Objective To construct early phase Ⅰ cardiopulmonary rehabilitation program for patients with Type A aortic dissection and to evaluate its clinical effects. Methods From January 2021 to October 2022，type A aortic dissection patients of a tertiary hospital in Beijing was selected by the destination sampling. They were divided into a control group and an intervention group. The intervention group was given early phase Ⅰcardiopulmonary rehabilitation program for patients with type A aortic dissection and the control group was given routine care. The 6-minute walking experiment（6MWT），Borg subjective fatigue score，the first time out of bed，the incidence of hypoxemia and related complications，and the incidence of adverse events related to rehabilitation nursing were compared between the 2 groups. Results A total of 130 cases were selected，among which 20 cases were excluded because of surgical complications and self-withdrawal. A total of 110 cases were finally included，with 57 cases in the intervention group and 53 cases in the control group. The results of walking distance of 6MWT，Borg subjective fatigue score and incidence of hypoxemia had statistical significance between the 2 groups（P<0.05）. The results of the time of the first time out of bed and the incidence of complications and the incidence of adverse events related to rehabilitation nursing had no statistical significance between the 2 groups（P>0.05）. Conclusion Early phase Ⅰ cardiopulmonary rehabilitation program for patients with type A aortic dissection benefits the improvement of the motor function，the reduction of incidence of hypoxemia.

This research provides an overview of the perioperative nursing care for a patient with a massive renal cell carcinoma and Mayo Stage Ⅲ tumor thrombus who underwent a robot-assisted nephrectomy complicated by significant intraoperative bleeding and CO₂ embolism. Key nursing considerations included multidisciplinary preoperative discussions，developing stepwise intraoperative emergency plans，establishing an integrated nursing workstation，and the optimization of patient monitoring. During the surgery，nursing efforts were focused on supporting the robot-assisted procedure，closely monitoring the patient’s condition，preventing intraoperative complications，initiating emergency plans as needed，actively managing major bleeding and CO₂ embolism，and implementing structured positioning to minimize the risk of falls during the procedure. Postoperatively，the focus was on preventing secondary thrombus formation，managing active bleeding，and monitoring for liver and kidney ischemia-reperfusion injury. Through multidisciplinary interventions and meticulous nursing care，the patient was discharged after a 13-day postoperative recovery.

Objective To explore the effect of Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional counseling intervention in patients with autoimmune liver disease of liver depression and spleen deficiency type. Methods 74 patients with autoimmune liver disease of liver depression and spleen deficiency type who were admitted to the hepatology department of a tertiary hospital from January 2021 to February 2022 were selected as research subjects，and they were divided into an experimental group and a control group by a random number table with 37 cases in each group. The control group was given routine treatment and nursing care，as well as Traditional Chinese Medicine’s emotional nursing. The experimental group received Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional counseling intervention on the basis of routine treatment and nursing care，with an intervention period of 4 weeks. The Generalized Anxiety Disorder Scale （GAD-7），Patient Health Questionnaire Depression Scale （PHQ-9） and Pittsburgh Sleep Quality Index（PSQI） were used to evaluate patients within 24 hours after admission and after 4 weeks of intervention. Results A total of 72 patients completed the study，with 36 in the experimental group and 36 in the control group. Before and after intervention，the scores of GAD-7，PHQ-9，and PSQI in the experimental group were compared，and the differences were statistically significant （P<0.001）. After the intervention，the GAD-7 score in the experimental group was （7.89±3.15），which was lower than （10.14±4.41） in the control group. The PHQ-9 score was （12.33±4.08） in the experimental group，which was lower than （14.64±5.34） in the control group. The PSQI score was （12.39±3.06） points，which was lower than （14.22±3.37） in the control group，and the differences were statistically significant （P<0.05）. Conclusion The application of Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional guidance intervention can effectively improve the sleep quality and help alleviate negative emotions in patients with liver depression and spleen deficiency type of autoimmune liver disease.

