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Expert consensus on family meeting in palliative care/Palliative Care Committee of Chinese Nursing Association （WritingCommittee：XU Xianghua, CHEN Yongyi, XIAO Yazhou, ZHU Lihui, LIU Xiangyu, LI Xuying, YING Wenjuan, HE Ruixian, YUAN Ling, XIANG Weilan, HU Chengwen, LIU Dongying, CHENG Qinqin, YAN Yixia） Chinese Journal of Nursing    2023, 58 (13): 1541-1543.   DOI: 10.3761/j.issn.0254-1769.2023.13.001 Abstract （1564）   HTML （17）    PDF （1197KB）（75）       Knowledge map    Save Objective To form an expert consensus on family meeting in palliative care and provide references for the staff engaged in palliative care to implement family meeting. Methods A consensus drafting group was set up to systematically search，evaluate and extract evidence related to family meeting in palliative care to form a draft consensus. After 2 rounds of Delphi expert consultation and expert demonstration meetings，expert opinions were sorted out and analyzed，the rough draft was revised，and then the final consensus draft was formed. Results The positive coefficient of the first round of expert consultation was 92.11%，and the second round was 100%. The coefficient of expert judgment was 0.95；the degree of familiarity was 0.89；the degree of authority coefficient was 0.92. The Kendall’s coefficients of the 2 rounds of consultation were 0.157 and 0.253，which were statistically significant（P<0.001）. The final consensus consisted of 8 aspects，including the scope，terms and definitions，basic requirements，timing of family meetings，preparation before meetings，implementation of meetings，records and follow-up，and precaution. Conclusion The consensus is practical，and it can provide guidance for the standardized implementation of family meeting in palliative care. Reference | Related Articles | Metrics

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Expert consensus on prone position nursing for conscious adult patients with acute respiratory distress syndrome Internal Medicine Professional Committee of Chinese Nursing Association, West China Evidence-Based Nursing Center of Sichuan University（Writing Committee：LUO Yunting, CHEN Yanling, WU Xiaoyan, XIE Wenyi, JIANG Yan, FENG Mei, WU Ying, WANG Cong, QIAN Weiqi, LIU Xiangmin） Chinese Journal of Nursing    2023, 58 (15): 1797-1801.   DOI: 10.3761/j.issn.0254-1769.2023.15.001 Abstract （1531）   HTML （12）    PDF （948KB）（90）       Knowledge map    Save Objective To compile an expert consensus on prone position nursing for conscious adult patients with acute respiratory distress syndrom（here in after referred to as the “consensus”），aiming to promote and standardize the implementation of awake prone position in hospitals at different levels. Methods The first draft of the consensus was formed by reviewing existing literature，conducting clinical stakeholder interviews and expert meetings，followed by 2 rounds of expert correspondence，and recommendations were revised based on expert opinions，and the evidence and recommendation levels were scientifically graded. Results After 2 rounds of consultations with 20 experts，the recommendations were finally formed. The effective return rate of the questionnaire was 100%，and the expert authority coefficient was 0.90. In the first round of consultation，the frequency of full marks for necessity is 95%~100%，and the coefficient of variation of recommendation approval degree is 0~0.227. In the second round，the average value of the degree of approval rating has increased，ranging from 4.65 to 5.00，and the frequency of full marks for necessity is 100%，and the coefficient of variation is 0~0.201. The Kendall W coefficients of the 2 rounds of inquiry were 0.136 and 0.168，and the difference was statistically significant（P<0.05）. The consensus includes the formation of multidisciplinary teams，nursing evaluation，implementation key points，monitoring and management，health education，prevention of adverse events，management of special populations on the obesity people，and nursing quality indicators. Conclusion This consensus combines the existing evidence，clinical needs and the recommendations of medical and nursing experts，and it can provide guidance for patients to carry out conscious prone position as early as possible. Table and Figures | Reference | Related Articles | Metrics

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Discussion on the starting time of shoulder and neck rehabilitation exercise in patients after endoscopic thyroid cancer surgery through gasless transaxillary endoscopic thyroidectomy FAN Yuxia, ZENG Dingfen, LI Guihua, JIANG Man, GUO Hui, CHEN Jinfeng, LIU Yiting, ZHOU Yuqiu, WANG Xu Chinese Journal of Nursing    2023, 58 (16): 1925-1931.   DOI: 10.3761/j.issn.0254-1769.2023.16.001 Abstract （1326）   HTML （5）    PDF （1019KB）（24）       Knowledge map    Save Objective To investigate the optimal starting time，safety and effectiveness of shoulder and neck functional rehabilitation exercise for patients undergoing gassless transaxillary endoscopic thyroidectomy（GTET）. Methods 175 patients who underwent GTET were selected by convenient sampling，with 121 patients in 2 test groups（61 patients in the test group 1 and 60 patients in the test group 2） and 54 patients in a control group. The starting time of postoperative shoulder and neck rehabilitation training in the control group，test group 1 and test group 2 were postoperative 7 days，postoperative 48 hours and 2 hours after general anesthesia wakening，respectively. The analysis among 3 groups included the amount of drainage（ml），the retention time of drainage tube （h），the postoperative hospital stay（d），the cases of bleeding，the pain score of incision（neck and armpit） at postoperative day 1 and day 3，the range of shoulder and neck movement and the quality of life. Results There was no statistically significant difference in term of drainage amount，retention time of drainage tube，bleeding cases，hospital stay and pain in neck and incisions at postoperative day 1 and day 3 among the 3 groups（P>0.05）. The motion range of cervical extension，lateral cervical flexion，cervical rotation，shoulder abduction，shoulder adduction，shoulder flexion and shoulder extension among different groups were statistically significant 1 month after surgery（P<0.001）. In term of quality of life（QOL），there were statistically significant differences in aspects of stiffness，pain，numbness of the neck or shoulder，and the impact on leisure and entertainment（P<0.05）. Conclusion Starting shoulder neck rehabilitation exercise 2 hours after awake under anesthesia in patients undergoing GTET would not cause bleeding and affect the comfort，and could safely and effectively improve the early QOL of patients in the early postoperative period. Table and Figures | Reference | Related Articles | Metrics

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Analysis of design type，data integration and common problems of mixed method research in nursing studies HU Yan, JING Feng Chinese Journal of Nursing    2024, 59 (3): 261-266.   DOI: 10.3761/j.issn.0254-1769.2024.03.001 Abstract （1177）   HTML （6）    PDF （7976KB）（118）       Knowledge map    Save The application of mixed method paradigm in nursing research has increased，which enriches the methodological diversity of nursing research，but there are some problems in application，such as mixed logic ambiguity，imprecise research design and weak result integration. This paper mainly analyzed the design type，data integration and common problems of mixed method research in nursing field，so as to promote rigor design and methodology quality of this research paradigm in nursing field. Table and Figures | Reference | Related Articles | Metrics

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Nursing care of a patient with synchronous multiple primary malignant tumor and situs inversus totalis：a case report ZHU Huidi, LI Yan, JIANG Yuehong, LI Beibei, XU Qiaoying, ZHAO Xuehong Chinese Journal of Nursing    2023, 58 (11): 1357-1360.   DOI: 10.3761/j.issn.0254-1769.2023.11.012 Abstract （1169）   HTML （14）    PDF （621KB）（80）       Knowledge map    Save To summarize the nursing experience of a patient with synchronous multiple primary malignant tumors and situs inversus totalis. Key points of nursing：establishing a case nursing group；predicting the surgical risk based on physiology and surgical severity，using individualized multimodal pre-rehabilitation management strategies，doing a good job in risk prevention and control nursing；sorting out the relevant operations on the left and right sides，cultivating the reverse thinking ability of total situs inversus；adequate bowel preparation，reducing gastrointestinal tension；doing a good job in the prevention and nursing of gastrointestinal fistula after surgery；continuing to do a good job in extended nursing after discharge. The patient was discharged 36 days after surgery and followed up for 3 months with good appetite and weight gain. Reference | Related Articles | Metrics

