Cognitive adaptation training can bypass the cognitive deficits of patients with severe mental illness （SMI），use personalized compensation strategies and environment to support the development of patients’ adaptive behaviors，and improve their social function，medication adherence，quality of life and prognosis. In recent years，nurse-led cognitive adaptation training has developed into a mature nursing intervention after feasibility exploration and continuous improvement of research methods abroad，and it has been integrated into psychiatric wards as routine nursing. This paper reviews the application status，intervention contents and intervention effects of cognitive adaptation training in patients with SMI，and puts forward suggestions on cognitive adaptation training in psychiatric wards and community environments in China from 4 aspects，in order to provide references for the research and clinical practice on cognitive adaptation training in China.

Objective To improve the subcutaneous tunnel needle and the method of establishing subcutaneous tunnel for PICC,and to explore its application effect. Methods The improved subcutaneous tunnel needle consists of 3 parts,including needle handle,solid needle core and needle head. The needle head has an arc chamfering structure,which can realize the stable connection between the catheter and the needle head. Patrticipants from a tertiary hospital in Guangdong Province were selected by convenience sampling. 97 tumor patients from November 2019 to January 2021 were allocated into an experimental group,while 115 tumor patients from August 2018 to October 2019 were in the control group. The experimental group received the improved subcutaneous tunnel needle via a 30°~45° degree with venipuncture for PICC catheterization under B-ultrasound,while the control group was treated with Seldinger technique for PICC catheterization under B-ultrasound. The amount of bleeding and the highest pain score,the incidence of bleeding and exudation at the puncture point 24 hours after the operation,the incidence of catheter prolapse within a month after the operation,the incidence of allergic dermatitis,the incidence of mechanical phlebitis,and the comfort of the patients’ arms at a month after the operation were compared between the 2 groups. Results The amount of bleeding and the highest pain score in the experimental group were higher than those in the control group,and the difference was statistically significant（P<0.001）. The incidence of bleeding and exudation at the puncture point 24 hours after the operation,the incidence of catheter prolapse within a month after operation and the incidence of allergic dermatitis in the experimental group were lower than those in the control group（P<0.05）,but the incidence of mechanical phlebitis within a month after operation in the 2 groups was not statistically significant（P=0.484）;a month after operation,the arm comfort of the experimental group was higher than that of the control group,and the difference was statistically significant（P<0.001）. Conclusion The improved subcutaneous tunnel needle and subcutaneous tunnel establishment method can reduce the incidence of blood and fluid leakage,catheter prolapse and allergic dermatitis at the puncture point,and improve the postoperative arm comfort of patients,but they could not increase the incidence of mechanical phlebitis.

At present,the quality of life of patients with bipolar disorder（BD） is relati-vely low,and because of the special nature of their lack of insight,few nursing interventions have been carried out in China for them. This article reviews the latest studies on quality of life in patients with BD,including the current status of their quality of life,assessment tools,and nursing interventions to improve quality of life. It is recommended that evidence-based nursing interventions should be developed and implemented in clinical practice and community setting. The effective nursing interventions that are suitable for China’s clinical reality and can improve the BD patients quality of life should be further explored,so as to provide bases for the construction of systematic intervention programs.

Objective The quality evaluation and content analysis of the existing guidelines concerning management of patient-controlled analgesia（PCA） in adult patients with postoperative acute pain were conducted to provide recommendations for its management. Methods Evidence-based guidelines involving recommendations of PCA management with postoperative pain were searched in guidelines networks,websites of pain management and anaesthesiology,and databases from inception to April 2021. AGREE Ⅱ was used to appraise the quality of guidelines;the recommendations related to PCA management of postoperative pain were synthesized. Results A total of 783 pieces of the literature were initially detected,and finally 9 evidence-based guidelines were included,among which 3 were rated as A and 6 were rated as B,with the relatively high quality. 23 recommendations were extracted and summarized from 9 guidelines,involving 6 domains,namely organization management,education and training,analgesia mode selection,patient education,preoperative assessment,and postoperative monitoring and assessment. Conclusion The guidelines are of high quality in total,providing recommendations on PCA management of postoperative pain;however,the independence and applicability of the guidelines need to be improved. The recommendations of PCA management are scattered in different guidelines and lack targeted specific PCA management strategies.