Objective To explore the relationship between health literacy （HL）,empowerment and quality of life （QOL） in disabled elderly and their spouses based on the theory of “dyadic coping”. Methods From December 2020 to June 2021,498 disabled elderly and their spouses in Guangzhou,Zhuhai and Shenzhen of Guangdong province were surveyed by sociological data questionnaire,Katz Index ADL Scale,Health literacy Scale for chronic disease patients,Chinese Elders Health Empowerment Scale and Chinese Short Form-36 Health Survey. Spearman correlation analysis and structural equation model were used to analyze the data. Results The median scores of HL,empowerment and QOL of the disabled elderly were 86.00,30.00 and 391.39,respectively. The median scores of HL,empowerment and QOL of the spouses were 93.00,32.00 and 617.28,respectively. Correlation analysis showed that there were positive correlations between all variables（r=0.156~0.657,P<0.05）,except correlation between spouses’ empowerment and QOL of the disabled elders（P=0.91）. The structural equation model showed that the HL of the disabled elderly could affect the QOL directly or indirectly through empowerment （path coefficients were 0.30 and 0.23,P<0.001）,and the model fitted well（GFI=0.811,AGFI=0.788,RMSEA=0.057）. The HL of the disabled elders and their spouses had a positive interaction（path coefficient was 0.47,P<0.001）. The QOL of the disabled elders was positively correlated with the QOL of their spouses（path coefficient was 0.18,P=0.004）. Conclusion The interaction of HL and QOL between the disabled elders and their spouses suggests that the disabled elders and their spouses should not be considered separately under the pressure of disability,which verifies the rationality of the application of “dyadic coping” theory. The disabled elders and their spouses should be educated and empowered together to improve their QOL.

Objective To retrieve relevant evidence of the postoperative home rehabilitation nursing for elderly patients with hip fracture，and provide evidence for clinical nurses to formulate home rehabilitation nursing pro-grams. Methods The relevant evidence of postoperative home rehabilitation nursing for elderly patients with hip fracture was systematically searched from domestic and foreign databases and websites，including clinical decision-making，guidelines，systematic reviews，expert consensuses and evidence summaries，and the search time limit is from the establishment of the databases to Oct.31，2021. There were 2 researchers who evaluated the quality of various literature and extracted recommendations and research conclusions from the included literature. Results A total of 15 articles were involved，including 3 articles on clinical decision-making，3 guidelines，2 systematic reviews，5 expert consensuses，2 evidence summaries. 27 pieces of the best evidence were formed on suitable population，discharge plan，rehabilitation assessment，rehabilitation expectation，exercise strategy，intensive training，health education and health follow-up. Conclusion The best evidence summary for postoperative home rehabilitation nursing in elderly patients with hip fracture was summarized. When applying the evidence，health care professionals should fully consider the specific clinical setting and formulate individualized rehabilitation nursing plans based on the needs and preferences of patients.

Objective To compare the screening ability of the Timed Up and Go Test (TUG),Berg Balance Scale (BBS),Single Leg Stance (SLS) and Brief-Balance Evaluation Systems Test (Brief-BESTest) for fall risk in people with chronic obstructive pulmonary disease (COPD),and to provide references for clinical selection of appropriate screening tools for balance function. Methods From February 2020 to February 2021,a total of 86 COPD patients hospitalized in the department of respiratory and critical care medicine of a tertiary hospital in Guangdong were selected by convenience sampling method. Their balance abilities were assessed using the TUG,BBS,SLS and Brief-BESTest. Taking 3-month history of falls as the diagnostic standard,the identification ability of the 4 scales for falls was compared by Bayes discriminant analysis and the area under the receiver operating characteristic curve (AUC). Results The cross-validation accuracy of TUG,BBS,SLS and Brief-BESTest were 60.47%,68.60%,51.16% and 72.09%. The Brief-BESTest showed the biggest area under ROC curve (0.818),compared with BBS (0.758),TUG (0.686) and SLS (0.568). At the cutoff score of 14,the Brief-BESTest demonstrated a positive test accuracy of 0.786 with the sensitivity of 0.739,the specificity of 0.825. Conclusion Among the 4 balance function tests,brief-BESTest was the best at screening a history of falls in COPD patients. Brief-BESTest was recommended for clinical staff to assess balance and predict fall risk in patients with COPD.

Objective To explore the effects of pulmonary rehabilitation technique combined with manual hyperinflation on patients with cervical spinal cord injury after tracheotomy. Methods From January 2017 to September 2019,66 patients with cervical spinal cord injury after tracheotomy were enrolled in this study. They were randomly allocated to an experimental group with 33 cases and a control group with 33 cases according to the block random number table generated by SPSS. In the experimental group,manual hyperinflation technique was added on the basis of routine lung rehabilitation nursing care,such as aerosol inhalation,vibration sputum expectoration,and sputum suction after abdominal compression. In the control group,routine lung rehabilitation nursing care was adopted. Before and after the intervention for 4 weeks,vital capacity（FVC）,forced expiratory volume in a second（FEV1）,maximum expiratory volume（PEF） were examined using spirometer and the incidence of atelectasis was calculated in both groups. Results After 4 weeks of interventions,FVC（4.17±0.70） L,FEV₁（3.86±0.94） L,PEF（266.67±36.70） L in the experimental group were significantly higher than these in the control group with FVC（3.06±0.73） L,FEV₁（2.91±0.72） L,PEF（221.73±19.53） L（P<0.05）,and the incidence of pulmonary atelectasis in the experimental group（3.03%）was lower than that in the control group（24.24%）（P<0.05）. Conclusion In patients with cervical spinal cord injury after tracheotomy,the application of manual hyperinflation technique can effectively improve the pulmonary function,increase the lung compliance of patients,reduce the occurrence of atelectasis and pulmonary collapse,and significantly improve the effects of pulmonary rehabilitation.

Objective To evaluate and summarize the best evidence of exercise instructions for breast cancer-related lymphedema,and to provide references for clinical practice. Methods We searched BMJ Best Practice,UpToDate,Cochrane Library,Joanna Briggs Institute（JBI） Library,JBI Clinical Online Network of Evidence for Care and Therapeutics（JBI CONNECT+）,National Institute for Health and Clinical Excellence（NICE）,National Guideline Clearinghouse（NGC）,Guideline International Network（GIN）,Scottish Intercollegiate Guidelines Network（SIGN）,National Comprehensive Cancer Network（NCCN）,Registered Nurses’ Association of Ontario（RNAO）,National Lymphedema Network（NLN）,International Society of Lymphology（ISL）,PubMed,CINAHL,Embase,Web of Science,Physiotherapy Evidence Database,China Guideline Clearinghouse,CNKI,Wanfang Database,CBM and VIP Database to collect guidelines,expert consensuses,evidence summaries and systematic reviews on exercise for patients with breast cancer-related lymphedema. The retrieval period was from the inception of databases to July 2019. 2 researchers with evidence-based nursing background assessed the quality of the literature independently and identified the level of evidence. Results A total of 19 articles were incorporated,including 1 clinical decision,1 clinical practice recommendation,1 evidence summary,5 guidelines,3 expert consensuses,8 systematic reviews. A total of 23 pieces of best evidence including 8 dimensions were summarized,namely contraindication,pre-exercise assessment,pre-exercise test,exercise intensity,safety,exercise program,announcements and health education related exercise. Conclusion Exercise interventions can alleviate symptoms of lymphedema. Clinical staff should consider patients’ opinions and provide personalized exercise programs for patients with breast cancer-related lymphedema according to the clinical situation,in order to further improve effectiveness of the exercise and quality of life of patients.