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Expert consensus on management of palliative care wards in Hunan province Hunan Cancer Hospital，Hospice Care Professional Committee of Hunan Nursing Association , （Writing Committee：HUANG Cong, SHEN Boyong, CHEN Yongyi） Chinese Journal of Nursing    2023, 58 (16): 1960-1963.   DOI: 10.3761/j.issn.0254-1769.2023.16.007 Abstract （1143）   HTML （138）    PDF （692KB）（560）       Knowledge map    Save Objective To form an expert consensus on management of palliative care wards （hereinafter referred to as the expert consensus） and to standardize the development，construction，management and other processes of palliative care wards in Hunan Province. Methods According to evidence-based methods，the literature related to the construction and management of hospice care wards was systematically searched in domestic and foreign guide websites or databases，with a search period from the establishment of the databases to January 2021. The relevant recommendation opinions were evaluated，extracted，and summarized to form a consensus draft. Through a round of expert consultations and 2 rounds of expert argumentation meetings，expert opinions were combined to modify and improve the content of each item to form an expert consensus final draft. Results The expert consensus includes 7 aspects，including environmental management，facilities and equipment management，personnel management，process management，infection prevention and control，safety management，quality evaluation and improvement. Conclusion The expert consensus can provide guidance for the standardization and institutionalization of the management of palliative care wards，and plays an active role in promoting the development of palliative care wards in Hunan Province. Table and Figures | Reference | Related Articles | Metrics

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Construction and application of a comprehensive exercise rehabilitation program in elderly patients with cirrhosis and frailty LI Siyu, YUAN Yuan, AN Ran, JI Yonghui, ZHANG Feng Chinese Journal of Nursing    2023, 58 (20): 2437-2445.   DOI: 10.3761/j.issn.0254-1769.2023.20.001 Abstract （1126）   HTML （13）    PDF （1365KB）（50）       Knowledge map    Save Objective This study aims to construct a comprehensive exercise rehabilitation program for elderly patients with cirrhosis and frailty，and to explore its application effect. Methods Through literature research and qualitative research，a comprehensive exercise rehabilitation program was drafted. From November to December 2021，16 experts were consulted，and a comprehensive exercise rehabilitation program for elderly patients with cirrhosis and frailty was formed. From January to June 2022，the convenience sampling was used to select the elderly patients with cirrhosis and frailty in the infection department of a tertiary A hospital in Zhengzhou City as the research subjects. The experimental group was given the comprehensive exercise rehabilitation program on the basis of routine care，while the control group was only given routine care. Liver weakness index，quality of life and adverse events were compared between the 2 groups at 1 and 3 months after the intervention. Results The effective questionnaire recovery rates of the 2 rounds of expert consultations were 85.00% and 94.12%；the expert authority coefficients were 0.823 and 0.833；Kendall harmony coefficients were 0.175 and 0.196（P<0.001）. Finally，the comprehensive exercise rehabilitation program included 2 first-level items and 8 second-level items and 24 third-level items. During the application of this program，10 cases dropped，and 58 cases were finally included in the experimental group and the control group respectively. At 1 month after the intervention，the Liver Frailty Index between the 2 groups were statistically significant（P=0.036）. At 3 months after intervention，there were significant differences in the Liver Frailty Index and Quality of Life between the 2 groups（P<0.05）. No adverse events such as falls and fractures occurred in the 2 groups. Conclusion The comprehensive exercise rehabilitation program constructed in this study is safe and effective for elderly patients with frailty cirrhosis，and it can improve the frailty status and quality of life of elderly patients with cirrhosis. Table and Figures | Reference | Related Articles | Metrics

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Evidence-based practice for the prevention and management of gastrointestinal dysfunction in patients with liver cancer after surgery GUO Xue’e, BIAN Lifang, LI He, LI Chunyan, SHI Xiaolan, LI Yan, CHEN Jiaping, LU Fangyan, ZHANG Huafang Chinese Journal of Nursing    2024, 59 (6): 645-653.   DOI: 10.3761/j.issn.0254-1769.2024.06.001 Abstract （959）   HTML （11）    PDF （1489KB）（43）       Knowledge map    Save Objective To develop an evidence-based practice program for the prevention and management of postoperative gastrointestinal dysfunction in patients with hepatocellular carcinoma，based on the best available evidence，and to evaluate the effectiveness of its application. Methods An evidence-based nursing approach was conducted for systematical search，appraisal and summary of the best evidence for the prevention and management of postoperative gastrointestinal dysfunction in postoperative hepatectomy patients. From September 2022 to October 2022，under the guidance of Knowledge to Action Framework，and in combination with clinical scenarios，the best evidence was screened and adjusted，and an evidence-based practice plan was formulated. From November 2022 to March 2023，the plan was implemented in the Department of Hepatobiliary and Pancreatic Surgery of a tertiary A hospital in Hangzhou City，Zhejiang Province，China. We compared the rate of implementation of the measures by healthcare personnel before and after the application of the evidence，the qualified rate of knowledge of perioperative management of gastrointestinal dysfunction，and the incidence of postoperative gastrointestinal dysfunction in postoperative hepatectomy patients，the first time to flatus and bowel，the length of hospital postoperative stays，the BMI and serum albumin level on discharge. Results After evidence-based practice，the implementation of 11 review indicators and knowledge pass rate increased，and the difference was statistically significant（P<0.05）.The incidence of postoperative gastrointestinal dysfunction in patients decreased from 11.9% to 4.0%（P=0.037）. First time to gas and bowel，and the length of hospital postoperative stays were shortened，and the differences were statistically significant（P<0.05）. Conclusion The implementation of clinical evidence-based practice for the prevention and management of postoperative gastrointestinal dysfunction in postoperative hepatectomy patients provided support for clinical decision-making，improved healthcare professional awareness and implementation of review entries. It effectively reduced the incidence of gastrointestinal dysfunction in postoperative hepatectomy patients and accelerated the recovery process. Table and Figures | Reference | Related Articles | Metrics

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Application of Interaction Model of Client Health Behavior in patients with coronary heart disease after stent implantation LU Yiwei, YANG Weimei, WANG Min, FAN Xuemei, CHENG Jie, LU Lijuan, WANG Zhaozhao, HE Xifei Chinese Journal of Nursing    2023, 58 (14): 1669-1675.   DOI: 10.3761/j.issn.0254-1769.2023.14.001 Abstract （952）   HTML （1）    PDF （961KB）（19）       Knowledge map    Save Objective To explore the effect of nursing interventions based on the Interaction Model of Client Health Behavior（IMCHB） in cardiac rehabilitation of patients with coronary heart disease after stent implantation. Methods The convenience sampling method was adopted to select 40 patients with coronary heart disease after stent implantation in the cardiovascular department of a tertiary A hospital in Wuhan from April to July 2022 as the experimental group，and this group received the cardiac rehabilitation guidance and nursing intervention based on the interactive model of health behavior. A total of 40 patients with coronary heart disease who were hospitalized from December 2021 to March 2022 after stent implantation were selected as the control group，and this group received the routine cardiac rehabilitation guidance and nursing. The 6-minute walking distance，low density lipoprotein levels，medication compliance scores，self-efficacy scores and quality of life scores before and after intervention were compared between the 2 groups. Results A total of 75 patients completed the study， with 38 in the experimental group and 37 in the control group. After the intervention，the 6 minutes walking distance of the experimental group was（526.79±40.70），which was higher than（469.41±55.82） in the control group. The level of low density lipoprotein was（1.49±0.39） in the experimental group，which was lower than （1.77±0.49） in the control group，and the differences were statistically significant（P<0.05）. The score of medication compliance in experimental group was（7.29±0.35） points，which was higher than（6.33±0.37） points in the control group. The score of self-efficacy was（7.04±0.65），which was higher than（5.98±0.74） in the control group. The quality of life score was （64.47±6.25），which was higher than（55.43±5.94） in the control group，and the differences were statistically significant（P<0.001）. Conclusion The cardiac rehabilitation guidance and nursing intervention based on the IMCHB can improve patients’ subjective initiative，so as to improve patients’ medication compliance，improve patients’ sense of self-efficacy and quality of life，promote patients’ cardiac rehabilitation. Table and Figures | Reference | Related Articles | Metrics