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 develop a health-promoting lifestyle scale for women with polycystic ovary syndrome （PCOS），and to test its reliability and validity，and preliminarily apply it. Methods Based on the Pender health promotion model，the item pool of the scale was constructed through literature research，semi-structured interviews and group discussions. After 2 rounds of Delphi expert consultation and pre-survey，the initial scale was formed. From April to July 2022，316 patients with PCOS in the health management center，reproductive medicine center and endocrinology department of a tertiary hospital in Nanjing were selected for item analysis，exploratory factor analysis and reliability test，respectively. From August to October 2022，358 PCOS patients were selected for confirmatory factor analysis. From November 2022 to February 2013，294 PCOS patients were selected，and the scale was used to investigate the status of health-promoting lifestyle in PCOS patients. Results The health-promoting lifestyle scale for PCOS patients included 5 dimensions and 33 items. The total content validity index of the scale was 0.942，and the content validity index of each item was 0.810-1.000. 5 common factors were extracted by 2 exploratory factor analyses，and the cumulative variance contribution rate was 62.399%. Confirmatory factor analysis showed that the model fit was good. The Cronbach’s α coefficient of the total scale was 0.930；the split-half reliability was 0.842；the test-retest reliability was 0.888. The preliminary application results showed that the total score of health-promoting lifestyle in PCOS patients was（96.925±14.273），and the average score of items was （2.937±0.433），which was at a medium level. Conclusion The health-promoting lifestyle scale for PCOS patients has good reliability and validity，which can be used as a tool for medical staff to assess the level of health-promoting lifestyle of PCOS patients，and can help nurses to quickly identify the level and dimensions of health-promoting lifestyle of patients，so as to formulate individualized precise health management plans.

Qualitative research has made important contributions to nursing practice and theory construction. Based on the authors’ rich experiences in conducting and teaching qualitative studies，this paper proposed some suggestions on the use of qualitative research，writing and quality evaluation of qualitative research papers. It aims to deepen the understanding of nursing researchers to qualitative research，so as to improve the quality of qualitative research in nursing papers.

Objective To investigate the general well-being of breast cancer peer educators and to analyze its influencing factors. Methods Convenience sampling method was used to select 210 breast cancer peer educators from 8 tertiary hospitals in China from January to February 2023. General information questionnaires，General Well-Being Scale，Cornor-Davidson Resilience Scale，and Social Support Rating Scale were used for investigation. Multiple linear regression analysis was used to explore the influencing factors of the general well-being in peer educators of breast cancer. Results A total of 206 breast cancer peer educators were investigated. The general well-being score was（86.70±14.08）. The results of multiple linear regression analysis showed that psychological resilience，the utilization of social support and the current self-funded treatment of less than 1，000 yuan per month were the influencing factors of general well-being（P<0.001）. Conclusion The general well-being of breast cancer peer educators is at a high level. Improving the social support system for breast cancer patients，selecting peer educators with strong psychological resilience，high utilization of social support and low self-funded treatment，and paying attention to the psychologic status of peer educators，providing timely and positive psychological interventions will help to raise the general well-being of breast cancer peer educators and ensure the quality and continuity of peer education.

