Objective To construct and preliminarily apply a graded exercise rehabilitation program for patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD），and to provide a theoretical basis for the scientific implementation of exercise rehabilitation by medical staff. Methods Based on Triangle model and evidence-based method，the first draft of the graded exercise rehabilitation program was constructed，and the items were revised through 2 rounds of expert consultations from March to October，2023. The graded exercise rehabilitation program was preliminarily applied in 10 patients with AECOPD. Results The effective recovery rates of the 2 rounds of expert consultation questionnaires were 100%；the expert authority coefficients were 0.857 and 0.863；the coefficients of variation were 0-0.285 and 0.052-0.244；the Kendall’s harmony coefficients were 0.167 and 0.145，respectively（all P<0.001）. The final plan includes 4 first-level indicators，13 second-level indicators，and 25 third-level indicators. The scores of 6 min walking test，mMRC and CAT after exercise were improved compared with those before exercise，and the differences were statistically significant（all P<0.05）. Conclusion The graded exercise rehabilitation program for patients with AECOPD constructed in this study has good scientificity and practicability，which can provide references for clinical implementation of exercise rehabilitation.

Objective To construct quality evaluation indicators for perioperative nursing in heart transplantation，and to provide standard and professional quantitative bases for monitoring and management of perioperative nursing quality. Methods This study was conducted based on the frame work of the three-dimensional “structure-process-outcome” quality model，using literature review，Delphi method and analytic hierarchy to determine the content of the indicators，and the weight of each index. Results A total of 22 experts from 14 qualified heart transplantation hospitals were included，and a total of 2 rounds of consultations were conducted. The effective recovery rates of 2 rounds of expert consultation questionnaires were 100%. The authority coefficients were 0.817. The variation coefficients of each item ranged from 0.025~0.169 and 0.039~0.157. The Kendall harmony coefficients were 0.126 and 0.225（P<0.001）. The final evaluation indicators for perioperative nursing quality in heart transplantation included 3 first-level indicators，12 second-lever indicators and 59 third-level indicators. Conclusion The evaluation indicators of perioperative nursing quality in heart transplantation was scientific，comprehensive and specialized，which can provide references for the evaluation of perioperative nursing quality in heart transplantation.

Objective Based on sentinel symptoms，a nursing intervention program for gastrointestinal symptom group of postoperative chemotherapy for lung cancer was constructed and its application effect was evaluated. Methods The nursing intervention program of gastrointestinal symptom group was constructed on the basis of reference guidelines，qualitative interview and expert consultation. From January 2021 to January 2022，a total of 330 patients with postoperative chemotherapy for lung cancer in a tertiary hospital in Shenyang were selected as research subjects. The experimental group received the gastrointestinal symptoms group nursing intervention program on the basis of routine nursing，and the control group received routine care. Patients were investigated with the M.D. Anderson Symptom Inventory and the MOS 36-Item Short-Form Health Survey before 1st chemotherapy（T1），3rd chemotherapy（T2） and 5th chemotherapy（T3）. Results After the intervention，the total scores of the 2 groups and the total scores of each symptom in T2 and T3 were statistically significant（P<0.05），and the score of the experimental group was lower than that of the control group. For the scores of 6 dimensions of physiological function，physical pain，overall health，vitality，emotional function，mental health in 2 groups between different time points，the differences are statistically significant（P<0.05）. Conclusion The nursing intervention program of the gastrointestinal symptom group based on sentinel symptoms is beneficial to reduce the severity of the gastrointestinal symptom group and improve the quality of life for postoperative chemotherapy for lung cancer patients.

Objective To retrieve，evaluate and summarize the best evidence of physical activity in patients with venous leg ulcer（VLU），and to provide the evidence for clinical practice of physical activity intervention for patients with VLU. Methods We systematically searched all relevant literature on the physical activity of patients with VLU，including clinical practice guidelines，clinical decision-making，systematic reviews，evidence summaries，expert consensuses，and original studies，from the guideline websites，databases，and professional association websites，with the search period from the database establishment to May 19，2023. 2 researchers independently evaluated the quality of the literature，and included and extracted and integrated evidence based on the judgment of professionals. Results A total of 18 articles were included，consisting of 6 guidelines，2 clinical decisions，6 systematic reviews，3 expert consensuses and 1 original study. Finally，26 pieces of best evidence were summarized，categorizing into 8 aspects which include timing of physical activity，patient assessment before physical activity，mode of physical activity，time and frequency of physical activity，intensity of physical activity，effect evaluation of physical activity，quality control and tips. Conclusion This study summarizes the best evidence of physical activity in patients with VLU. It is recommended that health care professionals should formulate individualized physical activity programs based on the practical conditions and clinical situation，and fully consider the evaluation results of patients.