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Construction and application of a graded exercise rehabilitation program for patients with acute exacerbation of chronic obstructive pulmonary disease YANG Nana, ZENG Hui, FU Dandan, WANG Yan, CHENG Chuanli, LIU Rong, LUO Luwen Chinese Journal of Nursing    2024, 59 (7): 773-780.   DOI: 10.3761/j.issn.0254-1769.2024.07.001 Abstract （950）   HTML （2）    PDF （1645KB）（19）       Knowledge map    Save Objective To construct and preliminarily apply a graded exercise rehabilitation program for patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD），and to provide a theoretical basis for the scientific implementation of exercise rehabilitation by medical staff. Methods Based on Triangle model and evidence-based method，the first draft of the graded exercise rehabilitation program was constructed，and the items were revised through 2 rounds of expert consultations from March to October，2023. The graded exercise rehabilitation program was preliminarily applied in 10 patients with AECOPD. Results The effective recovery rates of the 2 rounds of expert consultation questionnaires were 100%；the expert authority coefficients were 0.857 and 0.863；the coefficients of variation were 0-0.285 and 0.052-0.244；the Kendall’s harmony coefficients were 0.167 and 0.145，respectively（all P<0.001）. The final plan includes 4 first-level indicators，13 second-level indicators，and 25 third-level indicators. The scores of 6 min walking test，mMRC and CAT after exercise were improved compared with those before exercise，and the differences were statistically significant（all P<0.05）. Conclusion The graded exercise rehabilitation program for patients with AECOPD constructed in this study has good scientificity and practicability，which can provide references for clinical implementation of exercise rehabilitation. Table and Figures | Reference | Related Articles | Metrics

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Writing essentials and common issues in randomized controlled trials on nursing HU Rong, WANG Chunfeng Chinese Journal of Nursing    2024, 59 (3): 271-275.   DOI: 10.3761/j.issn.0254-1769.2024.03.003 Abstract （946）   HTML （8）    PDF （5646KB）（96）       Knowledge map    Save Randomized controlled trial（RCT） is the most rigorous scientific method of evaluating interventions and validating new techniques in nursing. Scientific research papers are not only the carrier of scientific knowledge dissemination，but also an important way of academic thoughts exchange. However，the quality of published randomized controlled studies in nursing research is uneven，and the paper writing are not standard. Based on existing literature review，CONSORT statements，and experience in writing and reviewing papers，the authors expound on the overall structure of RCTs and the essentials of each section，and summarize the common issues，to provide references for researchers to standardize the writing of RCTs in nursing. Reference | Related Articles | Metrics

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Differences between fall risk and fall risk perception among hospitalized elderly patients YANG Xin, YAO Meiqi, ZHANG Yuping, SHEN Xuhui, BAO Guanjun, BI Yan, GUO Zhiting, CHEN Haotian Chinese Journal of Nursing    2023, 58 (19): 2326-2332.   DOI: 10.3761/j.issn.0254-1769.2023.019.003 Abstract （920）   HTML （9）    PDF （964KB）（49）       Knowledge map    Save Objective The differences between fall risk and risk perception of hospitalized elderly patients were analyzed to provide references for improving fall assessment strategies，improving the accuracy of fall perception of hospitalized elderly patients，and accurately preventing falls. Methods A total of 468 hospitalized elderly patients in Zhejiang province were recruited from December 2022 to February 2023. The general information questionnaire，the Fall Risk Perception Scale for Older Adults and Morse Fall Scale were used to investigate the difference between fall risk and risk perception. Results In this group，the fall risk was 45.0（30.0，55.0），showing a high level，and the fall risk perception was 62.5（47.3，75.0），showing a medium level. There was no significant difference in the risk perception scores of hospitalized elderly patients with different risk levels（H=4.048，P>0.05）. There were 169 cases（67.6%） of under-perception in the high-risk group，38 cases（32.8%） of under-perception in the middle risk group，35 cases（30.2%） of over-perception in the middle risk group，and 66 cases（64.7%） of over-perception in the low risk group. The factors affecting fall risk and risk perception are basically similar. Univariate analysis showed that age，smoking，drinking，vision，activity pattern，sleep，medical payment and fall history in the last 3 months were influencing factors of fall risk in hospitalized elderly patients（P<0.05），and age，education level，drinking，sleep and fall history in the last 3 months were influencing factors of fall risk perception in hospitalized elderly patients（P<0.05）. The main difference was that education was related to risk perception，but not to fall risk. Conclusion Elderly hospitalized patients have a higher risk of falling，and there are problems of fall perception bias. It is suggested that in the prevention of falls，it is not only necessary to evaluate the fall risk of elderly hospitalized patients，but also to evaluate the perception of their own risk，so as to achieve individualized and precise protection. Table and Figures | Reference | Related Articles | Metrics

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Writing and quality evaluation of qualitative research papers in nursing LIU Jun’e, WANG Ying, SUN Liu Chinese Journal of Nursing    2024, 59 (3): 276-280.   DOI: 10.3761/j.issn.0254-1769.2024.03.004 Abstract （843）   HTML （6）    PDF （5235KB）（94）       Knowledge map    Save Qualitative research has made important contributions to nursing practice and theory construction. Based on the authors’ rich experiences in conducting and teaching qualitative studies，this paper proposed some suggestions on the use of qualitative research，writing and quality evaluation of qualitative research papers. It aims to deepen the understanding of nursing researchers to qualitative research，so as to improve the quality of qualitative research in nursing papers. Table and Figures | Reference | Related Articles | Metrics

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Construction of a practical program for interhospital transfer of critically ill children WANG Beibei, GU Ying, HU Jing, LU Guoping, CHENG Ye, SHEN Weijie, CHEN Weiming, LI Yang Chinese Journal of Nursing    2023, 58 (22): 2693-2701.   DOI: 10.3761/j.issn.0254-1769.2023.22.001 Abstract （830）   HTML （3）    PDF （1605KB）（21）       Knowledge map    Save Objective To develop an evidence-based，localized practice protocol for the interhospital transfer of critically ill children. Methods Through a comprehensive evidence summary and semi-structured interviews，a preliminary inter-hospital transfer practice protocol for critically ill children was formulated. A panel of 31 experts from 12 hospitals in China participated in 2 rounds of expert correspondence between May and July 2022，facilitating meticulous revision of the protocol entries. Results The response rate for both rounds of questionnaires was 100%，and the expert authority coefficients ranged from 0.926 to 0.931. In the second round of consultation，the coefficient of variation for the importance score of each entry ranged from 0.036 to 0.226，and the Kendall’s W was determined to be 0.201（P<0.001）. Additionally，the coefficient of variation for the feasibility score of each entry fell within the range of 0.070 to 0.314，with Kendall’s W of 0.124（P<0.001）. Ultimately，the final interhospital transfer protocol for critically ill children comprised 8 level Ⅰ entries，16 level Ⅱ entries，and 75 level Ⅲ entries. Conclusion The interhospital transfer protocol constructed in this study is grounded in scientific evidence and exhibits practical feasibility. It serves as a valuable reference for organizing and implementing interhospital transfers of critically ill children. Table and Figures | Reference | Related Articles | Metrics

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Application and progress of knowledge graphs in dietary management of patients with chronic diseases YAN Yu, GONG Shu, DUAN Difei, MA Dengyan Chinese Journal of Nursing    2024, 59 (6): 753-757.   DOI: 10.3761/j.issn.0254-1769.2024.06.016 Abstract （810）   HTML （9）    PDF （729KB）（60）       Knowledge map    Save Diet is an important modifiable factor affecting the onset，progression and prognosis of chronic diseases. However，the complexity and long-term nature of diet management of chronic diseases usually brings great challenges to patients. Knowledge graph uses semantic technology to standardize the representation，extraction，fusion and reasoning of massive knowledge，so that it has the characteristics of knowledge visualization and reasoning support. It helps users to obtain relevant knowledge conveniently，quickly and accurately，and provides a new idea and method for diet management of patients with chronic diseases. This study aims to comprehensively review the relevant literature at home and abroad，elaborate on the concept，development and application of knowledge graph in diet management of patients with chronic diseases，and put forward prospects，in order to provide references for the diet management of patients with chronic diseases. Reference | Related Articles | Metrics