Objective To construct and apply a management plan for microaspiration of oropharyngeal secretions in ICU intubated patients. Methods Based on evidence summaries and expert consultation，a management plan for microaspiration of oropharyngeal secretions in ICU intubated patients was constructed，consisting of 19 items covering 7 aspects including identification of risk factors，position management，tube and cuff selection，cuff management，mechanical ventilation management，pain and sedation management，removal of oropharyngeal and subglottic secretions，and oral care. Convenience sampling was used to select 141 ICU intubated patients from a tertiary A comprehensive hospital in Suzhou from June，2022 to September，2023. Patients were divided into an experimental group（n=72） and a control group（n=69） according to the wards. The experimental group received the management plan for microaspiration of oropharyngeal secretions in ICU intubated patients. The control group received the nursing bundle for ventilator associated pneumonia（VAP）. The incidence and time from intubation to microaspiration and VAP，duration of mechanical ventilation，ICU length of stay，and disease outcome were compared between the 2 groups. Results The incidence of microaspiration of oropharyngeal secretions，the duration of mechanical ventilation，time from intubation to microaspiration showed significant differences between the 2 groups（P<0.05）. There were no significant differences in the incidence of ventilator associated pneumonia，ICU length of stay，and disease outcome between the 2 groups（P>0.05）. The time from intubation to VAP in the experimental group was 7.5 days, and that in the control group was 3.8 days. Conclusion The application of the management plan for microaspiration of oropharyngeal secretions in ICU intubated patients is beneficial for reducing the incidence of microaspiration，delaying the time from intubation to microaspiration and VAP，and shortening the duration of mechanical ventilation.

Objective To explore the barriers and facilitators factors of adherence to complete decongestive therapy（CDT） in patients with breast cancer related lymphedema（BCRL）. Methods Based on the Health Action Process Approach theory，from September 2021 to February 2022，12 patients with BCRL undergoing CDT were purposely selected for semi-structured in-depth interviews. Data were collected and analyzed using the Colaizzi seven-step analysis method. Results The extracted barriers of CDT included insufficient risk perception，negative outcome expectation，low self-efficacy，lack of behavioral intention，lack of action and coping plan. The facilitators included perceived benefits of treatment，perceived harm of edema，enhanced self-efficacy，motivation of treatment，and construction of a new normal life. Conclusion The adherence of CDT in patients with BCRL is affected by a series of barriers and facilitators. In the future，targeted intervention strategies can be formulated based on the theory of health action process approach to improve the treatment adherence.

Objective To integrate the best evidence of non-pharmacological interventions for breast cancer-related lymphedema with evidence-based methods，and to provide evidence-based bases for standardized evaluation and management of lymphedema for clinical medical staff. Methods The best evidence about the prevention and management of lymphedema in breast cancer patients were searched systematically，such as relevant guidelines，expert consensuses，systematic reviews and so on. The retrieval period was from January 2016 to January 2022. Results A total of 25 pieces of the literature were included，including 6 guidelines，4 expert consensuses and 15 systematic evaluations，and 33 pieces of best evidences were integrated from 2 aspects，namely the preventive intervention and therapeutic intervention. Conclusion The summarized evidence can be used for the prevention and treatment of breast cancer lymphedema，and medical staff should provide specific health guidance for patients with lymphedema based on cultural background，clinical situation，and patients’ opinions.

Objective The scope of literature review correlated to narrative intervention for patients living with breast cancer was conducted to define the object，form，content，timing/duration and patient outcomes. It can provide references for future research and development of efficient，scientific，and rigorous narrative intervention programs for breast cancer patients and guide clinical practice. Methods According to the scoping review methodology，we systematically searched PubMed，CINAHL，Embase，Web of Science，Cochrane library，CNKI，WanFang database and VIP database. The search period is from the establishment of the database to December 31，2022. There are 2 researchers who analyzed the included studies independently. Results A total of 25 papers from 6 countries were included，and 12 of which coming from China. The results found that the narrative intervention runs throughout the treatment of breast cancer patients. Patients at different treatment stages have different needs for narrative intervention. Less attention had been paid to breast cancer survivors. The forms of narrative intervention include “telling story”，“writing story” and “watching/reading story”. Most of narrative practice forms were “telling story”. Overall，the narrative intervention had significant improvements in psychological，physical，cognitive and life quality，family relationship/social support for breast cancer patients. Conclusion Narrative intervention has positive effects on patients with breast cancer. Currently，the forms of narrative practice for patients with breast cancer need to be further enriched. More attention should be paid to breast cancer survivors，and narrative intervention programs should be individualized according to patient characteristics to enhance intervention effects.

