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    Nursing guidelines for intravenous thrombolysis in acute ischemic stroke
    Internal Medicine Nursing Committee of Chinese Nursing Association , Xuanwu Hospital Capital Medical University , Writing Committee:CHANG Hong, ZHANG Su, FAN Kaiting, ZHAO Jie, TIAN Siying)
    Chinese Journal of Nursing    2023, 58 (1): 10-14.   DOI: 10.3761/j.issn.0254-1769.2023.01.001
    Abstract4529)   HTML726)    PDF (963KB)(4087)       Save

    Objective To develop an intravenous thrombolysis nursing guideline for acute ischemic stroke as a guiding tool for the implementation of intravenous thrombolysis for acute ischemic stroke,and to provide a reference for the practice and management of nursing in the standardization of thrombolytic therapy. Methods According to the method of evidence-based nursing practice guidelines,the draft of intravenous thrombolysis nursing guidelines for acute ischemic stroke was constructed. The draft guidelines were reviewed by experts using the catalogue of Clinical Guidelines Research and Evaluation System Ⅱ. According to the results and suggestions of expert review,the guidelines were modified to form the formal guidelines. Results The recommendations included 5 aspects,namely hospital organization management,disease observation,observation and treatment of complications,posture and bed-leaving activities,and quality management. Conclusion The guidelines for intravenous thrombolysis nursing in acute ischemic stroke are evidence-based guidelines based on the best evidence,clinical practice and the judgment of professionals,and can be used as a practical basis for clinical medical staff to make scientific decisions on intravenous thrombolysis therapy in patients with acute ischemic stroke.

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    Expert consensus on safety management of transfusion connection devices for vascular access
    Hospital Infection Management Committee of Chinese Nursing Association , Intravenous Therapy Committee of Chinese Nursing Association , Written by WANG Xia, SUN Zhong, ZHAO Lu, WANG Pei, MA Jingmiao, HOU Xiufeng, ZHANG Kaili, YUAN Xiaoning, WANG Lei, SUN Wenyan, GAO Fengli, WANG Huafen, SUN Hong, CAI Meng
    Chinese Journal of Nursing    2022, 57 (23): 2821-2824.   DOI: 10.3761/j.issn.0254-1769.2022.23.001
    Abstract3805)   HTML884)    PDF (744KB)(3590)       Save

    Objective The aim is to establish an expert consensus(hereinafter referred to as "Consensus")on safety management of transfusion connection and port protection devices for vascular access,to prevent catheter related bloodstream infection and provide patients with safe,effective and standardized intravenous therapy. Methods Using evidence-based methods,according to the level of evidence,the evidence in this field was searched,evaluated and summarized,and relevant recommendations and research conclusions were extracted,and then the first draft of consensus was formed. Through a round of Delphi expert consultation and 2 rounds of expert meetings,opinions from domestic experts in many fields and disciplines were sought and integrated;the content was adjusted and the consensus was reached. Results The positive coefficient is 100%;the authoritative coefficient is 0.92;the average value of each index is more than 4;the coefficient of variation is less than 0.22. The Kendall’s harmony coefficient of the expert’s opinion is 0.35( χ2=144.44,P<0.001). A consensus recommendation on the classification and maintenance of infusion connection devices was reached. Conclusion The Consensus is scientific,which can provide a reference for the safety management of transfusion connection and port protection devices in China,and provide a basis for clinical decision-making to prevent catheter related bloodstream infection.