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Construction and application of a prevention programme for central venous catheter-related thrombosis in critically ill children ZHAO Xiaoshuang, ZHANG Dan, GUAN Ruixin, ZHANG Baorong, SUN Hairui, WU Hanshu, XING Weijie Chinese Journal of Nursing    2023, 58 (10): 1157-1165.   DOI: 10.3761/j.issn.0254-1769.2023.10.001 Abstract （799）   HTML （1）    PDF （1285KB）（36）       Knowledge map    Save Objective To construct a prevention programme of central venous catheter-related thrombosis （CRT） in critically ill children，and to evaluate its clinical effects. Methods Based on the theory of “structure-process-result” quality evaluation model，literature research and evidence summary，2 rounds of expert consultations were conducted to construct a CRT prevention programme for critically ill children from August to September 2021. The critically ill children who received central venous catheterization in the pediatric intensive care unit（PICU） of a tertiary hospital in Jilin Province from January to March 2022 were selected as an experimental group by convenience sampling，those who received central venous catheterization from October to December 2021 as a control group. The experimental group was given the CRT prevention programme，while the control group was given routine precautions. The implementation rate of precautions，incidence of CRT，incidence of adverse events and hospitalization time in PICU were compared between 2 groups. Results The effective recovery rates of 2 rounds of expert consultations were 100%，and the authority coefficient were 0.85，0.90. In the second round，the coefficient of variation of importance score of each item was 0-0.144，and the Kendall’s harmony coefficient was 0.359（P<0.001）；the coefficient of variation of the feasibility score was 0-0.141，and the Kendall’s harmony coefficient was 0.513（P<0.001）. Finally，the CRT prevention programme for critically ill children included 3 first-level items，10 second-level items and 24 third-level items. The application results showed that the utilization rate of deep venous thrombosis risk assessment tool，timing of risk assessment，rate of jugular vein catheterization and the compliance rate of drug prevention in the experimental group were higher than those in the control group，and the incidence of CRT and hospitalization time in PICU were lower than those in the control group（P<0.05）. Conclusion The CRT prevention programme constructed in this study is scientific and practical. The implemented the programme can improve the implementation rate of precautions，decrease the incidence of CRT in critically ill children and shorten the hospitalization time. Table and Figures | Reference | Related Articles | Metrics

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Application progress of stepped care model in chronic disease health management WANG Dan, WANG Jiajia, WANG Qian, ZHANG Zhenxiang, WANG Wenna Chinese Journal of Nursing    2023, 58 (16): 2034-2038.   DOI: 10.3761/j.issn.0254-1769.2023.16.019 Abstract （785）   HTML （5）    PDF （644KB）（16）       Knowledge map    Save As a new health care service model，the stepped care model can adjust the intervention strategies in time according to the treatment effect，improve the resource allocation and expand the scope of care services on the one hand，and give personalized care support according to the treatment effect on the other hand，which has the advantages of low cost and high efficiency. In order to provide references for chronic disease prevention and treatment，this article introduces the origin and development，core elements，application and application dilemma of the stepped care model in chronic disease health management. Table and Figures | Reference | Related Articles | Metrics

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Application of nurse-led discharge preparation in perioperative lung transplant patients GAO Chunhua, LIN Yan, YU Chao, REN Yayu, CHU Junqing, ZHANG Shuai, DONG Zhenyuan, ZHOU Li Chinese Journal of Nursing    2023, 58 (18): 2181-2188.   DOI: 10.3761/j.issn.0254-1769.2023.18.001 Abstract （766）   HTML （2）    PDF （1247KB）（45）       Knowledge map    Save Objective To investigate the effect of specialty nurse-led discharge preparation in the perioperative period of lung transplantation patients. Methods Based on the transition theory，literature analysis and expert meetings，the hospital discharge preparation service plan for lung transplant patients was established. We selected 33 lung transplant patients in a tertiary hospital in Zhejiang Province for this study based on convenience sampling，and they were divided into an experimental group and a control group by random number method. The experimental group received the discharge preparation service program led by specialty nurses，and the control group received routine perioperative management of lung transplantation. Data from admission to 3 months after discharge were collected. Between the 2 groups，they were compared on readiness for hospital discharge，reintubation，readmission，and part 2 of Partners at Care Transitions Measure（PACT-M2）. Results A statistically significant difference was found in the scores for readiness for hospital discharge，reintubation rate，and Chinese version PACT-M2（P<0.05）. There was no significant difference in the number of readmissions 1 month and 3 months after discharge between the 2 groups（P>0.05）. Conclusion Specialized nurse-led discharge preparation services for lung transplant patients can improve their readiness for discharge and enhance the quality of self-care at home. Table and Figures | Reference | Related Articles | Metrics

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Evidence-based practice for the prevention and care of ocular complications in ICU patients WANG Lizhu, CHEN Yuaner, LI Qian, HU Yaling, LU Haifei, XIANG Yan, WANG Ziwei, QI Xuefeng Chinese Journal of Nursing    2024, 59 (7): 781-788.   DOI: 10.3761/j.issn.0254-1769.2024.07.002 Abstract （738）   HTML （0）    PDF （1465KB）（15）       Knowledge map    Save Objective To develop an evidence-based practice program for ICU eye care and evaluate its application effect using Stetler model of research utilization. Methods The systematic search was carried out in domestic and foreign guidelines，systematic reviews，evidence summaries，expert consensuses on eye care for ICU patients. The quality of the included literature was evaluated and the evidence was summarized. The evidence based on expert advice，clinical context and stakeholder opinions was screened. According to Stetler model of research utilization，the evidence translation/application was formulated from 3 aspects，including method，level and type of evidence application，and the evidence translation was implemented using a stepwise trial design. Five ICUs in a tertiary hospital in Zhejiang Province were selected，and the order of enrollment of each ICU was determined by computer-generated random numbers from April to september，2022. In the first month，all ICUs were in pre-evidence-based practice period，and in the second month，an ICU was trained and entered the evidence-based practice period. Until the 6th month，all ICUs entered the evidence-based practice period. Then the rate of ocular symptoms and implementation rate of eye care measures were compared before and after EBP. Results A total of 1 540 patients were included. With regard to the implementation rate of eye care measures，the rate of lubricant use and suspected ocular infection management in patients at high risk for ocular complications in evidence-based practice period was significantly higher compared with pre-evidence-based practice period（P<0.001），and no statistically significant difference was found in the rate of eyelid closure. The incidence of conjunctival exposure，subconjunctival hemorrhage，conjunctival congestion，and ocular discharge in non-neurology critical care patients decreased compared with pre-evidence-based practice period（P<0.05），and the incidence of conjunctival edema and conjunctival congestion in NICU patients decreased compared with pre-evidence-based practice period as the intervention continued（P<0.001）. Conclusion Evidence-based practice in eye care for ICU patients using Stetler model of research utilization can standardize the practice of eye care for ICU patients and improve the quality of care. Table and Figures | Reference | Related Articles | Metrics

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Construction and preliminary application of a lifestyle decision support system for population with high-normal blood pressure MU Tingyu, XU Rixiang, ZHU Qianyin, CHEN Lingshan, HUANG Junping, LI Zhimin, SHEN Cuizhen Chinese Journal of Nursing    2024, 59 (6): 654-661.   DOI: 10.3761/j.issn.0254-1769.2024.06.002 Abstract （738）   HTML （11）    PDF （1227KB）（61）       Knowledge map    Save Objective To construct a lifestyle decision support system for people with high normal blood pressure，and assess its effectiveness and usability in lifestyle management for people with high normal blood pressure. Methods A system development team was established to build an evidence-based lifestyle decision support system for people with high normal blood pressure. The system consists of a mobile application and a desktop management system. The mobile application includes the health assessment，decision results（including data overview/traditional Chinese medicine health care/nutritional recipes/energizing exercises/spiritual space），and data recording. The desktop management system includes user management and data supplementation，decision management，and data analysis. 20 patients with high normal blood pressure were recruited from September 19， 2022 to November 14，2022 at the Hangzhou Community Health Service Center for the initial application of the system. Results After using lifestyle decision support system，the population with high-normal blood pressure revealed statistically significant differences（P<0.05） in systolic blood pressure，moderate physical activity time per week，stress，anxiety，depression，self-management ability，and halophilic behavior. The majority of the high-normal blood pressure population（14 cases） and community healthcare workers（5 cases） rated the usability of lifestyle decision support system as Good. Conclusion The lifestyle decision support system constructed in this study is scientific and feasible，and can provide professional lifestyle guidance for individuals with high-normal blood pressure. The lifestyle decision support system plays a positive role in improving the unhealthy lifestyle of people with high-normal blood pressure，and provides an auxiliary decision-making system for people with high-normal blood pressure and community healthcare workers. Table and Figures | Reference | Related Articles | Metrics