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 develop an evidence-based decision support system for nutritional risk screening and assessment in children with congenital heart disease（CHD），and to evaluate its clinical effect. Methods The best evidence for nutritional risk screening and assessment in CHD children was summarized，and an evidence-based decision support system was developed. A before-and-after study design was adopted，and the medical staff and children with CHD admitted to the Cardiac Intensive Care Unit of a tertiary A-level hospital for children in Shanghai were selected as the research subjects. The data of the experimental group was collected from September to December 2021，while the data of the control group was collected from September to December 2020. The outcome measurement were the consistency of nutritional risk screening results of the responsible nurses and nutrition specialist nurses，the time-consuming of nutritional risk screening，the proportion of children receiving nutritional assessment and intervention，the response time of high-risk warning value of nutritional screening，and the satisfaction of medical staff with the use of information system. Results 191 children were included in the experimental group，and 193 were in the control group. The consistency coefficient of the nutritional risk screening results was 0.890 in the experimental group，and it was 0.689 in the control group. The nutritional risk screening time was（2.97±1.05） min in the experimental group，and it was（4.05±1.01） min in the control group. The proportion of infants who received nutritional assessment in the experimental group was 95.29%，compared with 89.64% in the control group；the proportion of infants receiving nutritional intervention was 69.11% in the experimental group，and 54.92% in the control group. The response time of the high-risk warning value of nutritional screening in the experimental group was（4.73±2.31） min，while the control group was（41.53±9.13） min. The satisfaction score of medical staff on the use of the clinical nursing information system was（108.04±11.31） points，and it was（92.89±9.37） points in the control group. The above data were compared between the 2 groups，and all the difference were statistically significant（P<0.05）. Conclusion Using the evidence-based decision support system for nutritional risk screening and assessment of CHD children can improve the consistency of nutritional risk screening results，shorten the time-consuming of nutritional risk screening，promote nutritional assessment and nutritional intervention by medical staff，and improve satisfaction with the use of information system.

Fatigue is one of the most common complaints in patients with interstitial lung disease（ILD） and seriously affects their prognosis and quality of survival. The study introduces the hazards of fatigue in patients with interstitial lung disease，and describes the common measurement tools for fatigue symptoms in ILD. Management measures to improve their symptoms are summarized in order to provide a basis for the development of comprehensive，multidisciplinary and individualized ILD fatigue management programs in the clinical settings.

Objective To evaluate the value of discharge planning demand score for prediction of prolonged length of stay in older patients with chronic heart failure，and analyze corresponding nursing strategies. Methods From November 2021 to June 2022，343 older patients with chronic heart failure admitted to the cardiology wards of a tertiary hospital in Beijing were recruited，and the general data，the score of discharge planning demand and the length of stay were collected. We divided the patients into 2 groups according to the length of stay. Binary logistic regression analysis was used to explore the influencing factors of prolonged length of stay. Predictive value of discharge planning demand score for prolonged length of stay was assessed by receiver operating curve（ROC） analysis. Results There were 343 older patients with chronic heart failure included in this study. Length of stay was prolonged in 136 cases（>7 d）. The results of binary logistic regression analysis showed that living alone（OR=2.721，P=0.027） and the discharge planning demand score（OR=1.503，P<0.001） were independent predictors for pro-longed length of stay. The area under the ROC curve was 0.828（95%CI 0.781~0.876，P<0.001）；the optimal critical value was 3.5，and the corresponding sensitivity was 70.6% and the specificity was 85.5%. Conclusion The discharge planning demand score has good predictive value for the prolonged length of stay in older patients with chronic heart failure，so as to be used for early identification of high-risk individuals with prolonged length of stay.

