Objective To establish the rehabilitation program of external diaphragm pacer and to explore its preventive effect on ventilator-induced diaphragmatic dysfunction（VIDD） in patients with ICU non-invasive mechanical ventilation. Methods Through the literature review,group meeting and pre-experiment,a program was formulated to prevent VIDD in patients with non-invasive ventilation in ICU. Patients with non-invasive ventilation were conveniently selected from September 2020 to June 2021 in a respiratory intensive care unit of a tertiary hospital in Henan province. They were divided into 2 groups by random number table method. On the basis of routine nursing care,the experimental group was given the external diaphragm pacer training program,and the control group was given routine nursing program. The incidence of VIDD,diaphragm thickness score,diaphragm displacement and blood gas analysis were compared between 2 groups after the intervention. Results A total of 74 patients were included with 10 cases fallen off,and finally 64 cases were included with 32 cases in the experimental group and 32 cases in the control group. After the intervention,the incidence of VIDD was 6.25% in the experimental group,while that was 43.75% in the control group. The difference between 2 groups was statistically significant（P=0.001）. Conclusion The external diaphragm pacer rehabilitation program can reduce the incidence of VIDD and improve diaphragm and respiratory function in patients with ICU non-invasive mechanical ventilation.

Objective To develop and implement a grading program of cardiac rehabilitation（CR）nursing intervention among the patients with severe coronary artery disease. Methods In July 2019,we started a specialized group to analyze the characteristics and difficulties of CR nursing among the patients with severe coronary artery disease through literature review and clinical practice. We formulated a program of cardiac rehabilitation grading nursing care and carried out it for clinical application and data collection during August 2019 to January 2021. Results Since the launch of CR grading care,a total of 817 patients with severe coronary artery disease have been included;519（63.5%）patients had underground activities before being discharged,and 13（1.6%）patients had adverse events. Conclusion The program can effectively provide the suitable CR nursing and satisfy the rehabilitation needs among patients with severe coronary artery disease.

The evaluation of early morning symptoms can timely understand the frequency and severity of symptoms,and it is an important basis for formulating symptom management plans. This paper describes the contents,characteristics and application of early morning symptom assessment tools for COPD patients at home and abroad,and analyzes the advantages and disadvantages of different tools,so as to provide references for the follow-up related research and the construction of nursing interventions.

Objective To translate the Essentials of Magnetism Scale(EOM) into Chinese，and test the reliability and validity of the scale for initially establishing a Chinese version of the Essentials of Magnetism Scale. Methods A total of 1 389 clinical nurses were tested from a tertiary comprehensive hospital in Qingdao using the Chinese version of EOM which was developed through the process of translation，back-translation and cultural adaptation to verify its reliability and validity according to Brislin model. Results The Chinese version scale was extracted for 7 factors and 45 items by the factor analysis using the maximum orthogonal rotation，the cumulative contribution rate was 72.328%. Cronbach’s alpha coefficient for the overall scale was 0.980, the split-half reliability coefficient was 0.919 and the test-retest reliability coefficient was 0.889. Conclusion The Chinese version of the Essentials of Magnetism Scale has been proved to be reliable and valid which can be used to objectively evaluate the magnetic level and health status of nursing work environment in China.