Objective To systematically evaluate the psychological experience of adolescent suicide attempters. Methods Computer search was conducted on Pubmed，CINAHL，Embase，PsychInfo，Web of Science，Cochrane Library，CNKI，Wanfang Database，VIP database，and Chinese Biomedical Literature database to retrieve qualitative studies on the psychological experience of adolescent patients with suicide attempts. The retrieval period was from the establishment of the databases to July 2022. Qualitative research quality evaluation criteria（2016 edition） of the Joanna Briggs Institute（JBI） Center for Evidence-based Health Care in Australia were used for literature quality evaluation，and meta-integration method was used for integrated analysis of the results. Results A total of 11 studies were included，and 61 research results were extracted，which were summarized into 9 new categories and integrated into 4 integrated results. ①mental and emotional storms，including mental and emotional breakdown，feeling of love and regaining confidence；②obstructed life and study，including lack of life goals，heavy academic pressure；③conflicted intimate relationships，including family friction，love failure，friendship failure；④adjustment and coping，including multiple external support，self-adjustment and perception. Conclusion Nursing staff should pay attention to the psychological experience of adolescent patients with suicide attempts，guide them to relieve the pressure of life and study，relieve family conflicts，assist patients to establish a positive view of friendship and love，and jointly develop a long-term intervention program of multidisciplinary，in order to prevent patients from suicide again.

Objective To explore a homogenized training management program and its application effects for specialist nurses，in order to improve the quality of training. Methods From January 2020 to December 2021，the convenience sampling method was used to select the trainees of 2021 specialist nurse training course of China Nursing Association as the experimental group and the trainees of 2020 as the control group. The trainees in the 2 groups involved 3 300 hospitals in 31 provinces，autonomous regions and municipalities across the country. The experimental group took the homogenized training management program and the control group took the routine training. The training effect and satisfaction of the 2 groups were compared. Results The number of trainees was 6 012 in the experimental group，and 4 619 in the control group. After the intervention，the theoretical test score was （84.14±5.12） points in the experimental group，and（79.66±8.36） points in the control group. The difference was statistically significant（t=-32.133，P<0.001）. The clinical practice test score was （94.24±3.58） points in the experimental group，and（90.70±5.21） points in the control group. The difference between the 2 groups was statistically significant（t=-39.637，P<0.001）. The overall satisfaction of theoretical training stage and clinical practice stage was （75.00±1.38） points and （72.53±0.92） points，respectively，which were higher than those of control group（P<0.001）. Conclusion Homogeneous management can effectively improve the quality of specialist nurse training and improve student satisfaction. The strict implementation of the homogeneous training management strategy plays an important leading role in promoting the high-quality development of specialist nurse training in China.