Objective To explore the influencing factors of the transition to adults on children with cancer from the perspective of professional care providers,so as to improve their transition readiness. Methods From September 2020 to June 2021,by phenomenological research methods,semi-structured in-depth interviews were conducted with 5 doctors,19 nurses and 3 social workers. The interview data were transcribed,coded,analyzed and refined. Results From the perspective of professional care providers,the factors influencing the transition of children with cancer can be summarized into 4 factors,i.e. individual,family,medical system and society,and 9 sub-factors,i.e. diagnosis and treatment experience,disease cognition,autonomy,transitional consciousness,education style,professional team,profes-sional service,social environment and service system. Conclusion There are multiple factors influencing the transition to adulthood. To assist them to effectively cope with the long-term impact of disease and treatment,it is necessary to raise the public attention,encourage children to be informed and participate in disease management,upgrade professionals’ capabilities,strengthen the continuity of long-term follow-up,develop the service system,and develop individualized and targeted intervention adapted to Chinese situations.

Objective To systematically evaluate the experience of elderly patients on coping with multiple chronic conditions（MCCs）.Methods Pubmed,the Cochrane Library,Web of Science,EmBase,CNKI,Wanfang Database and VIP database were searched for qualitative research studies on experience of elderly patients with MCCs. The retrieval period was from inception to August 2021. The Joanna Briggs Institute Critical Appraisal Tool for qualitative research（2016） in Australia was used to evaluate quality of the studies. A meta-synthesis method was used to integrate the results.Results A total of 15 studies were included;60 findings were extracted;10 cate-gories were summarized;3 integrated results were formed,namely changes caused by MCCs and aging,reflection and response to MCCs,adjusting to a normal life.Conclusion Aging with MCCs brings many challenges to the life of elderly patients. Health professionals should pay attention to the different coping styles of patients with MCCs,and develop feasible and support programs to help them better cope with MCCs which derived from their wisdom.

Objective To explore the true perception of patients with breast cancer who participated the rehabilitation exercise of limb function.Methods Using the purposive sampling method,18 postoperative breast cancer patients admitted in a tertiary hospital in Wuhan,China,from February 2021 to March 2021 were recruited for semi-structured interviews based on the theory of planned behavior. Collected data were analyzed to summarize the main themes by the Colaizzi phenomenological method（7 steps）.Results The true experience of postoperative breast cancer patients on the rehabilitation behavior of limb function can be summarized as 3 themes. Behavioral attitude：negative emotions following stress,rehabilitation behaviors that are systematically underestimated,and the value of reconstructing the image of women. Subjective normative measurement：influence of social roles,peer effect,and medical staff support. Perceived behavior control：the confinement of the comfort zone,and the needs of the rehabilitation environment.Conclusion The behavior of limb function rehabilitation in postoperative breast cancer patients is affected by the behavioral attitude,subjective norms measurement and perceived behavioral control. From the perspective of patients,medical staff should correct cognitive bias in rehabilitation behavior of breast cancer patients. Negative cognition needs to be avoided through positive belief factors. Meanwhile,multiple sources of support should be highlighted to stimulate patients’ sense of self-management,create a rich rehabilitation environment,and promote the improvement of breast function rehabilitation behavior of postoperative breast cancer patients.

Objective Through systematic evidence retrieval and literature quality evaluation，the best evidence on the preventive strategies of unplanned extubation of tracheal tubes in pediatric intensive care units （PICU） was extracted and summarized，so as to provide research-based evidence for clinical practice. Methods The literature related to the preventive strategies of unplanned extubation of endotracheal intubation in children with mechanical ventilation were systematically searched in domestic and foreign computer decision support systems，guide networks，databases and websites of relevant societies. The retrieval time limit is from January 2010 to January 2022. The literature types cover clinical decision-making，clinical practice guidelines，evidence summaries，systematic evaluations and expert consensuses. 5 different types of publications were retrieved and evaluated by 4 experts. Results A total of 14 publications were included，involving 6 guidelines，2 expert consensuses，6 systematic reviews. 25 pieces of best evidence of preventive strategies in 6 aspects，namely risk factors，tracheal intubation and airway management，sedation evaluation and management，analgesia evaluation and management，delirium monitoring and prevention，and PICU human resources and facilities were summarized. Conclusion The best evidence summarized in this study provides an evidence-based basis for the prevention of unplanned extubation of tracheal intubation in children with PICU mechanical ventilation. Before applying the evidence，medical workers should evaluate the clinical situation and obstacle factors，so as to promote the effective and safe transformation of the evidence into clinical practice.