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    Chinese expert consensus on cardiac rehabilitation nursing care
    Geriatric Nursing Committee of Chinese Nursing Association, Committee of Cardiac Rehabilitation and Prevention of Chinese Association of Rehabi-litation Medicine, Organ Rehabilitation Committee of Chinese Elder Health Care Association, Writing Committee: SHEN Lin, MENG Xiaoping, CHEN Xiaoming, ZHU Liyue, WANG Mei, CAO Yingjuan
    Chinese Journal of Nursing    2022, 57 (16): 1937-1941.   DOI: 10.3761/j.issn.0254-1769.2022.16.003
    Abstract2105)   HTML119)    PDF (843KB)(991)       Save

    Objective To form the Chinese expert consensus on cardiac rehabilitation nursing care,so as to standardize the work related to cardiac rehabilitation nursing. Methods The first draft was initially formed,based on a comprehensive review of domestic and foreign cardiac rehabilitation guidelines,expert consensuses,systematic reviews,original research and other literature,as well as related disease diagnosis and treatment plans,management consensuses and related literature. Results The draft was thereafter reviewed by a total of 37 experts in related fields. This consensus was finalized after 3 rounds of discussions and modifications. The expert consensus covers the following 4 topics,namely the work goals of cardiac rehabilitation nursing care,the qualifications,training,core competencies and responsibilities of cardiac rehabilitation nursing care,the components of cardiac rehabilitation nursing care,and quality control of cardiac rehabilitation nursing care,and the safety management of cardiac rehabilitation patients. Conclusion The consensus was formed on the basis of comprehensive expert opinions and relevant guidelines,consensuses and clinical research on cardiac rehabilitation,which can provide guidance for medical institutions to carry out cardiac rehabilitation nursing practice.

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    Expert consensus on parenteral nutrition safety infusion
    Chinese Medical Association of Parenteral and Enteral Nutrition Nursing Group, (Writing Committee:LI Suyun, SHAO Xiaoping, TANG Xiaoli, YE Xiang-hong, CHEN Yongyi, YAN Rong, LIU Yunfang, KONG Shanshan, XIONG Zhaoyu, XIONG Ziwei, MI Yuan-yuan, HUANG Haiyan, SHI Wenjia, WU Beiwen)
    Chinese Journal of Nursing    2022, 57 (12): 1421-1426.   DOI: 10.376/j.issn.0254-1769.2022.12.002
    Abstract4945)   HTML182)    PDF (969KB)(885)       Save

    Objective To form an expert consensus on parenteral nutrition safety infusion, and standardize the operation process of clinical parenteral nutrition safety infusion,so as to reduce the parenteral nutrition complications. Methods On the basis of the evidence-based method,we searched the high level evidence about the parenteral nutrition safety infusion in databases such as UpToDate,BMJ Best Practice,National Institute for Health and Care Excellence,Guidelines International Network,National Guideline Clearinghouse,Registered Nurses' Association of Ontario,Scottish Intercollegiate Guidelines Network,European Society for Clinical Nutrition and Metabolism,American Society for Parenteral and Enteral Nutrition,Chinese Society for Parenteral and Enteral Nutrition,China Guide Network,Joanna Briggs Institute,China Biomedical Literature Network,VIP,Wanfang,CNKI,PubMed,Web of Science,Scopus,Embase. The retrieval period is from the establishment of the databases to January 2021. Studies were evaluated and collected; relevant recommendations and research results were selected to form the draft of the expert consensus. Experts were invited to complete 2 rounds of Delphi expert consultations and 2 rounds of expert meetings. Each item was revised and improved through 2 rounds of Delphi expert consultations and expert meetings,and the final draft of the consensus was formed. Results The positive coefficient of experts in the 2 rounds of correspondence consultations were 100%; the expert authority coefficients were 81.00% and 89.50% respectively,and the coordination coefficients of expert opinions were 0.13 and 0.15 respectively. Finally,the consensus summarizes the latest evidence on 4 aspects of multidisciplinary team formation,evaluation,operation norms,and complication management. Conclusion The establishment of the consensus can provide a reference for the standardization of safe infusion of parenteral nutrition in clinical practice to ensure patient safety and improve service quality.

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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
    Abstract1168)   HTML143)    PDF (692KB)(581)       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.