Objective To describe the change trajectory of cardiac rehabilitation information needs and self-management in patients undergoing percutaneous coronary intervention （PCI） at different time points，and to explore the correlation between them. Methods A longitudinal study was conducted. From June 2021 to January 2022，186 PCI patients who met the criteria were enrolled in the cardiology ward and cardiovascular clinic of a tertiary A hospital in Jiangxi Province. General information questionnaire，the Cardiac Rehabilitation Information Needs Scale and Coronary Heart Disease Self-Management Behavior Rating Scale were employed for follow-up at 1 day before surgery，3 days after surgery，and 1，3，and 6 months after discharge to evaluate the patients’ cardiac rehabilitation information needs and self-management behavior. Results 165 cases were finally included. The total demand for cardiac rehabilitation information and the scores of each dimension in perioperative PCI patients showed an overall upward trend，but the demand for diagnosis and treatment reached the peak before surgery and within 1 month after discharge，showing a dynamic change overall. Within 6 months after discharge，the total demand for cardiac rehabilitation information，self-management and scores of each dimension of PCI patients showed an overall downward trend，but the demand for risk factor management showed an upward trend within 3 months after discharge. Within 6 months after discharge，self-management，daily life management and medical disease management of PCI patients showed a downward trend，while emotional cognitive management showed an upward trend. There was a positive correlation between them at 1 month after discharge（r=0.185，P<0.05），and a negative correlation between them at 6 months after discharge（r=-0.174，P<0.05）. Conclusion The information needs，self-management and dimensions of cardiac rehabilitation in patients with PCI change dynamically during perioperative period and within 6 months after discharge. The self-management of PCI patients was positively correlated with the total demand for cardiac rehabilitation information at 1 month after discharge，and negatively correlated at 6 months after discharge. It is suggested that medical staff should strengthen the follow-up management of patients and meet the needs of patients in all aspects of disease rehabilitation，which can further improve the self-management ability of patients and help to reduce the rate of cardiovascular events and readmission.

To summarize the perioperative nursing experience of a child with erythropoietic protoporphyria who underwent liver transplantation and splenectomy. The key points of preoperative care include implementing diversified interventions to reduce the accumulation of porphyrin in the body； actively controlling pain and improving the comfort of children； early debridement and treatment，and good care of solar allergic dermatitis. The key points of postoperative care include protecting the transplanted liver and preventing the deposition of protoporphyrin； strengthening respiratory management to control lung infection； psychological counseling throughout the process to reduce negative emotions； individualized follow-up management to prepare for bone marrow transplantation. After careful treatment and nursing，the child recovered smoothly and was discharged from the hospital. A follow-up visit after 1 month discharge showed a good recovery.

Understanding the disease cognitions of chronic patients is crucial for self-management of their disease. The common-sense model of self-regulation（CSM） outlines the process by which patients engage in self-regulation to understand and manage their disease，providing a theoretical framework for understanding the relationship between disease perceptions，coping procedures and health outcomes. This article reviews the development and evolution of CSM，its theoretical framework，and the current application in chronic disease management. The objective is to enhance healthcare professionals’ understanding of the model and its potential role in supporting the health management of chronic patients.

To summarize the weaning nursing practice of a patient with postoperative cardiogenic shock complicated by acute type A aortic dissection receiving veno-arterial extracorporeal membrane oxygenation. The key points of nursing were as follows：the interprofessional team cooperation model was adopted，and the extracorporeal membrane oxygenation special class team was established；a goal-oriented extracorporeal membrane oxygenation management plan was formulated and individualized pre-weaning nursing was implemented. The evaluation and preparation before weaning should be improved，and the cooperation during weaning and the observation after weaning should be strengthened. After careful treatment and nursing，extracorporeal membrane oxygenation was successfully removed on the 7th day after operation，and the patient recovered and was discharged on the 10th day after surgery，and the follow-up was in good condition.

Objective To summarize the best evidence for non-pharmacological airway clearance techniques in patients with chronic respiratory diseases. Methods We searched domestic and international databases，guideline networks，clinical decision support systems and websites of respiratory professional associations. The types of the literature include guidelines，expert-consensuses，clinical decision-making，recommended practices and systematic re-views. The retrieval time is from the establishment of the databases to May 2022. There were 2 investigators who evaluated the quality of the literature and pooled evidence. Results A total of 16 publications were included，in-volving 6 guidelines，6 expert consensus articles，1 recommended practice，and 3 systematic reviews. A summary of the best evidence for the overall requirements of 20 airway clearance techniques in 6 areas，namely pre-treatment assessment，interventions，precautions，frequency and duration，assessment of efficacy and health education. 8 com-monly used airway clearance techniques were also summarized，with 32 pieces of evidence for the principles of use，including effective cough or huffing，maneuver-assisted cough，active cycle of breathing techniques，autogenous drainage，manual techniques，postural drainage，high-frequency chest wall oscillatory，and positive expiratory pressure or oscillating positive expiratory pressure. Conclusion In the clinical application of non-pharmacological airway clearance techniques，medical staff should carefully formulate airway clearance techniques plan according to the individual situation of patients，so as to maximize the benefits of patients.