Objective To retrieve，evaluate and summarize the evidence of self-management of patients with chronic heart failure，and to provide evidence-based bases for medical staff to conduct self-management health education and standardize patients’ self-management behavior. Methods We searched UpToDate，BMJ Best Practice，Joanna Briggs Institute（JBI），National Institute for Health and Clinical Excellence（NICE），Guidelines International Network（GIN），National Guideline Clearinghouse（NGC），Scottish Intercollegiate Guidelines Network（SIGN），Cochrane Library，PubMed，SinoMed，CNKI，Wanfang Database to collect relevant clinical decisions，evidence summaries，syste-matic reviews，guidelines，expert consensuses and original articles published from the databases establishment to July 14，2022. There were 3 researchers who evaluated the quality of the literature that met the quality standards，and 2 researchers extracted and integrated evidence. Results A total of 18 pieces of literature were included，including 1 clinical decision，10 guidelines，2 systematic reviews，3 randomized controlled trials and 2 expert consensuses. Finally，39 pieces of evidence were summarized in 9 aspects，including multidisciplinary team cooperation，learning disease-related knowledge，medication management，symptom monitoring，exercise training，dietary and nutrition，lifestyle，psychological adjustment，medical treatment and follow-up. Conclusion This study summarizes the best evidence of self-management of patients with chronic heart failure，which can provide references for clinical medical staff to guide self-management of patients with chronic heart failure in a more comprehensive and scientific way.

Objective We review the scope of relevant nurse staffing policies at home and abroad，compare and analyze their characteristics，in order to provide references for the nurse staffing in China. Methods We systematically searched pubmed，web of science，CNKI，Wanfang and relevant websites of government，policy and international organization. The retrieval time is from the establishment of the databases to September 30，2021. Results 15 policy papers from 8 countries/regions were eventually included. In terms of configuration reference indexes，China and Northern Ireland adopted the bed-to-nurse ratio，while other countries/regions adopted the nurse-to-patient ratio. The nursing staff skill mix mainly includes registered nurses and non-registered nurses，and the proportion of nursing staff is various in different countries. 3 countries/regions have stipulated the allocation of nurse staffing in the emergency department. The nursing staffing allocation of the emergency department in China is based on the general standard of bed-to-nurse ratio;referring to the nurse-to-patient ratio，California in the US and Victoria in Australia further refine the nursing staffing allocation of emergency departments based on the work area or shifts. 5 countries/regions stipulate the allocation of the nurse staffing in the intensive care unit （ICU）. The reference basis of the allocation is different，and the ratio of nurse to patient in departments of critical care medicine is the highest in China. Conclusion It is necessary to further improve our nursing staffing policy，give full play to the application value of the nursing staff skill mix，continue to improve the allocation plan of emergency and critical care departments，and promote the implementation of the nurse staffing policy.

Non-ventilator associated hospital-acquired pneumonia is one of the most common hospital infection types,and it is the leading cause of death from hospital infection. It is of great significance to master knowledge regarding nursing prevention strategies. This article reviewed the definition,mechanism,threat,prevention strategies and challenges,so as to provide references for clinical staff.