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    Expert consensus on packaging techniques of reusable medical instruments
    Professional Committee of Central Sterile Supply Departments, Chinese Nursing Association(Writing Committee:YAO Zhuoya, ZHANG Qing, QIAN Liming, KANG Jie)
    Chinese Journal of Nursing    2023, 58 (5): 517-523.   DOI: 10.3761/j.issn.0254-1769.2023.05.001
    Abstract1946)   HTML51)    PDF (1405KB)(473)       Save

    Objective To standardize the packaging techniques of reusable medical instruments in central sterile supply departments. Methods From October 2021 to August 2022,the Professional Committee of the Central Sterile Supply Department of Chinese Nursing Association addresses the key problems of reusable medical instruments packaging. On the basis of clinical practice,literature analysis and the operation experience of the national central sterile supply department experts,we made the initial version of Expert Consensus on Packing Techniques of Reusable Medical Instruments(hereinafter referred to as the Consensus). Experts were invited to complete 2 rounds of Delphi expert consultations and 3 rounds of expert meetings. Each item was adjusted,revised and improved,and the final version of the Consensus was formulated. Results The positive coefficients of experts in 2 rounds of Delphi expert consultations were all 100%,and the degrees of expert authority were 0.957 and 0.973,respectively. The average importance value of each item was higher than 4.00;the variation coefficient of each item was less than 0.25. The Kendall’W were 0.181 and 0.338,respectively(all P<0.001). Finally,an agreement was reached on the terms and definitions,basic principles,personnel requirements,environmental requirements,packaging equipment requirements,packaging materials and sterilization monitoring material requirements,packaging auxiliary tools requirements,pre-packaging evaluation,packaging operation and packaging quality confirmation of the reusable medical devices packaging techniques. Conclusion The Consensus covers all aspects of the reusable medical instruments packaging techniques,which is highly practical and scientific,and it also helps to guide the sterile supply professionals to standardize the implementation of packaging techniques,improve the quality of aseptic supplies,and ensure the quality of medical treatment and the life safety of patients.

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    Chinese Journal of Nursing    2023, 58 (1): 5-6.  
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    The development of a patient guideline on non-pharmacological management of gestational diabetes mellitus
    Center for Evidence-based Nursing, Fudan University, (Writing Committee:XING Nianlu, ZHOU Yingfeng, CHEN Shuyu, FANG Yuan, LI Li, GU Yanhong, ZHAO Minhui, PAN Xiuhong)
    Chinese Journal of Nursing    2024, 59 (6): 662-668.   DOI: 10.3761/j.issn.0254-1769.2024.06.003
    Abstract495)   HTML140)    PDF (1303KB)(276)       Save

    Objective To construct a patient guideline for the non-pharmacological management of gestational diabetes mellitus(GDM) to provide decision support for the self-management of patients with GDM. Methods Utilizing evidence-based methods,health problems were identified through literature analysis,personal interviews,and on-site investigations. Systematic search was conducted on domestic and international guideline websites,professional association websites,and comprehensive databases. The quality of evidence was graded according to the GRADE system. The Evidence-to-Decision(EtD) framework was employed to summarize the evidence,leading to the initial formulation of recommendations. These recommendations were then refined,and the consensus was achieved through a round of expert consensus meetings and 2 rounds of Delphi method for expert correspondence,resulting in the final draft of the patient guideline. Results The core content of the patient guideline encompasses 5 aspects:screening and diagnosis of GDM,prenatal management,labor and delivery management,neonatal hypoglycemia management,and postpartum management. Conclusion This patient guideline,developed through a rigorous process,takes into account patients’ preferences,and it is scientifically sound,acceptable,operable,and readable. It can provide a foundation for decision-making in the self-management of patients with GDM.

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    Development of health science popularization works for the prevention of deep vein thrombosis in patients after joint replacement
    WANG Yu, XU Yuan, DENG Haibo, WANG Lei, WANG Xiaojie, HAO Yufang, ZHU Liyun, LIU Jia, SUN Jianhua, AN Ranxun, MA Yufen, WU Xinjuan
    Chinese Journal of Nursing    2024, 59 (6): 699-705.   DOI: 10.3761/j.issn.0254-1769.2024.06.008
    Abstract472)   HTML48)    PDF (1194KB)(233)       Save