Objective To explore the different application types of combined exercises in patients with type 2 diabetes，and to clarify the characteristics of different combined exercises. Methods Guided by the scoping review framework proposed by Arksey et al.，a literature search was performed in the Chinese and English literature Databases. The retrieval period was from the establishment of the database to February 26，2022，and relevant information such as research subjects，sample size and monitoring indicators of the included literature was extracted. Results A total of 18 articles were included. Combined exercises can be divided into different combined types by exercise types（same，different），intensity（high intensity intermittent，moderate-intensity continuous，mixed intensity and different intensities of resistance） and sequence（dual-task，interactive and sequential）. When applied to patients with type 2 diabetes mellitus，combined exercises not only present a single aspect of characteristics，but also intersect with each other. Conclusion The 3 combined exercises have a significant impact in terms of increasing exercise variety，adjusting exercise rhythms and enhancing exercise effects. However，there are still limitations in exercise selection and effect evaluation. Therefore，there is still a need to further explore how to develop normative operational standards，intelligently recommend personalised programmes and identify suitable populations in combined exercises.

Objective To evaluate the application effect of elevating Yang moxibustion therapy in elderly female patients with stress urinary incontinence of kidney-Yang deficiency. Methods The elderly female patients with stress urinary incontinence in kidney-Yang deficiency were enrolled from a tertiary A hospital in Hangzhou between September 2019 and May 2021. By the random number table,they were divided into an experimental group（n=40） and a control group（n=40）. The control group took pelvic floor muscle and bladder function training,the experimental group took the elevating Yang moxibustion on the basis of the control group for a course of 12 weeks,followed up to the 16th week. The daily urinary incontinence frequencies,1-hour urine leakage from pad test,ICI-Q-SF score and TCM syndrome score of stress urinary incontinence in kidney-Yang deficiency were compared between the 2 groups. Results At the 12th week of treatment,the difference in the number of daily incontinence between the 2 groups was statistically significant（t=-3.794,P<0.001）;the decrease of urine leakage in 1-hour pad test in the experimental group was greater than that in the control group （Z=5.270,P<0.001）;the ICI-Q-SF score（t=-3.297,P=0.001） and TCM syndrome score（t=-2.035,P<0.05） were compared between the 2 groups; the differences were statistically significant. At the 16th week of treatment,there were statistically significant differences in the number of daily urinary incontinence,ICI-Q-SF score and TCM syndrome score between the 2 groups. There were statistically significant differences in the number of daily urinary incontinence,ICI-Q-SF score and TCM syndrome score between the 2 groups at each time point（P<0.05）. Conclusion Moxibustion with elevating Yang method can reduce the daily frequencies of urinary incontinence and the urine leakage amount of 1-hour pad test in elderly female stress urinary incontinence patients with kidney-Yang deficiency,reduce the score of ICI-Q-SF and TCM syndrome score,thus improving the symptoms of urinary incontinence,and the quality of life of elderly female patients.

Objective To retrieve,evaluate and summarize the evidence of self-management of patients with venous leg ulcer（VLU）,and to provide evidence-based references for health education and self-management of patients.Methods We systematically searched all relevant literature on the self-management of patients with VLU,including clinical practice guidelines,best practices,expert consensuses,evidence summaries,systematic reviews and original studies,from the guideline websites,databases and professional association websites,with the search period from the database establishment to August 2021. 2 researchers independently evaluated the quality of the included literature,and extracted and integrated evidence based on the judgment of professionals.Results A total of 14 articles were included,including 9 guidelines,2 best practices,2 systematic reviews and 1 expert consensus. Finally,21 pieces of best evidence were summarized,including 5 aspects of patient self-assessment,stress management,diet and nutrition management,exercise management,and skin management around the wound.Conclusion This study summarizes the best evidence of self-management of patients with VLU,and clinical medical staff can use the best evidence to guide the self-behavior management of patients with VLU in a more targeted and scientific way.