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Intervention study of lung cancer patients undergoing postoperative chemotherapy based on sentinel symptoms MA Jingshuang, WANG Aiping, WANG Yanjie, LI Wei, LIU Yanxia Chinese Journal of Nursing    2024, 59 (2): 133-141.   DOI: 10.3761/j.issn.0254-1769.2024.02.001 Abstract （714）   HTML （1）    PDF （1430KB）（36）       Knowledge map    Save Objective Based on sentinel symptoms，a nursing intervention program for gastrointestinal symptom group of postoperative chemotherapy for lung cancer was constructed and its application effect was evaluated. Methods The nursing intervention program of gastrointestinal symptom group was constructed on the basis of reference guidelines，qualitative interview and expert consultation. From January 2021 to January 2022，a total of 330 patients with postoperative chemotherapy for lung cancer in a tertiary hospital in Shenyang were selected as research subjects. The experimental group received the gastrointestinal symptoms group nursing intervention program on the basis of routine nursing，and the control group received routine care. Patients were investigated with the M.D. Anderson Symptom Inventory and the MOS 36-Item Short-Form Health Survey before 1st chemotherapy（T1），3rd chemotherapy（T2） and 5th chemotherapy（T3）. Results After the intervention，the total scores of the 2 groups and the total scores of each symptom in T2 and T3 were statistically significant（P<0.05），and the score of the experimental group was lower than that of the control group. For the scores of 6 dimensions of physiological function，physical pain，overall health，vitality，emotional function，mental health in 2 groups between different time points，the differences are statistically significant（P<0.05）. Conclusion The nursing intervention program of the gastrointestinal symptom group based on sentinel symptoms is beneficial to reduce the severity of the gastrointestinal symptom group and improve the quality of life for postoperative chemotherapy for lung cancer patients. Table and Figures | Reference | Related Articles | Metrics

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Study on the theoretical framework of health behavior changes in first-degree relatives of breast cancer survivors CHEN Shaohua, LIU Jun’e, GUO Dongmei, SU Yali, LIU Yu Chinese Journal of Nursing    2023, 58 (16): 1932-1939.   DOI: 10.3761/j.issn.0254-1769.2023.16.002 Abstract （706）   HTML （2）    PDF （1139KB）（17）       Knowledge map    Save Objective To explore the health behavior changes in first-degree relatives（FDRs） of breast cancer（BC） survivors. Methods A multiple embedded case study was adopted，and a total of 21 FDRs of BC survivors were recruited by purpose sampling between January 2020 and July 2021. Data were collected through individual interviews，original documents，and observation. Then，thematic analysis was performed based on case study analysis strategies. Results Health behavior change types included “with intention and condition”，“no intention，with condition”，“with intention，no condition”，and “no intention and condition”. Meanwhile，there were 6 influencing factors，including personal restrictions，exposure，adverse circumstances，coping ability，endorsement from social network，and special events. Based on behavior change types and influence factors，6 hypotheses were drawn and a model of FDRs’ behavior changes for coping with BC risk was developed. Conclusion Healthcare professionals should design targeted interventions based on FDRs’ individual circumstances and help them tilt the model scale to the right by increasing facilitators，reducing barriers，strengthening special events，and improving coping ability，which will ultimately lead to the occurrence of protective behaviors and a reduced risk of BC. Table and Figures | Reference | Related Articles | Metrics

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Application of self-monitoring of blood glucose information management platform based on medical consortium in community patients with type 2 diabetes WU Quanying, GUO Lixin, SUN Chao, PAN Qi, ZHOU Qi, YU Shuyi Chinese Journal of Nursing    2023, 58 (24): 2949-2956.   DOI: 10.3761/j.issn.0254-1769.2023.24.001 Abstract （682）   HTML （0）    PDF （1367KB）（25）       Knowledge map    Save Objective To study the effect of self-monitoring of blood glucose information management platform based on the medical consortium on the level of blood glucose control by improving the implementation rate of self-monitoring of blood glucose prescriptions for type 2 diabetes patients in the community. Methods A convenient sampling method was used to select 121 patients with type 2 diabetes from April 2021 to April 2023 who were enrolled in a community of a tertiary hospital medical consortium in Beijing. They were randomly divided into 61 patients in an experimental group and 60 patients in a control group. The control group received routine blood glucose monitoring and guidance education，while the experimental group was managed by a self-monitoring of blood glucose information management platform based on the medical consortium with nurses as the main body. Glycated hemoglobin，glucose test，fasting blood sugar，blood glucose 2 hours after meal，and the completion of self blood glucose monitoring prescriptions were evaluated and analyzed in the first week and the twelfth week of the 2 groups. Results 61 cases in the experimental group and 58 cases in the control group completed the follow-up，and the patients who completed the follow-up were analyzed. There was no statistically significant difference in glycated hemoglobin between the 2 groups at baseline（P=0.117）. After 12 weeks，the reduction standard-reaching rate in glycated hemoglobin in the experimental group was significantly different from that in the control group（P=0.014）. The number of self-monitoring of fasting blood glucose and the total number of other time periods in experimental group were significantly higher than those in the control group（P<0.001）；the implementation rate of self-monitoring prescription in the experimental group was better than that in the control group（P<0.001）. Conclusion A self blood glucose monitoring information platform was built to manage community type 2 diabetes patients，so that patients can master and implement the personalized blood glucose monitoring prescription formulated by the medical union team with nurses as the main body，and it is conducive to improving the frequency of blood glucose monitoring and the level of blood glucose control of diabetes patients. Table and Figures | Reference | Related Articles | Metrics

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Effects of multi-component exercise nursing intervention on frailty in elderly patients with chronic heart failure LIANG Qian, WANG Xiaoli, LIU Mengqi, WANG Jiurui, LUAN Xiaorong Chinese Journal of Nursing    2023, 58 (23): 2821-2828.   DOI: 10.3761/j.issn.0254-1769.2023.23.001 Abstract （680）   HTML （4）    PDF （1199KB）（57）       Knowledge map    Save Objective To investigate the effects of a multi-component exercise nursing intervention on frailty，activities of daily living and quality of life in elderly patients with chronic heart failure. Methods Through literature analysis and expert meeting，the multi-component exercise nursing intervention program was formed. A total of 71 elderly patients with chronic heart failure who admitted from January 2022 to September 2022 in a tertiary A hospital in Shandong Province were randomly divided into an intervention group（35 cases） and a control group（36 cases）. The control group received usual care，while the intervention group received an additional multi-component exercise nursing training. 2 groups were evaluated by Tilburg frailty indicator scale，modified Barthel index scale and 12-item short form health survey scale before the intervention，4 weeks and 12 weeks after the intervention. Results A total of 62 patients（31 in the experimental group and 31 in the control group） completed the study. Generalized estimation equation results showed that the inter-group effect，time effect and interaction effect of frailty，activities of daily living and quality of life in the 2 groups were statistically significant（P<0.05）. At 4 weeks and 12 weeks after the intervention，the Tilburg Frailty Indicator scale scores in the intervention group were lower than that in the control group（P<0.05），and the scores of the modified Barthel index scale and 12-item short form health survey scale were significantly higher than those in the control group（P<0.05）. Conclusion The multi-component exercise nursing intervention can effectively improve frailty，activities of daily living and quality of life in elderly patients with chronic heart failure. Table and Figures | Reference | Related Articles | Metrics

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Integrative nursing experience of a case with chronic refractory wound formation caused by drug extravasation ZHANG Yuanyuan, LONG Xiuhong, LÜ Chan, LI Xian, WANG Yi, HUANG Lanying, TU Huiqiong, QIN Huijuan Chinese Journal of Nursing    2024, 59 (7): 808-811.   DOI: 10.3761/j.issn.0254-1769.2024.07.006 Abstract （674）   HTML （6）    PDF （774KB）（39）       Knowledge map    Save To sum up integrative nursing experience of a case with chronic refractory wound formation caused by drug extravasation. The essentials of integrative nursing are：structured nursing intervention of “assessment-management-treatment” based on the Triangle of Wound Assessment；determination of the timing for integrative nursing according to the theory of TCM sores and ulcers；implementation of copper board scraping method to promote circulation of qi and blood；use of Huo-long Comprehensive Moxibustion Therapy to promote muscle regeneration. With the help of the cooperation of the multidisciplinary specialist nursing team，the wound was completely healed after 59 days of integrated traditional Chinese and Western medicine nursing interventions. Reference | Related Articles | Metrics

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The historical and cultural confidence of nursing profession from the development history of Chinese nursing SHI Ruifen, ZHOU Jin, JIANG Xiaoying Chinese Journal of Nursing    2023, 58 (16): 1940-1944.   DOI: 10.3761/j.issn.0254-1769.2023.16.003 Abstract （662）   HTML （1）    PDF （1813KB）（34）       Knowledge map    Save Objective The article is to strengthen the nurses’ understanding of Chinese nursing history，enhance the historical consciousness and cultural confidence of the nursing profession，and motivate the sense of professional identity and historical honor in nursing. Methods Based on the research of traditional Chinese culture and the development history of nursing at home and abroad，the original historical materials of modern Chinese nursing were studied，and the historical，cultural genes of nursing profession were traced and analyzed. Results Chinese nursing started with the introduction of Western medicine，and developed and boomed in the Chinese national culture. It not only has the Nightingale spirit as the cornerstone，but also has a profound cultural heritage of the Chinese nation，and at the same time，it has modern times’ spirit of innovation. Conclusion The historical and cultural genes of nursing profession provide much enough for Chinese nurses to build professional self-confidence. Table and Figures | Reference | Related Articles | Metrics

