Objective This study aimed to describe social isolation-related psychological experiences of cancer patients，in order to provide practicable references for developing relevant nursing support programs. Methods This descriptive qualitative study，involving a semi-structured in-depth interview of 20 cancer patients based on purposive sampling，was conducted from November to December 2021 at a tertiary A tumor hospital in Shanghai. The qualitative content analysis was performed in order to summarize and extract themes from the interview texts. Results The cancer isolation-related psychological experiences of cancer patients were extracted and classified into 3 themes，which should be dealt in a positive and comprehensive way in order to produce a supportive environment for survivors：social withdrawal（distress of cancer-related symptoms，worries regarding health impairment，stigma regarding change of body image and social prejudice，lack of interest in social activities）；hiding of inner feelings （the psychological distress tolerated by oneself，worries about influencing others，failure to communicate with others）；eagerness for support（reliance on family support，feelings of gratefulness for the support of friends，eagerness for seeking professional support）. Conclusion The study found that cancer patients suffered social isolation because of their impaired physical health，poor psychological status and insufficient social support. Medical staff should strengthen the symptom management and psychological counseling provided to these survivors and enhance their family and social support，in order to help cancer survivors return and adapt to society.
Objective To explore the trajectory of oral sucking function of premature infants with gestational age and its relationship with oral feeding progression. Methods From April 2018 to April 2019，we conveniently selected premature infants from a tertiary children’s hospital in Shanghai，and used a self-developed oral sucking evaluation tool to measure the oral sucking function of premature infants when their corrected gestational age was 32~36 weeks. The measurement parameters included average sucking negative pressure peak，average sucking positive pressure peak，average sucking peak interval of negative pressure，average sucking peak interval of positive pressure，average sucking peak interval of positive pressure to negative pressure，number of sucking negative pressure，number of sucking positive pressure. At the same time，the time for premature infants to start and complete oral feeding was recorded，and the correlation between oral sucking function and corrected gestational age at 32 weeks was analyzed. Results A total of 132 premature infants completed the evaluation of oral sucking function and were finally included. The results showed that with the increase of gestational age，the amplitude and number of positive and negative sucking pressure of premature infants increased significantly（P<0.001），and the interval duration decreased significantly（P<0.001）. At the same time，the positive sucking pressure amplitude at the time of correcting the gestational age of 32w was negatively correlated with the gestational age of starting oral feeding（r=-0.217，P=0.040），and the negative sucking pressure duration at the time of correcting the gestational age of 32w was positively correlated with the gestational age of complete oral feeding（r=0.334，P=0.002）. Conclusion The positive sucking pressure and negative sucking pressure of premature infants showed the same trend with the increase of gestational age. The average sucking peak of negative pressure at 32 weeks of gestational age was negatively correlated with the time to start oral feeding，and the average sucking negative pressure peak interval was positively correlated with full oral feeding. Caregivers should pay attention to the peak of positive sucking pressure at the beginning of oral feeding readiness assessment and its effect on sucking frequency when performing oral motor interventions to promote full oral feeding.
Objective To assess the incidence and risk factors of postoperative nausea and vomiting（PONV） in liver cancer patients,and to provide references for clinical nursing intervention. Methods We used consecutive sampling method to select liver cancer patients who underwent liver resection at Zhongshan Hospital of Fudan University from October 2020 to April 2021. A total of 352 patients were prospectively studied. PONV was assessed after 2 hours,6 hours and 24 hours after surgery,respectively. Demographic data,disease information,and surgery information were collected to analyze the risk factors. Results The overall incidence of PONV in liver cancer was 48.30%（170 cases）,of which 58.82%（100 cases） developed within postoperative 2 hours,20.00%（34 cases） developed between 3-6 hours after surgery,and 21.18%（36 cases） developed between 7-24 hours after surgery. Logistic regression identified the female,length of surgery,PONV history or motion sickness history,time of portal vein occlusion≥15 min and age<60 years old as risk factors of PONV. Conclusion The incidence of PONV within 24 hours in liver cancer was high.Nurses should pay much attention to those who were female at a younger age,with longer surgery,PONV or motion sickness history,longer time of portal vein occlusion,and take preventive measures to avoid or reduce PONV.
Objective To explore the application of cognitive interview in the development of patient experience with nursing care scale. Methods According to the conceptual framework of patient experience with nursing care,the scale was developed by interviewing and expert consultations. By purposive sampling method,23 inpatients were selected as interviewees from June to July of 2020 in a tertiary hospital in Shanghai. 3 rounds of cognitive interviews were conducted to explore the respondents’ understanding of each item and their suggestions. The items of the scale were revised according to the results of the interviews and the expert group discussions. After the revision,we used convenient sampling to select 427 inpatients who were admitted to Zhongshan Hospital of Fudan University from May to June 2021 for testing psychometric properties,and the best potential structure of the scale was formed through program analysis and exploratory factor analysis. Results The first round of results showed that 8 items were revised due to "vague and unclear sentence"; the second round of results showed that an item was revised due to "incomprehensible keywords";the third round of results showed that the respondents were able to understand all the items. The final version of the scale includes 7 dimensions,namely,admission and discharge management,information and education,emotional support,observation and treatment,safety and privacy,response needs,communication and coordination,and the cumulative variance contribution rate is 70.785%. The Cronbach’s α coefficient of the scale is 0.945,and the average content validity index is 0.959 with good reliability and validity. Conclusion Cognitive interviews are helpful to the development of patient experience with nursing care scale,which effectively guides the revision of items,and can efficiently solve the problems of understanding differences and measurement errors in the process of scale development,so as to improve the scientificity,accuracy and applicability of the scale.