Objective To develop a quality evaluation indicator system for perioperative nursing in pediatric liver transplantation,and to provide standard and professional quantitative bases for monitoring and management of perioperative nursing quality.Methods This study was conducted from January to June 2021 based on the frame work of the three-dimensional“structure-process-outcome” quality model,using literature review,Delphi method and analytic hierarchy process（AHP） to determine the content of the system,and the weight of each index.Results The effective recovery of 2 rounds of expert consultations were 95.2% and 100%. The authority coefficients were 0.88 and 0.89. The variation coefficients of each item ranged from 0.05 to 0.19 and from 0.06 to 0.23. The Kendall harmony coefficients were 0.128 and 0.184. The final quality evaluation indicator system for perioperative nursing in pediatric liver transplantation was established,including 3 first-level indicators,14 second-lever indicators and 61 third-level indicators.Conclusion The quality evaluation indicator system for perioperative nursing in pediatric liver transplantation was scientific,reliable,comprehensive and specialized,which can provide references for the evaluation of perioperative nursing quality in pediatric liver transplantation.

The evaluation of the family discharge readiness of hospitalized children can timely understand the care needs of the family,help nursing staff to formulate and implement personalized follow-up plans for the children after discharge,and reduce the rate of readmission and unplanned visit of children. This paper reviews the major contents,characteristics,application and limitations of the discharge readiness assessment tools in family with hospitalized children at home and abroad. It aims to provide references for the localization of the development of discharge readiness assessment tools in family with inpatient children and clinical nurses to select appropriate assessment tools. Meanwhile,it provides some useful information for the improvement of the discharge planning for hospitalized children.

Objective Cognitive interviews were used to explore the Chinese target population’s cognition and understanding of Attitudes Related to Trauma-Informed Care Scale（ARTICS） in the Chinese context. The purpose was to verify the consistency of the language expression of the revised ARTICS and the original scale. Methods Using the purpose sampling method,26 psychiatric nurses who met the inclusion criteria were selected as interviewees from a secondary mental health centre in a district of Shanghai. 2 rounds of cognitive interviews were conducted to explore the respondents’ understanding of the items of the Chinese version of ARTICS. The items with ambiguities were revised according to the interview results to form the Chinese version of ARTICS. Results ARTICS consists of 35 items across 5 dimensions. The results of the first round of interviews showed that some respondents had ambiguities in the semantic expression and understanding of the 6 items in the scale,and these items were modified after discussion. The results of the second round of interviews showed that the content of the revised items was semantically consistent with the original scale. Conclusion The use of cognitive interview can help the scale adapt to different cultural background,improve the target population’s understanding and acceptance of scale items,reduce measurement errors caused by misunderstanding of certain items,and improve the response rate of the scale.

Objective To explore the current situation of Traditional Chinese Medicine（TCM） nurse-led clinics in Zhejiang Province, and to provide a basis for the management and formulation of related policies. Methods From July 2020 to November 2020,our hospital used the questionnaire of TCM nurse-led clinic survey to investigate the infrastructure,operation mode and personnel qualification of the public TCM institutions in Zhejiang Province. Results 94 hospitals participated,and we got 94 valid questionnaires. The survey shows that 74.47% of hospitals have independent TCM nurse-led clinics,and 80.00% of them were opened in recent 5 years,and only 32.86% have full-time staff. 57.14% of TCM nurse-led clinics carry out over 10 suitable TCM technologies; the average daily outpatient volume was up to 200,with a wide range of diseases,including pain,sleepless,disease treatment,etc.;34.29% of TCM nurse-led clinics carry out Internet+ nursing services. Conclusion TCM nurse-led clinics in Zhejiang public TCM institutions are developing fast. It meets the health needs of patients,and promotes innovative development of TCM nursing. In the future,we should further strengthen the connotation of TCM nursing,promote relevant policies,systems and service standards,pay attention to infrastructure construction and vigorously develop TCM Internet+ nursing services.

Objective To conduct a meta-synthesis of the perception and feeling of nursing staff in advance care planning（ACP） from the perspective of nursing staff，and provide guidance for the development and implementation of ACP in China. Methods We searched databases including PubMed，Web of Science，the Cochrane Library，Embase，CINAHL，CNKI，Wan Fang，VIP and CBM. The above databases were included to retrieve the literature on the perception and feeling of nursing staff in advance care planning from inception until July 2022. JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of included studies，and meta-synthesis was used to summarize and integrate results. Results A total of 9 studies were included;32 themes were extracted;8 categories were summarized and 3 synthesis results were obtained，namely the perception of nursing staff in ACP，the perceived benefits of nursing staff in ACP，and realistic dilemmas of ACP from the perspective of nursing staff. Conclusion The implementation of ACP is affected by patients，diseases，social support and other aspects. Multidisciplinary cooperation is needed to promote the implementation of ACP.

