliability and validity,aiming to provide a scientific and objective aspiration risk assessment tool for doctors and nurses. Methods The draft of the Assessment Scale of Aspiration Risk for Nasal Feeding Patients was constructed based on the literature analysis and 2 rounds of Delphi consultations. Using convenience sampling,the data of 122 patients with nasal feeding from November 2020 to March 2021 in tertiary A hospital of Shenzhen was collected,and item screening and the test of reliability and validity were carried out. Results The Assessment Scale of Aspiration Risk for Nasal Feeding Patients includes 3 dimensions,10 first-level items and 22 second-level items. The exploratory factor analysis extracts 3 common factors,and the cumulative variance contribution rate is 61.699%. The load value of common factors of each item is between 0.473 to 0.931. The correlation coefficient of the effective standard（whether aspiration occurs） is 0.739;the area under the ROC curve for predicting the risk of aspiration in nasal feeding patients is 0.961,and the confidence interval of 95% is between 0.929 to 0.993（P<0.001）;the content validity is 0.953;the Cronbach’s α coefficient of the scale is 0.739. Conclusion The Assessment Scale of Aspiration Risk for Nasal Feeding Patients has good reliability and validity,and it can be used as a tool in clinical practice to assist in the identification and prediction of aspiration.

Objective This study aims to construct a grief counseling programme for women undergoing termination of pregnancy due to fetal anomaly（TOPFA） and apply the programme to clinical practice，so as to provide references for future work. Methods Through qualitative research and literature research，a grief counseling programme was drafted and constructed. From March to April 2021，19 experts were consulted using Delphi method，and a grief counseling programme for pregnant women with fetal anomaly was formed. From June 2021 to November 2021，the convenience sampling was used to select pregnant women with fetal malformation in an obstetrics and gynecology hospital in Hangzhou as the research subjects. The experimental group was given the grief counseling programme on the basis of routine care，while the control group was given routine care. Perinatal Grief Scale（PGS） was used to evaluate the application effect of the programme. Results The effective recovery rates of the questionnaire were 90.48% and 100%，the expert authority coefficients were 0.845 and 0.861，and Kendall harmony coefficients were 0.323 and 0.262（P<0.001）. Finally，the established grief counseling programme for women with fetal anomaly included 6 first-level items and 34 second-level items. The increase of PGS score in the experimental group was 1.50（-7.75，16.50） which is lower than that in the control group of 16.00（11.00，29.50），Z=-2.123（P<0.05）. Conclusion The grief counseling programme constructed in this study is scientific and practical，and the programme could reduce their grief level a month after the delivery. The programme can be popularized and applied after further verification.

Objective To investigate the effect of catheter removal at different times on patients with unruptured intracranial aneurysm（UIA） after interventional embolization under the concept of enhanced recovery after surgery. Methods Convenience sampling method was used to select 140 patients with UIA who underwent interventional embolization in an interventional operating room of a tertiary A hospital in Sichuan Province from October 2021 to January 2022 as the research subjects. They were divided into an experimental group and a control group by table method，with 70 patients in each group. After the Aldrete score ≥12 points in the experimental group，the urinary catheter was removed within 2 h after the operation，and the urinary catheter in the control group was removed within 24 h after the operation. Results A total of 135 patients were included in the study，with 68 in the experimental group and 67 in the control group. There was no significant difference in the general data between the 2 groups（P>0.05）. The agitation score and agitation rate in the wake-up period before leaving the anesthesia recovery room in the experimental group were lower than those in the control group，and the difference was statistically significant（P=0.013 and P=0.008）. The urine output was lower than that of the control group，and the difference was statistically significant（P<0.05）.Compared with the control group，there was no significant difference in the first urination in the experimental group（P>0.05）. The visual analog scores of pain in the experimental group before，during and 2 hours after the extubation were lower than those in the control group，and the difference was statistically significant（P<0.05）. Conclusion Removing the urinary catheter within 2 hours after surgery can help to reduce rate of restlessness during recovery after interventional embolization in patients with UIA，not increase the risk of urinary retention and catheter replacement，and reduce the the pain of the urethra.It is recommended to remove the urinary catheter as soon as possible while ensuring the safety of patients with UIA after interventional embolization.

Objective To understand the needs and attitudes of grief counseling for women with fetal abnormalities,so as to provide references for the grief counseling work in the future. Methods A descriptive qualitative approach was conducted and a total of 19 women with fetal abnormalities were enrolled for semi-structural in-depth interviews between September and November 2020 from a women’s hospital in Hangzhou,Zhengjiang. Colaizzi method was used to analyze the data. Results 3 themes and 13 sub-themes were extracted,including characteristics of grief counseling needs（needs were hidden,needs correspond to stages of psychological development）,content of grief counseling needs （respectful care needs,needs for infant and parents identity,information needs for dead infant treatment,confirmation of decision of induced labor,emotional needs,continuous bonding）,influencing factors of grief counseling needs （popularization of grief counselling,attitudes of family members,traditional thoughts of reincarnation,opinion on grief counseling,attitudes towards the fetus）. Conclusion Nurses should accurately assess grief counseling needs of women with fetal abnormalities induced labor,provide multi-dimensional grief counseling support,and avoid increasing maternal grief reaction while providing grief counseling. Medical institutions should integrate various resources,reduce the factors influencing maternal grief counseling decision-making to alleviate the pressure of the clinical grief counseling and explore the grief counseling working mode based on the needs of women with fetal abnormalities in China.

Objective To discuss the model and significance of caring experience-oriented integrated competence training for nursing students. Methods “Warm-up training” course of integrated competence training was carried out among nursing students before clinical practicum. The effects of training were measured by comprehensive assessment and self-experience reports before and after the practicum. Results Two themes were extracted by analyzing 250 self-experience reports，which were “caring experience in the teaching” and “caring experience in clinical practice”. Students before practicum responded that the course greatly promoted their personal growth and quality， helped them to eliminate the strangeness of clinical work. Students after practicum responded good self-perception； they showed a strong comprehensive ability and caring communication skills； they were more willing to dedicate themselves and to perceive patients thoroughly. Conclusion The pre-practicum integrated competence training can help students to develop the quality of caring，the skills of communication and creative thinking.