Objective This study was to investigate the status and risk factors of cognitive frailty in elderly patients with chronic obstructive pulmonary disease（COPD）,and to develop a risk screening model. Methods A total of 386 elderly patients with COPD hospitalized in the respiratory department and geriatric department of a tertiary hospital in Shanxi Province from May 2020 to March 2021 were selected and divided into a cognitive frailty group（n=123） and a non-cognitive frailty group（n=263）,according to their occurrence of cognitive frailty. Univariate analysis and multivariate Logistic regression were used to analyze the independent risk factors of cognitive frailty in elderly COPD patients. A risk screening model was established and the nomogram was drawn. From April to July 2021,158 elderly COPD patients from the same hospital were recruited for external validation. Results The incidences of cognitive frailty in training set and validation set were 31.9% and 35.4%,respectively. The multivariate regression analysis showed that age,daily intellectual activity,comorbidity,duration of disease,lung function grade and PaCO₂ were independent risk factors of cognitive frailty in elderly COPD patients. The H-L test P=0.328,and the AUC was 0.813. The Youden index was 0.481,with the sensitivity of 0.764 and the specificity of 0.703. While the external validation H-L test P=0.468,the AUC was 0.886 with the sensitivity of 0.732 and the specificity of 0.824. Conclusion The prevalence of cognitive frailty in elderly COPD patients is high;age≥70,non-dai-ly intellectual activity,comorbidity,duration of disease≥5 years,GOLD>Ⅰ and PaCO₂>50 mmHg（1 mmHg=0.133 kPa） can increase the risk of cognitive frailty in elderly COPD patients. This risk screening model has good differentiation and correction,which can provide references for clinic to screen the risk of cognitive frailty in elderly COPD patients and take effective nursing care.

Objective To systematically review the effect of telemedicine on the prevention of pressure injury among community-dwelling patients with spinal cord injury,and to provide evidence-based bases for future research. Methods Both Chinese and English databases（CBM,CNKI,WanFang,VIP,Cochrane Library,PubMed,Embase,Web of Science,Scopus,ProQuest and BMJ Best Practice） were searched from their inception to August 2021. 2 researchers evaluated the quality of the included articles,and the meta-analysis was performed by RevMan 5.3 software. Results A total of 14 articles were included （9 randomized controlled trials and 5 quasi-experimental studies）,with totally 1 582 community-dwelling patients with spinal cord injury. The results of meta-analysis showed that telemedicine can decrease the incidence of pressure injury in community-dwelling patients with spinal cord injury [RR=0.29,95%CI（0.20,0.43）,P<0.001],improve the quality of life[SMD=0.94,95%CI（0.19,1.68）,P=0.010] and satisfaction[SMD=0.86,95%CI（0.58,1.13）,P<0.001],and the incidence of adverse events caused by pressure injury did not increase significantly[RR=0.50,95%CI（0.20,1.27）,P=0.140]. Conclusion The current evidence shows that telemedicine could decrease the incidence of pressure injury,improve quality of life and satisfaction in community-dwelling patients with spinal cord injury,proving that telemedicine is safe and feasible. Due to the limited quality and quantity of included articles,the above conclusion needs to be verified by more high-quality studies.

Mental disorder is a prominent social problem,which has attracted extensive attention in the field of global public health. This paper summarizes the application of mobile health technology in the management of patients with mental disorders,including application program,mobile phone short message,online network platform,wearable device,virtual reality and telephone support. It also summarizes the advantages and application effects of mobile health technology in the management of patients with mental disorders,and analyzes the shortcomings of research and application at this stage. The prospect was put forward,in order to provide references for the application of mobile health in the management of patients with mental disorders in China.

ICU acquired weakness affects the recovery of critically ill patients and the quality of life after discharge. Early functional exercise can reduce the incidence of ICU acquired weakness and promote the recovery of patients. In this article,the necessity of early functional exercise for ICU patients is described firstly. Secondly,the assessment of early functional exercise is also summarized,including the specific contents of the initial and continuous assessment of early functional exercise. Besides,the current status and problems of the research on the implementation of early functional exercise,including progressive functional exercise and goal-oriented functional exercise,are reviewed. Lastly,the impediments to the implementation of early functional exercise are analyzed,and the corresponding countermeasures are proposed. The purpose of this study is to provide a reference for clinical and nursing staff to implement early functional exercise effectively and safely.