Objective To identify the characteristics and research status of symptom clusters in patients with gynecologic cancer receiving chemotherapy. Methods This scoping review was conducted under the Joanna Briggs Institute guidelines. A literature search was performed in the PubMed,Embase,CINAHL,Web of Science,Medline,Scopus,CNKI,Wanfang,and CBM databases to identify relevant studies about symptom clusters in patients with gynecologic cancer from inception until November 29,2021. The included studies were summarized and analyzed. Results A total of 12 articles were included. The elements of identifying symptom clusters included symptom assessment and analysis methods. There were 13 kinds of symptom clusters during chemotherapy. The psychological symptom cluster and gastrointestinal symptom cluster are the most serious symptom cluster before chemotherapy and after 1st chemotherapy respectively. The body image symptom cluster is the most serious symptom cluster after 3rd and 6th chemotherapy. Conclusion Gynecologic cancer patients receiving chemotherapy experienced multiple symptom clusters with dynamic change. Future research should combine specific symptom measurement for gynecologic cancer patients with advanced machine learning techniques,and explore the construction of an accurate symptom cluster management scheme.

Objective To analyze the application status of different dairy products for very and extremely low birth weight infants in Yangtze River Delta，so as to provide evidence for making better feeding choices in clinic Practice. Methods From January 2019 to December 2019，the self-made “form of feeding situation in very low birth weight infants（VLBW） in neonatal intensive care unit（NICU）” was used to collect data and uploaded to the database，and the clinical data of VLBW infants with gestational age ≤35 weeks and admitted to the NICU within 24 hours after birth in 5 tertiary hospitals in the Yangtze River Delta were retrospectively analyzed，and the composition ratio of different dairy types was obtained. At the same time，the clinical outcomes related to feeding in the exclusive breastfeeding group and the formula supplement group were compared. Results 830 cases of VLBW infants were admitted to the NICUs of 5 hospitals，among which 667 cases met the inclusion criteria. Among them，82（12.3%） received exclusive maternal breast milk;5（0.8%） received exclusive donated breast milk;65（9.8%） received both maternal and donated breast milk，the above three feeding types were collectively referred to as exclusive breastfeeding, a total of 152（22.9%） cases. 34（5.1%） received both donated breast milk and formula;75（11.2%） received exclusive formula;333（49.9%） received both maternal breast milk and formula;73（10.9%） received formula，maternal and donated breast milk. The number of days of parenteral nutrition in the donor breast milk supplement group was less than that in the formula supplement group，and the incidence of necrotizing enterocolitis and septicemia was lower than that in the formula supplement group，with statistical significance（P<0.05）. Conclusion The exclusive breastfeeding rate of VLBW infants in various institutions in the Yangtze River Delta region is not optimistic. When the mother’s breast milk is insufficient，formula supplement feeding is still not as effective as exclusive breastfeeding.

Objective The aim of this study is to do a scoping review on nurse practitioners（NPs） in patients with diabetes mellitus and to analyze the research status in this filed,to provide references for future research in China. Methods According to methodology framework,Chinese and English literature from the establishment of the database to 19th November 2021 were searched and screened,and relevant studies on the application of NPs in diabetes were collected. Results From the initial 3 319 search results,64 studies qualified for inclusion were identified. NPs provide services mainly in primary health care institutions,focusing on patients with type 2 diabetes. Their service contents cover the implementation of health education,life style,psychological support,diabetic foot care and so on. The outcome types were mainly the effect evaluation of patients with diabetes and feasibility evaluation of interventions. Conclusion As a member of primary health care team,NPs play the important role in health management with diabetes,which has been confirmed. As there is little research on the nursing studies of NPs in China,this study may help improving the health management of diabetics.