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Construction and application of standardized process for regional transport of mobile extracorporeal membrane oxygenation patients led by nurses LI Lian, WANG Jinning, CHEN Chenkan, JIN Jiajia, PAN Xiangying Chinese Journal of Nursing    2023, 58 (17): 2053-2058.   DOI: 10.3761/j.issn.0254-1769.2023.17.001 Abstract （641）   HTML （6）    PDF （928KB）（14）       Knowledge map    Save Objective A nurse-led standardized process for regional transport of mobile extracorporeal membrane oxygenation（ECMO） patients was constructed and applied，and its application effect was analyzed. Methods Based on the opinions of extracorporeal life support organization ECMO transport guidelines，a nurse-led standardized process for the regional transport of mobile ECMO patients was constructed through literature search，expert consultation and exercise testing. A convenient sampling method was used to continuously select 82 patients who applied mobile ECMO out-of-hospital treatment in the general care unit of a tertiary hospital in Zhejiang Province from August 2020 to July 2022 as the study subjects，including 47 cases admitted in August 2021 to July 2022 as the experimental group，and 35 cases admitted from August 2020 to July 2021 as the control group. The experimental group was implemented by a nurse-led standardized transport process for mobile ECMO patients，and the control group was implemented by a routine mobile ECMO patient transport process，and the differences in material preparation time，departure time of personnel，time from towel laying to transferring，and transport adverse event rate were compared between the 2 groups. Results There were no significant differences in gender，age，and disease type between the 2 groups. Compared with the control group，the material preparation time（10.09±2.96）minutes, the departure time of personnel arrival （12.74±4.61） minutes and the time from towel laying to transferring（31.40±6.44） minutes were significantly shortened, and the incidence of adverse events in the experimental group decreased significantly. The differences were statistically significant（P<0.05）. Conclusion The application of the nurse-led standardized process for regional transport of mobile ECMO patients can shorten the time related to transport and reduce the incidence of adverse events during transport，and the nurse-led transport can improve its efficiency and reduce the transport risk of ECMO patients. Table and Figures | Reference | Related Articles | Metrics

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Study on the construction of a nurse-led pulmonary rehabilitation management program and its application to ventilator-dependent patients in ICU HE Bin, YANG Zheng, MO Beirong, HE Guilan Chinese Journal of Nursing    2023, 58 (15): 1802-1807.   DOI: 10.3761/j.issn.0254-1769.2023.15.002 Abstract （636）   HTML （1）    PDF （1346KB）（33）       Knowledge map    Save Objective To establish a nurse-led pulmonary rehabilitation management program，and to explore its effects on the weaning time，lung function and activity function of ventilator-dependent patients in ICU. Methods By setting up a multidisciplinary pulmonary rehabilitation team and formulating the responsibilities of the nursing assistant，the nurse-led pulmonary rehabilitation management program was established，including the starting standard and weaning standard of pulmonary rehabilitation，respiratory target training，movement target training，target analgesia and sedation. By convenience sampling method，30 ventilators dependent patients admitted to ICU from June 2021 to October 2022 were selected as the experimental group，and 30 ventilators dependent patients admitted from June 2019 to May 2021 were selected as the control group. The experimental group received a nurse-led pulmonary rehabilitation management program on the basis of routine nursing. The control group was given routine airway care and early rehabilitation training. The differences of success rate，weaning time，ICU stay，oxygenation index，6-min walking distance and scores of ICU activity scale were compared between the 2 groups. Results The ICU stay time and weaning time of the experimental group were shorter than those of the control group；the scores of the ICU activity scale and the 6-min walking distance of the patients were better than those of the control group（P<0.05）. There was no significant difference in weaning success rate and oxygenation index between the 2 groups （P>0.05）. Conclusion The nurse-led pulmonary rehabilitation management program can effectively shorten the withdrawal process of ventilator-dependent patients，improve lung function and activity function，and provide guidance for clinical nursing practice. Table and Figures | Reference | Related Articles | Metrics

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The key points of quality criteria for expert consensus papers in nursing WANG Zhiwen, HAN Shuyu Chinese Journal of Nursing    2024, 59 (3): 267-270.   DOI: 10.3761/j.issn.0254-1769.2024.03.002 Abstract （629）   HTML （2）    PDF （5313KB）（57）       Knowledge map    Save The number of expert consensus publications has been increasing year by year as an industry guidance document. However，due to the lack of unified reporting guidelines and methodological standards，the current published expert consensuses in nursing exhibit inconsistent writing formats and varying quality. This article combines the quality evaluation points for expert opinions from the Jonna Briggs Institute in Australia，focusing on 6 aspects，covering the authority of the expert team，clarity of viewpoint expression，adequacy of evidence-based foundation，standardization of the consensus-reaching process，taking into account of interests of relevant research populations，and the potential for application in specific clinical settings. These points are introduced as review criteria for expert consensus papers，aiming to provide references for improving the quality and standardization of expert consensus papers in the future. Table and Figures | Reference | Related Articles | Metrics

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Analysis of the current status of puerperal fatigue in women at advanced maternal age and its influencing factors WANG Jingyi, LI Yizhang, MA Bin, WANG Jingjing, ZHANG Zeyi, CHEN Ou Chinese Journal of Nursing    2023, 58 (11): 1292-1297.   DOI: 10.3761/j.issn.0254-1769.2023.11.002 Abstract （619）   HTML （1）    PDF （964KB）（17）       Knowledge map    Save Objective To evaluate the puerperal fatigue status of women at advanced maternal age and to explore its influencing factors. Methods This study included 210 women at advanced maternal age who were reviewed on 42 days postpartum at 4 hospitals in Jinan from December 2019 to October 2020，and clinical data was collected by the General Information Questionnaire，Fatigue Scale，Pittsburgh Sleep Quality Index，Anxiety Self-Rating Scale，Edinburgh Postpartum Depression Scale，and Social Support Rating Scale. Univariate analysis and multiple linear regression were used to analyze the factors influencing the occurrence of puerperal fatigue in women at advanced maternal age. Results The fatigue score during the puerperium for women at advanced maternal age was（6.84±3.11），and the prevalence of fatigue was 94.61%. Multiple linear regression analysis revealed that pregnancy and childbirth history，delivery mode，anxiety，depression，sleep quality，and social support were the main factors influencing their level of fatigue（P<0.05）. Conclusion The puerperal fatigue level of women at advanced maternal age is at a high level. Healthcare workers should pay more attention to the assessment of fatigue levels during the puerperium and provide accurate and individualized postpartum psychological and physiological care. Table and Figures | Reference | Related Articles | Metrics

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Weaning nursing of a patient with extracorporeal membrane oxygenation after aortic dissection complicated with cardiogenic shock WANG Yan, WANG Zheyun, ZHAO Weiwei, YU Yun, ZHANG Chi, KANG Yubei Chinese Journal of Nursing    2023, 58 (16): 1996-1999.   DOI: 10.3761/j.issn.0254-1769.2023.16.013 Abstract （611）   HTML （0）    PDF （603KB）（28）       Knowledge map    Save To summarize the weaning nursing practice of a patient with postoperative cardiogenic shock complicated by acute type A aortic dissection receiving veno-arterial extracorporeal membrane oxygenation. The key points of nursing were as follows：the interprofessional team cooperation model was adopted，and the extracorporeal membrane oxygenation special class team was established；a goal-oriented extracorporeal membrane oxygenation management plan was formulated and individualized pre-weaning nursing was implemented. The evaluation and preparation before weaning should be improved，and the cooperation during weaning and the observation after weaning should be strengthened. After careful treatment and nursing，extracorporeal membrane oxygenation was successfully removed on the 7th day after operation，and the patient recovered and was discharged on the 10th day after surgery，and the follow-up was in good condition. Reference | Related Articles | Metrics