    Objective To develop evidence-based health science popularization works for the prevention of deep vein thrombosis(DVT) in patients after joint replacement. Methods In this study,guided by the Guideline International Network patient guideline formulation manual and Patient Education Materials Assessment Tool,we conducted semi-structured interviews to clarify the health science themes. These themes were matched with relevant evidence,and the relevant evidence recommendation items for each theme were refined. It is translated into easily understandable language and other forms. 12 representatives(doctor,nurse,patient,science popularization expert and evidence-based methodology expert) conducted an external review of the quality of these science popularization works. Results Prevention of post-operative DVT,patients’ main concerns and the most urgent need for action were extracted from a total of 6 scientific topics. After the matching with 22 pieces of evidence,a health education content system for the prevention of DVT after total joint arthroplasty was created. According to the system framework and evidence,as well as the preferences and needs of patients,a popular science manual and popular science video were created,with the final external review rate of 94%~100% and the coefficient of variation of 0~0.101. The revised health science works for the prevention of DVT after joint replacement included popular science manuals-trifolds and popular science videos. The copyright of both popular science manuals(copyright number:Guozuo Dengzi-2022-L-10159159) and popular science videos(copyright number:Guozuo Dengzi-2022-I-10162339) have been registered. Conclusion The method of developing science popularization works on the prevention of DVT in patients after joint replacement is scientific. It can provide a methodological reference for the development of other science popularization works.

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    Chinese Journal of Nursing    2023, 58 (1): 7-9.  
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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
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    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.

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    Evidence summary for subcutaneous injection of low molecular weight heparin
    SONG Qingqing, LUO Fangling, TANG Qian, HUANG Juan, XIE Jianhui, GU Ying, LUO Tingwei, ZHU Lihui
    Chinese Journal of Nursing    2023, 58 (2): 232-237.   DOI: 10.3761/j.issn.0254-1769.2023.02.015
    Abstract1689)   HTML25)    PDF (805KB)(99)       Save

    Objective To retrieve,evaluate and integrate evidence related to subcutaneous injection technique of low molecular weight heparin. Methods The clinical decisions,recommended practices,evidence summaries,technical reports,guidelines,expert consensuses,and systematic evaluations on the subcutaneous injection of low molecular weight heparin in domestic and foreign databases and related professional websites were searched by computer. The evidence was extracted and summarized according to the subject after the independent literature quality evaluation by 2 researchers. The literature retrieval time limit was from the establishment of the database to November 2021. Results According to the inclusion criteria,9 pieces of literature were screened,including 2 evidence summaries,2 expert consensuses,and 5 systematic reviews. Through literature reading,evidence extraction and classification,a total of 12 pieces of evidence were summarized,including preparation before injection,skills during injection,and post-injection disposal. Conclusion This study summarized the best evidence of subcutaneous injection techniques of low molecular weight heparin,so as to provide references for nurses to carry out clinical practice. Nurses should carefully select and apply evidence in combination with clinical situations and patients’ wishes,so as to ensure injection safety and reduce the incidence of related complications.

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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
    Abstract953)   HTML8)    PDF (5646KB)(96)       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.

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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
    Abstract867)   HTML6)    PDF (5235KB)(95)       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.

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    Experiences of social isolation in cancer patients:a qualitative research
    DONG Zhaohui, LU Huijuan, LU Zhenqi, ZHANG Xiaoju, ZHANG Yuxia
    Chinese Journal of Nursing    2023, 58 (6): 670-675.   DOI: 10.3761/j.issn.0254-1769.2023.06.004
    Abstract580)   HTML7)    PDF (1007KB)(93)       Save

    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.