Objective To establish a hospital-community-home three-level linkage palliative care service model （hereinafter referred to as palliative care service model） for patients with advanced tumor,and to promote the development of regional palliative care. Methods On the basis of the literature research and expert group meeting,the initial draft of the palliative care service model was constructed. 20 palliative care experts were invited to conduct 2 rounds of correspondence to revise the items. The constructed palliative care service model was preliminary applied in 10 cases of tumor patients. Results The effective recovery rates of 2 rounds of question-naires are 100%. The second round of expert judgment coefficients was 0.84;the degree of familiarity of the experts was 0.91;the degree of authority was 0.93;the Kendall harmonic coefficient was 0.086~ 0.193. The finally formed palliative care service model includes 7 first-level indicators（model purpose,implementation agency,organiza-tional structure and time limitation,job responsibilities and requirements,implementation methods,core service content,evaluation and continuous improvement）,24 second-level indicators,30 third-level indicators and 19 fourth-level indicators. Conclusion The palliative care service model constructed in this study is comprehensive and scien-tific,and it can provide references for the whole-process care model of patients with advanced tumors in the region.

This article summarized the postoperative nursing experience of 6 children with classic maple syrup urine disease undergoing liver transplantation. Key points of nursing care included：precisely take immunosuppressants to prevent acute rejection;early rehabilitation exercises to promote the development of the nervous system;closely observe changes in the condition and do emergency care for gastrointestinal bleeding;structured skin care to reduce diaper dermatitis;provide multiple forms of support to relieve family pressure;implementation of the "Internet +" follow-up model,continuous family rehabilitation care. After careful treatment and care,the 6 children recovered and were discharged after surgery. They were followed up for 15 days to 4 months and recovered well up to now.

Objective To retrieve,evaluate and integrate domestic and foreign evidence on the prevention and nursing care of chemotherapy-induced alopecia in breast cancer patients,and to summarize the best evidence. Methods We systematically searched the evidence in databases such as UpToDate,Cochrane Library,JBI,BMJ,NICE,RNAO,SIGN,ASCO,ONS,MASCC,etc.,for high level evidence on prevention and nursing care of chemotherapy-induced alopecia in breast cancer patients,including guidelines,best practice information sheets,expert consensuses,systematic reviews and evidence summaries. The retrieval period was from the inception of databases to December 2020. Two researchers independently completed the quality evaluation of the included literature,and combining with the judgment of professionals,they extracted and summarized the evidence of the literature which the quality conformed to the standard. Results A total of 18 articles were incorporated,including 9 guidelines,4 systematic reviews and 5 expert consensuses. 19 aspects were summarized,including team building,assessment content,physical prevention,drug prevention,cosmetic,psychological care,health education and other hair changes. Conclusion The best evidence for prevention and nursing care of chemotherapy-induced alopecia in breast cancer can provide references for clinical doctors and nurses,but the best evidence should be selected according to the environment of the department and patients’ preferences. The symptoms of chemotherapy-induced alopecia should be managed in a scientific way,in order to improve the quality of nursing care and the quality of life of patients.

Objective To systematically evaluate the qualitative research on the work experience of male nurses,and to provide the evidence for the growth and management of male nurses. Methods Chinese and English databases including Pubmed,Psyc INFO,Cochrane Library,JBI,Embase,Web of Science,CINAHL,CNKI,VIP,CBM,Wanfang were searched for qualitative studies on work experience of male nurses from the inception to September 2020. The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies. The results were synthesized by the Meta integration method. Results 17 studies were included in the final review. Totally 48 findings were extracted;7 new categories were generated;3 integrated results were synthesized as following,① "Double edged sword" situation brought by male roles;②Transformation of professional identity of male nurses;③ Male nurses’ desire for opportunities and success. Conclusion Male roles not only bring advantages to male nurses,but also bring a lot of troubles. Hospital and nursing leaderships should pay attention to male nurses’ advantages in work,take measures to improve male nurses’ professional identities,and make training plans for male nurses’ career development,so as to improve their clinical work experience.