Objective To retrieve,evaluate and summarize the best evidence of resistance training for breast cancer-related lymphedema.Methods We searched BMJ Best Practice,UpToDate,Registered Nurses’ Association of Ontario（RNAO）,National Comprehensive Cancer Network（NCCN）,National Institute for Health and Clinical Excel-lence（NICE）,Scottish Intercollegiate Guidelines Network（SIGN）,Medive,PubMed,CINAHL,Cochrane library,Joanna Briggs Institute（JBI） COnNECT+,CNKI,Wanfang,National Lymphedema Network（NLN）,International Society of Lymphology（ISL） to collect relevant guidelines,evidence summaries,recommended practice,systematic reviews and expert consensuses published from database construction to September 1st of 2020. 2 researchers evaluated the quality of various literature,and extracted recommendations and research conclusions from the included literature.Results Totally 21 articles were involved,including 1 guideline,14 systematic reviews,2 expert consensuses,1 recommended practice and 3 evidence summaries. Finally,23 pieces of best evidence about contraindications,timing of training,training forms,training intensity and training effectiveness were summarized.Conclusion Resistance training combined with individualized exercises,professional guidance and regular monitoring management is safe and beneficial. Clinical staff should develop resistance training program based on clinical environment as well as patient’s individual situation and training conditions.

Objective We conducted a scoping review to systematically review the literature reporting discharge planning,and identify the quality evaluation indicators and its collection time,along with related tools. Then the differences between the quality evaluation indicators for discharge planning at home and abroad were explored. Methods Focusing on the quality evaluation indicators for discharge planning,we systematically searched the relevant databases,guidelines and government websites. The information,including research topic,research type,the first author/institution,year of publication,country,evaluation indicator,participants,collection time and method,evaluation tool,were also extracted and summarized. Results The quality evaluation indicators for discharge planning were divided into 3 dimensions,namely patient-related indicators,medical institution-related indicators,and caregiver-related indicators. A total of 167 papers were included and 26 indicators were extracted. There were 12 patient-related indicators,and the top 5 were readmission rate,patient satisfaction,quality of life,self-care ability and mortality. There were 9 medical institution-related indicators,and the top 3 were length of stay in hospital,frequency of outpatient/emergency visits,and medical expenditure. There were 5 caregiver-related indicators,the most common of which is caregiver satisfaction. The readmission rate,quality of life,self-care ability,frequency of outpatient/emergency visits,and activities of daily living had statistically significant differences among the top 10 evaluation indicators for discharge planning at home and abroad. Conclusion The medical institutions should not only monitor patient outcome indicators,but also audit related indicators of medical institutions and caregivers. The researchers should also unify core evaluation indicators and corresponding measurement tools,select sensitivity indicators,develop indicators that can be extracted by using Electronic Information System in the future.

Objective To establish an index system for evaluating the core competence of breast cancer case managers in China. Methods The items were constructed based on literature review and panel discussion. 19 medical and nursing specialists of breast cancer in Beijing,Guangdong,Guangxi,Zhejiang and Taiwan were consulted twice during October to December 2019,and then the weight of each index was calculated. Results The evaluation index system of core competence of breast cancer case managers was finally established,including 5 first-level indicators,12 second-level indicators and 43 third-level indicators. The authority coefficient of expert consultation was 0.93;the familiarity coefficient was 0.92 and 0.91;the judgment basis coefficient was 0.95. The coordination coefficient of the indicators in the first round of expert consultation was 0.121~0.208,and it was 0.191~0.341 in the second round. Conclusion The expert consultation on the core competence of breast cancer case managers at all levels tends to be consistent and reliable,which can provide quantifiable references for the training,assessment and evaluation of breast cancer case managers.