Objective To explore the status and development trend of kinesiophobia after percutaneous coronary intervention（PCI） in patients with acute myocardial infarction（AMI）,and to provide evidence for the best intervention time point of kinesiophobia. Methods From November 2020 to June 2021,a total of 105 patients with AMI after PCI admitted to the Department of Cardiology of tertiary A general hospitals in Hangzhou were selected by convenience sampling method. The general data questionnaire,tampa scale of kinesiophobia-heart and cardiac anxiety questionnaire were used to investigate and observe the degree of kinetophobia and psychogenic anxiety at 3 time points（within 1 week of hospitalization,2 weeks after discharge and 3 months after discharge）. Results The kinesiophobia scores of AMI patients at 3 time points after PCI were（40.82±5.40）,（41.90±4.60）,（37.40±3.35）,which were higher than the norm（32.20±7.40）. The results of repeated measure ANOVA showed that different time,different age groups and cardiac anxiety significantly affected the score of kinesiophobia（P=0.022,P=0.048,P<0.001）. After the control for covariates,different time had a significant interaction with age（P=0.013）,T1 and T2 time had significant interaction with cardiac anxiety（P=0.001,P<0.001）. Conclusion Due to the interaction of time, age and cardiac anxiety, the level of kinetophobia in AMI patients was higher after PCI and within 3 months after discharge. At T2 time point, the score of kinesiophobia and cardiac anxiety in the young and middle-age groups was significantly higher than those in the elderly group. The trajectory of kinesiophobia showed a slight increase in acute convalescence period,and a natural trend of gradual decrease in middle and post convalescence period. The kineophobia kinesiophobia of AMI patients after PCI lasts for a long time with a wide impact,so it is necessary to timely carry out interventions.

Cardiac rehabilitation can help to reduce the total mortality of 13%~24% of patients and 31% of the hospital readmission rate within one year in the secondary prevention of cardiovascular disease. It's the first-level recommendation for cardiovascular disease prevention,but patients always have low compliance. The emergence of virtual reality technology has helped to break the limitations of traditional cardiac rehabilitation time,location and traffic,and to increase the participation of patients in cardiac rehabilitation,which has become an auxiliary means of cardiac rehabilitation. This article reviews the development,technical types,using methods,precautions and application effects of virtual reality technology in cardiac rehabilitation,and provides a reference for the development of virtual reality technology in cardiac rehabilitation in our country.

Objective To retrieve the best evidence on early enteral nutrition in patients after pancreaticoduodenectomy（PD）and to summarize the best available evidence for clinical nurses to provide evidence-based guidance for the management. Methods All evidence on early enteral nutrition in patients after PD was retrieved from databases and websites including UpToDate,BMJ Best Practice,JBI Library,Cochrane Library,NICE,ASPEN,ESPEN,PubMed,CBM,VIP,CNKI and Wanfang. The retrieved evidence included guidelines,expert consensuses,evidence summaries,systematic reviews,meta-analysis and related original studies. The retrieval period was from the inception of databases to June 15,2020. 2 researchers with evidence-based nursing background assessed the quality of the literature independently,combined with the opinions of professionals,extracted and summarized the evidence of the literature that met the quality standards. Results A total of 281 references were obtained from the initial search,and 12 pieces of literature were included,including 4 guidelines,1 expert consensus,2 systematic evaluations and 5 meta-analysis. Finally,totally 11 pieces of best evidence were summarized from 4 aspects on indications and safety assessment of early enteral nutrition,timing of early enteral nutrition,route selection and target nutrient requirement management. Conclusion Early enteral nutrition after PD is safe and feasible. Evidence users should select best evidence based on the clinical context,the promoting factors and the obstacles and willingness of patients,so as to form a scientific and evidence-based practice plan for early enteral nutrition after PD management,and to accelerate patients’ recovery and improve nursing quality.

Objective To design and develop quality management information platform for gerontological nursing safety,and evaluate the effects of application in order to improve quality management of nursing safety for elderly care. Methods Using safety quality index system for elderly care as the core,a platform with the function of learning and application of safety risk assessment,safety risk prevention,and adverse event report for gerontological nursing was designed and developed. Two medical institutions were selected to carry out a three-month platform application,and the effects of application were evaluated. Results The platform included four major modules. After the test of the platform was completed,14 safety high-risk items for gerontological nursing were identified. Nurses’ knowledge of safety for gerontological nursing was improved（t=4.941,P<0.001）,and the incidence of adverse events for gerontological nursing was decreased（ χ ²=5.860,P<0.05）. Nurses’ satisfaction for the platform was 91.54%. Conclusion The platform could help to screen safety risks for gerontological nursing and enhance gerontological nursing quality,which is an effective tool of quality management for gerontological nursing safety.