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Nursing care of a patient with severe toxic epidermal necrolysis complicated by acute respiratory distress syndrome ZHAO Ling, LIU Ying, JIANG Qi, CAI Li Chinese Journal of Nursing    2023, 58 (13): 1629-1634.   DOI: 10.3761/j.issn.0254-1769.2023.13.015 Abstract （608）   HTML （3）    PDF （912KB）（33）       Knowledge map    Save The nursing care of a patient with severe toxic epidermal necrolysis complicated by acute respiratory distress syndrome was summarized. Key points of care：personalized sedation and analgesia，management of prone ventilation，extracorporeal membrane oxygenation combined with continuous renal replacement therapy，protection of damaged mucosa，refined skin management，prevention and control of infection，etc. The patient was transferred out of the department after 10 days，and after 5 months of regular follow-up，the patient recovered well. Reference | Related Articles | Metrics

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Evidence-based practice of target temperature management in patients with traumatic brain injury MENG Xiaojing, LI Xiang, FENG Yingpu, FAN Jingli, HUO Xiaoran, ZHANG Chunxia, ZHOU Limin, GAO Min Chinese Journal of Nursing    2023, 58 (19): 2309-2318.   DOI: 10.3761/j.issn.0254-1769.2023.19.001 Abstract （606）   HTML （2）    PDF （1176KB）（16）       Knowledge map    Save Objective To apply the best evidence of target temperature management in patients with traumatic brain injury to clinical practice and to evaluate its effect. Methods Followed the application model of JBI evidence-based nursing center，16 review indicators were developed based on the best evidence，and the evidence-based continuous quality improvement model was taken as the theoretical framework. From June 2021 to April 2022，the evidence-based practice was applied to patients with traumatic brain injury in neurosurgery ICU according to the baseline review，practice change and review of change effect after evidence application，and the implementation rate，target temperature management related knowledge level，evidence-based ability，patient complication rate and organizational culture level were compared. Results After evidence-based practice，the implementation rates of the first and second rounds of reviews for various review indicators have improved compared to the baseline，with significant increases in the implementation rates of review indicator 2，3，7，8，9，10，11 and 13（P<0.05）. There was a significant decrease in the incidence of grade 3 chills in the 3 groups of patients before and after the baseline review，the first review，and the second review（χ2=7.680，P=0.021）. Before and after the implementation of the baseline review，the first round of review，and the second round of review，the scores of the nurses’ knowledge status questionnaire on target temperature management for patients with traumatic brain injury，and the evidence-based practice influencing factors questionnaire were all improved（F=3.827，P=0.025；F=4.997，P=0.009），while the scores of the nurses’ evidence-based nursing practice obstacle scale were lower than those before the implementation（F=4.174，P=0.018）. The level of organizational culture has improved compared to it before implementation（F=7.421，P=0.024）. Conclusion Through the continuous improvement of evidence-based practice，target temperature management for patients with traumatic brain injury in neurosurgery ICU can effectively standardize the diagnosis and care behavior of medical staff and reduce the incidence of patients’ complications，but it still needs continuous quality supervision and review in the later stage. Table and Figures | Reference | Related Articles | Metrics

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The status and influencing factors of dyspnea-related kinesiophobia in patients with high-flow nasal cannula oxygen therapy LÜ Dan, LIU Qing, LI Meng, LI Xinhui, SONG Fujuan, CHEN Yunfang Chinese Journal of Nursing    2023, 58 (13): 1585-1589.   DOI: 10.3761/j.issn.0254-1769.2023.13.008 Abstract （591）   HTML （0）    PDF （679KB）（19）       Knowledge map    Save Objective To investigate the current status of dyspnea-related kinesiophobia in patients with high-flow nasal cannula oxygen therapy（HFNC） and to analyze the influencing factors. Methods A total of 195 patients were recruited from the Department of Respiratory Medicine，the Central Hospital of Tianjin from November 2021 to August 2022. General data questionnaire，Chinese version of the Breathlessness Beliefs Questionnaire，Self-efficacy for Exercise Scale and Charlson comorbidities index were used for investigation. Univariate analysis and Logistic regression were performed to analyze the influencing factors. Results The patients had a high degree of kinesiophobia，and Breathlessness Beliefs Questionnaire score of the 195 patients was（41.63±7.60）. Among them，the fear of dyspnea score is （17.73±4.30），and the fear of activity score is（24.10±4.13）. Logistic regression analysis showed that age，course of disease，regular physical exercise，exercise self-efficacy and Charlson comorbidities index were the influencing factors of dyspnea-related kinesiophobia in HFNC patients. Conclusion The patients had a high degree of kinesiophobia. Clinical nursing staff can develop intervention measures to promote them to participate in physical activities and exercise to improve their exercise endurance and quality of life. Table and Figures | Reference | Related Articles | Metrics

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Investigation and research of the gap between clinical practice and guidelines of nurse knowledge, attitude and practice on insulin injection CUI Peirong, ZHOU Yingxia, ZHANG Mingxia, ZHAO Fang, YUAN Li, XIAO Lingfeng, XING Qiuling, WANG Qun, MO Yongzhen Chinese Journal of Nursing    2023, 58 (10): 1178-1184.   DOI: 10.3761/j.issn.0254-1769.2023.10.004 Abstract （582）   HTML （2）    PDF （876KB）（24）       Knowledge map    Save Objective To investigate and analyze the gap between the current clinical practice and guidelines of insulin injection knowledge，attitude and practice，and to provide a basis for further construction of an intervention program for insulin injection knowledge，attitude and practice that conform to the actual situation in China. Methods The stratified random convenience sampling method was used to investigate 5550 nurses from 3 primary，7 secondary and 11 tertiary hospitals from July 28 to August 30，2019，using the general information questionnaire and the questionnaire of nurses’ knowledge，attitude and practice on insulin injection.SPSS26.0 was used for independent sample T test，variance analysis and correlation analysis on the influencing factors of knowledge，attitude and practice，and Mplus8.3 was used to analyze the path of influencing factors of knowledge，attitude and practice. Results The scores of nurse knowledge, attitude and practice on insulin injection were 68.17±15.76，87.22±13.34 and 93.74±7.97，respectively. There was a positive correlation between nurses’ insulin injection knowledge and attitude，knowledge and practice，attitude and practice scores（r=0.321，0.298，0.561，P<0.001）. Gender and professional title were the main influencing factors of nurses’ insulin injection knowledge scores. Knowledge，hospital level，number of beds，professional title，department，and the last time you engaged in insulin injection were the main influencing factors of nurses’ attitude score of insulin injection. Hospital level，education，knowledge and belief were the main influencing factors of nurses’ insulin injection practice score. Attitude played a partially mediating role in knowledge and nurses’ insulin injection practice. The total effect value was 0.299；the indirect effect was 0.163；the intermediary effect accounted for 54.5% of the total effect value. Conclusion There is still a big gap between clinical practice and guidelines of nurse knowledge，attitude and practice on insulin injection. Nursing managers should strengthen the evaluation of hospital nurses’ knowledge，attitude and practice of insulin injection，and take intervention measures according to the characteristics and influencing factors of nurses’ knowledge，attitude and practice of insulin injection to improve their knowledge，attitude and practice. Table and Figures | Reference | Related Articles | Metrics

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Research on the application of Traditional Chinese Medicine’s five-element music therapy in patients with autoimmune liver disease of liver depression and spleen deficiency type WANG Xuan, HU Jingxian, HAN Shuyu, WANG Ying, WU Xuan, ZHAO Yanchao, LIU Xuejiao Chinese Journal of Nursing    2024, 59 (7): 789-795.   DOI: 10.3761/j.issn.0254-1769.2024.07.003 Abstract （582）   HTML （2）    PDF （1271KB）（23）       Knowledge map    Save Objective To explore the effect of Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional counseling intervention in patients with autoimmune liver disease of liver depression and spleen deficiency type. Methods 74 patients with autoimmune liver disease of liver depression and spleen deficiency type who were admitted to the hepatology department of a tertiary hospital from January 2021 to February 2022 were selected as research subjects，and they were divided into an experimental group and a control group by a random number table with 37 cases in each group. The control group was given routine treatment and nursing care，as well as Traditional Chinese Medicine’s emotional nursing. The experimental group received Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional counseling intervention on the basis of routine treatment and nursing care，with an intervention period of 4 weeks. The Generalized Anxiety Disorder Scale （GAD-7），Patient Health Questionnaire Depression Scale （PHQ-9） and Pittsburgh Sleep Quality Index（PSQI） were used to evaluate patients within 24 hours after admission and after 4 weeks of intervention. Results A total of 72 patients completed the study，with 36 in the experimental group and 36 in the control group. Before and after intervention，the scores of GAD-7，PHQ-9，and PSQI in the experimental group were compared，and the differences were statistically significant （P<0.001）. After the intervention，the GAD-7 score in the experimental group was （7.89±3.15），which was lower than （10.14±4.41） in the control group. The PHQ-9 score was （12.33±4.08） in the experimental group，which was lower than （14.64±5.34） in the control group. The PSQI score was （12.39±3.06） points，which was lower than （14.22±3.37） in the control group，and the differences were statistically significant （P<0.05）. Conclusion The application of Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional guidance intervention can effectively improve the sleep quality and help alleviate negative emotions in patients with liver depression and spleen deficiency type of autoimmune liver disease. Table and Figures | Reference | Related Articles | Metrics