Objective To further understand the dilemma experience of self-management in patients with hemophilic arthropathy（HA）,so as to provide references for the development of self-management intervention programs that meet the needs of patients. Methods With phenomenological research methods,a semi-structured in-depth interview was conducted among 13 patients with HA who were scheduled to undergo joint replacement surgery in an orthopedic ward of a tertiary Level A hospital in Beijing. Colaizzi 7-step analysis method was used to collect the data,to analyze and refine the theme. Results The self-management difficulty of HA patients mainly includes 2 factors,namely internal factors and external factors. The internal factors include the lack of attention on self-management of disease,differences in knowledge acquisition approaches,and high economic pressure. The external factors include the uncertainty about the disease,limited coverage of social support,poor drug accessibility,and response to the public health emergencies. Conclusion Patients with HA still have many problems and obstacles in self-management. Health care workers can help patients correctly understand and implement disease management through health education in multiple ways,and meanwhile give full play to the role of the family. Furthermore,the telemedicine platform could also be utilized to explore a new mode of disease self-management for patients with rare diseases.

This paper summarizes the nursing experience of 3 children with blastic plasmacytoid dendritic cell tumor. Nursing points include skin and mucous membrane nursing,medication nursing,illness observation,strengthening of protective isolation,exercises guidance,attention to parents’ psychological intervention and health education. At present,these 3 children are in remission. All the skin lesions have been healed without nursing complications.

Objective To evaluate the incidence,types,causes and influential factors of medication discrepancy in hospital-family transitional period in elderly patients with Type 2 Diabetes;to explore the effects of medication discrepancy in hospital-family transitional period on blood concentration. Methods 332 patients with Type 2 Diabetes discharged from a tertiary hospital in Lanzhou city from March to October 2019 were selected. A baseline survey was conducted before discharge. A week after the discharge,Summary of Diabetes Self-Care Activity（SDSCA）,Morisky Medication Adherence Scale with Eight-Item（MMAS-8） and the Chinese Version of the Medication Discrepancy Tool（MDT） were used to evaluate the patients by telephone follow-up. The fasting blood glucose and postprandial 2 h blood glucose were recorded. Binomial logistic regression analysis was run to identify the risk factors of medication discrepancy in hospital-family transitional period. The independent sample t test was used to analyze the relationship between the medication discrepancy and the blood glucose. Results The incidence of medication discrepancy in 332 patients within a week after discharge was 79.5%. The main type of discrepancy was the decrease in the types of medication. The results of Binomial logistic regression analysis showed medication discrepancy was affected by medication compliance,quantity of prescribed drugs and the diabetes self-management score. Compared with the patients without medication discrepancy,the fasting and 2 h postprandial blood glucose values of elderly Type 2 Diabetes patients with medication discrepancy were higher,and the difference was statistically significant（P<0.05）. Conclusion In the early post-hospital period,the incidence of medication discrepancy is higher in elderly patients with Type 2 Diabetes,and medication discrepancy can have adverse effects on blood glucose level of patients. Therefore,nurses should pay more attention to the management of medication discrepancy in elderly patients with Type 2 Diabetes,actively communicate and cooperate with pharmacists and doctors,and provide guidance for patients and their families on discharge medication,so as to ensure the safety of medication and the stability of blood glucose.

Objective To develop a multidisciplinary nursing program for recipients of living small bowel transplantation and to evaluate its effectiveness. Methods A multidisciplinary team was set up,consulting the guidelines,operation specifications and related literature according to the nursing difficulties. A multidisciplinary nursing program was developed,including nutrition management,infection prevention and control,rejection monitoring,immunosuppression,rehabilitation exercise,psychological interventions and continuous care. 6 adult recipients of living small bowel transplantation admitted to a level A tertiary hospital from August 2019 to March 2020 were selected, to carry out a multidisciplinary nursing program and to evaluate their postoperative rehabilitation. Results Among 6 recipients in this group,1 case was diagnosed enterococcus faecium infection with ascites culture. The infection was controlled after active interventions,and there was no acute rejection case. The 6 recipients were discharged from the hospital after their condition was stable,and the stoma was completed as scheduled within 3 months after the operation. The follow-up compliance after discharge reached 100%;blood drug concentration was well controlled. Conclusion The application of the multidisciplinary nursing program can reduce the incidence of complications,accelerate the process of postoperative rehabilitation,and ensure the safety of recipients during the transition period from hospital to family.