Objective To translate the Rheumatoid Arthritis Pain Scale（RAPS） into Chinese and to evaluate its reliability and validity. Methods The Chinese version of RAPS was translated,back translated and modified for cultural adaptation according to Brislin translation model. After the content validity was tested by an expert committee,a convenience sample of 236 rheumatoid arthritis patients in a tertiary hospital in Shanghai was investigated using the Chinese version of RAPS to test the reliability and validity of the scale. Results The Chinese version of RAPS includes 24 items,and Cronbach’s α was 0.969. Cronbach’s α coefficient of each dimension was 0.881~0.954.The scale-level content validity index was 0.97,and the item-level content validity index were over 0.80. Factor analysis showed that a total of 3 factors were extracted explaining 73.582% of the total variance,namely physiological,sensory and emotional cognition. Conclusion The Chinese version of RAPS has good reliability and validity,and it can be used to evaluate the pain level of patients with rheumatoid arthritis in Chinese cultural background.
Objective To evaluate and summarize the best evidence for non-pharmacological management of postoperative nausea and vomiting,and to provide evidence for clinical nurses to prevent postoperative nausea and vomiting. Methods We systematically searched for evidence on postoperative nausea and vomiting in databases such as UptoDate,Chinese Biomedical Literature Database,CNKI,Website of Chinese Medical Association Anesthesia Branch,BMJ Best Practice,the Joanna Briggs Institute,Cochrane Library,etc. The retrieved evidence included clinical decision-making,guidelines,systematic reviews,etc. The search time limit is from the establishment of the databases to December 31,2020. There were 2 researchers evaluating the quality of the literature and extracting the data. Results A total of 20 articles were included in this study,including 1 clinical decision,3 guidelines,and 16 systematic reviews. Finally,8 pieces of evidence were summarized from 4 aspects,including risk assessment,routine management,non-pharmacological interventions,and cost-benefit analysis. Conclusion Our research summed the best evidence on the risk assessment and non-pharmacological management of postoperative nausea and vomiting. In the actual clinical application,it is necessary to fully consider the clinical situation,combine the judgment of professionals and the wishes of patients,follow the principle of individualization,analyze the obstacles and facilitating factors of the application of evidence,and apply the evidence to the clinical practice prudently.
Objective To develop a symptom experience measurement scale for liver transplantation recipients and to test its reliability and validity,so as to lay the foundation for effective symptom assessment and management. Methods Guided by the framework of Symptom Experience Model,a systematic scoping review on symptom experience of liver transplantation recipients was conducted and interviews of liver transplantation recipients on their symptoms were carried out. A preliminary comprehensive pool of items was then formed, evaluated and supplemented through expert reviews. Finally,project analysis and exploratory factor analysis were employed to identify the best potential structure of the scale. Results The symptom experience measurement scale of liver transplantation recipients contains 20 items which can be subfactored into 6 dimensions,namely reduced ability of activity,mental dimension, neurological dimension,digestion,sleep,bile duct obstruction. The 6 dimensions can explain 61.619% of total variance. The cronbach’s alpha coefficient was 0.791;split-half reliability coefficient was 0.746;content validity index was 0.917. Conclusion The scale has good reliability and validity,and can be used to evaluate symptom experience of liver transplantation recipients.
Objective To explore the current status and influencing factors of health education literacy of clinical pediatric nurses in China,so as to help clinical managers to formulate targeted training programs and provide references for the improvement of health education literacy of clinical nurses. Methods Pediatric nurses from 31 provinces and cities at all levels in the country were selected as survey subjects by the method of general survey,and a self-made “Pediatric Nurse Health Education Literacy Questionnaire” was distributed to investigate the knowledge,attitude and practice of health education literacy of nurses. The influencing factors of health education literacy were analyzed by multiple linear regression method. Results A total of 15,800 questionnaires were collected,of which 15,765 were valid with an effective recovery rate of 99.78%. 31 provinces,autonomous regions and municipalities nationwide participated in this survey. The knowledge of health education literacy of nationwide pediatric nurses scored（37.80±4.46）;the score of attitude was（31.74±3.60）;the practice scored（77.03±7.76）. Multiple linear regression analysis showed that professional titles,related publications,and the attendance of related trainings were main influencing factors of health education literacy of pediatric nurses（P<0.05）. Conclusion The health education literacy of pediatric clinical nurses in China was at a medium level,which needs to be further improved. Active participation in various forms of training could help nurses form a complete framework of health education and improve the holistic level of health education literacy. Nursing managers should provide effective trainings for nurses based on clinical needs and make joint efforts to improve the health education literacy of pediatric clinical nurses.
Objective To identify types,constitution,distribution of symptom clusters among liver transplantation recipients,and analyze the influencing factors,so as to lay foundation for symptom management. Methods We conducted a cross-sectional study to evaluate 342 liver transplantation recipients’ symptom characteristics using two self-designed questionnaires. We adopted exploratory factor analysis to identify symptom clusters and analyzed the influencing factors by logistic multivariate regression analysis. Results The five most common symptoms of participants were fatigue（38.6%）,decreased memory（34.5%）,easy wakening up（33.5%）,difficulty in falling asleep（31.9%）,and dreaminess（28.1%）. Three symptom clusters were identified,including sleep-related symptom cluster,nervous system symptom cluster,and reduced activity tolerance symptom cluster. Liver cancer as the primary disease,and disease belief were the independent predictive factors of symptom clusters. Conclusion Liver transplantation recipients experienced complicated symptoms,which were mutually enhanced and existed as symptom clusters.Appropriate intervention should view a symptom cluster as an unit and assist patients to form correct recognition towards disease,to help patients involve disease management into individual and family’s normal activities.