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Research progress of the Common-Sense Model of Self-Regulation in the management of chronic diseases HUANG Yunmeng, LIU Yu, WANG Yangyang, HUANG Mingqian Chinese Journal of Nursing    2023, 58 (18): 2293-2298.   DOI: 10.3761/j.issn.0254-1769.2023.18.018 Abstract （576）   HTML （0）    PDF （700KB）（22）       Knowledge map    Save Understanding the disease cognitions of chronic patients is crucial for self-management of their disease. The common-sense model of self-regulation（CSM） outlines the process by which patients engage in self-regulation to understand and manage their disease，providing a theoretical framework for understanding the relationship between disease perceptions，coping procedures and health outcomes. This article reviews the development and evolution of CSM，its theoretical framework，and the current application in chronic disease management. The objective is to enhance healthcare professionals’ understanding of the model and its potential role in supporting the health management of chronic patients. Table and Figures | Reference | Related Articles | Metrics

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The application of internet based whole health education of pulmonary rehabilitation in patients undergoing lung cancer surgery QIN Mengxia, QIAN Yan, XU Rong, DONG Cuiping, CAI Chun Chinese Journal of Nursing    2023, 58 (15): 1808-1814.   DOI: 10.3761/j.issn.0254-1769.2023.15.003 Abstract （573）   HTML （4）    PDF （1148KB）（32）       Knowledge map    Save Objective To explore the application of internet based whole health education of pulmonary rehabilitation in patients undergoing lung cancer surgery，and to explore the practicability of such innovative health education in clinical settings. Methods Patients undergoing lung cancer surgery from the Department of Thoracic Surgery of a tertiary hospital from Wuhan in May to November 2022 were selected by convenience sampling and included as the study subjects. With a prospective non-concurrent control design，50 patients undergoing surgery in September to November 2022 were included as the experimental group，and 50 patients undergoing surgery in May to July 2022 were included as the control group. The experimental group received internet based whole health education of pulmonary rehabilitation，while the control group received routine pulmonary rehabilitation health education. The differences between the 2 groups in postoperative scores of the Knowledge-Attitude-Practice（KAP） questionnaire of pulmonary rehabilitation，postoperative chest tube indwelling time，Six-Minute Walk Distance（6MWD），hospital stay and patient satisfaction. Results The score of the KAP questionnaire of pulmonary rehabilitation in the experimental group was（107.76±5.05），which was significantly higher than that in the control group of（98.78±5.11）（P<0.001）. The postoperative chest tube indwelling time in the experimental group was 71.00（51.00，101.25） h，which was significantly lower than that in the control group of 84.50（63.75，131.50） h（P=0.035）. The △6MWD in the experimental group was （141.80±29.93） m，which was significantly lower than that in the control group of（155.80±33.54） m（P=0.030）. Again，the satisfaction survey score in the experimental group was 95.00（90.00，98.00），which was significantly higher than that in the control group of 89.00（86.25，94.00）（P<0.001）. Conclusion The internet based whole health education of pulmonary rehabilitation can improve the score of KAP questionnaire of pulmonary rehabilitation post lung cancer surgery，boost the compliance of pulmonary rehabilitation exercises，shorten the chest tube indwelling time，mitigate the decline of postoperative exercise capacity，and improve patient satisfaction. The innovative whole health education of pulmonary rehabilitation is practical in clinical settings. Table and Figures | Reference | Related Articles | Metrics

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Evidence summary of Traditional Chinese Medicine rehabilitation nursing during recovery in patients with stroke limb dysfunction HUANG Yimin, HUANG Lijun, WENG Danting, ZHUANG Ping, TAN Yibing Chinese Journal of Nursing    2024, 59 (7): 812-819.   DOI: 10.3761/j.issn.0254-1769.2024.07.007 Abstract （571）   HTML （7）    PDF （1333KB）（30）       Knowledge map    Save Objective To search and integrate relevant evidence of Traditional Chinese Medicine rehabilitation care during recovery of stroke patients with limb dysfunction，and to provide the evidence for clinical practice. Methods We systematically search domestic and foreign guideline websites，professional association websites，and databases such as Cochrane Library，PubMed，Embase，CNKI，CBM for evidence on Chinese medicine rehabilitation care for limb dysfunction following stroke. The search included guidelines，clinical decisions，evidence summaries，systematic reviews，expert consensuses，and randomized controlled trials，with the search timeframe spanning from the inception of the respective databases to May 2023. The literature was evaluated and rated for quality by 2 researchers independently. Results A total of 17 articles，including 7 guidelines，4 systematic reviews，1 evidence summary and 5 randomized controlled trials were included to summarize 28 pieces of evidence on Traditional Chinese Medicine rehabilitation care for stroke patients with limb dysfunction. The evidence can be categorized into 4 areas，including evaluation，Traditional Chinese Medicine nursing technology，health education and precautions. Conclusion Traditional Chinese Medicine nursing technology for stroke patients with limb dysfunction have various forms and rich contents. Appropriate Traditional Chinese Medicine nursing techniques should be selected according to the actual situation and the willingness of patients to promote the rehabilitation of their limb functions. Table and Figures | Reference | Related Articles | Metrics

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Application research of ultrasound oblique axis plane guidance technique in PICC puncture XIANG Xiaoyan, ZHU Wei, QIN Xiaoying, HUANG Peipei, LU Qi, ZHANG Ye, CUI Zhiping Chinese Journal of Nursing    2024, 59 (4): 389-394.   DOI: 10.3761/j.issn.0254-1769.2024.04.001 Abstract （568）   HTML （2）    PDF （1011KB）（32）       Knowledge map    Save Objective To explore the application efficacy and safety of oblique ultrasound-guided techniques in PICC puncture，in order to provide guidance and references for clinical application. Methods Through convenient sampling，654 patients from a tertiary A hospital in Zhejiang Province from March to December 2022 were selected as the study subjects. The random numbers were generated through Excel table functions and they were randomly grouped into 3 groups：A，B，and C. The ultrasound short axis method，long axis method，and oblique axis method were employed to guide PICC puncture catheterization，respectively. The success rate of PICC puncture，the number of subcutaneous adjustments of the puncture needle，puncture time，and the occurrence of puncture complications （such as hematoma，puncture of the posterior wall of blood vessels，accidental injury to arteries，and accidental injury to nerves） were recorded during the catheterization process in 3 groups. Results A total of 654 patients completed the study，including 215 in group A，219 in group B，and 220 in group C. The success rate of first-time puncture in the group C（86.36%） was higher than that in group A（73.95%） and group B（63.93%），and there was a statistically significant difference among 3 groups（P<0.001）. The subcutaneous adjustment frequency of the puncture needle was 1（1，1） in group C，1（1，2） in group A，and 1（1，2） in group B. The difference between 3 groups was statistically significant（P<0.001）；the puncture time of group C was shorter than that of group A and group B，and the difference was statistically significant（P<0.001）. There was a statistically significant difference in the puncture time between 3 groups（P<0.017）；the pairwise comparison of the number of subcutaneous needle adjustments and the success rate of a puncture between 3 groups showed that there was a statistical difference between group C and group A，and between group C and group B（P<0.017），while there was no statistical difference between group A and group B（P>0.017）.There was statistical significance（P<0.05） among 3 groups in terms of complications such as accidental nerve injury and puncture of the contralateral vascular wall by puncture needle，but there was no statistical significance in terms of accidental arterial injury and hematoma occurrence among 3 groups. Conclusion Compared with the short axis approach and the long axis approach，the ultrasound oblique axis approach guided PICC puncture has statistical differences in the success rate of a puncture and the incidence of puncture complications，etc. It is recommended to use the ultrasound oblique axis approach during PICC puncture. Table and Figures | Reference | Related Articles | Metrics