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    Expert consensus of suicide care interventions for psychiatric inpatients with depression
    Mental Health Professional Committee of Chinese Nursing Association(Writing Committee:WANG Chen, XU Dongmei, SHAO Jing, GU Jianing, QU Yanhua, YE Xiaolu, ZHANG Mengqian, LUO Wei, LI Yuqi, XU Enyao, WANG Cuiling, LI Feifei, LIANG Hong)
    Chinese Journal of Nursing    2022, 57 (18): 2181-2185.   DOI: 10.3761/j.issn.0254-1769.2022.18.001
    Abstract2545)   HTML27)    PDF (909KB)(92)       Save

    Objective To form an expert consensus on suicide nursing interventions for inpatients with depression in psychiatric departments,standardize the contents of suicide nursing interventions for depression patients in psychiatric departments. Methods Evidence-based methods and literature analysis were used to extract recommendations and research conclusions of suicide nursing interventions for inpatients with depression,and the consensus draft was formed. After 2 rounds of expert letter consultation and 2 expert discussions,the draft was adjusted,modified and improved,and the final draft of the consensus was formed. Results The positive coefficients of the experts in 2 rounds of letter consultation were 100%;the authority degree of the experts was 0.924;the mean values of importance of each index were >3.5 points;the coefficient of variation was<0.25;the Kendall harmony coefficients of the experts were 0.182 and 0.260,respectively(P<0.01). Finally,the operational definition,suicide risk assessment,intervention form and time,theoretical basis of intervention,general principles of intervention,suicide impression intervention,suicidal behavior intervention,key points of intervention in special populations,evaluation of intervention effect and post-discharge evaluation of suicide care in hospitalized patients with depression were analyzed. A total of 11 components of the health education program were agreed upon. Conclusion The consensus provides the guidance for the suicide nursing interventions of psychiatric inpatients with depression,so that the suicide nursing intervention of psychiatric inpatients with depression is more standardized.

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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
    Abstract1536)   HTML12)    PDF (948KB)(90)       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.

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    Evidence summary for prevention and management of central venous catheter occlusion
    LI Huaiyan, LI Yuling, YU Jing, MENG Xiaohong, CUI Yingqin
    Chinese Journal of Nursing    2022, 57 (23): 2842-2850.   DOI: 10.3761/j.issn.0254-1769.2022.23.004
    Abstract899)   HTML11)    PDF (1247KB)(82)       Save

    Objective To search,evaluate and summarize the best evidence for prevention and management of central venous catheterization. Methods According to the "6S" evidence model,related databases including BMJ Best Practice,UpToDate,NGC,JBI evidence-based database,Scopus platform,Yimaitong Guide.com,CINAHL,CNKI,Wanfang Database,CBM were searched from top to bottom. All evidence related to the prevention and management of central venous catheterization from August 2011 to August 2021 was included,involving clinical practice guidelines,systematic reviews,evidence summaries,best practice,expert consensuses,and original literature. 2 researchers independently evaluated the quality of relevant literature and standardized the integration and summary of the evidence finally included in the literature. Results Totally 14 pieces of the literature were included,involving 3 guidelines,3 systematic reviews,4 evidence summaries,3 expert consensuses and 1 meta-analysis. Finally,28 pieces of best evidence were formed,including 6 dimensions,namely intravenous treatment team,cathetering site and method,catheter flushing tool and operation,blockage prevention strategy,blockage treatment strategy,and patient education. Conclusion The best evidence for the prevention and management of central venous catheter blockage is helpful for clinical nurses to formulate personalized catheter blockage prevention strategies according to the actual situation of patients,to standardize the management strategies of catheter blockage,so as to reduce the incidence of central venous catheter blockage and ensure the safety of patients.

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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
    Abstract1201)   HTML14)    PDF (621KB)(81)       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.

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    Evidence summary of limb management in transradial coronary intervention
    TAN Junyang, MA Fang, HU Qiulan, ZHOU Hang, ZHU Zheng, MA Xueqin, BAI Yangjuan
    Chinese Journal of Nursing    2022, 57 (13): 1572-1578.   DOI: 10.3761/j.issn.0254-1769.2022.13.006
    Abstract752)   HTML8)    PDF (1269KB)(77)       Save

    Objective The best evidence on the limb management of transradial coronary intervention was retrieved,evaluated and integrated to provide evidence-based support for clinical practice. Methods By an evidence-based approach,the literature was searched according to the ‘6S’ pyramid of evidence model,with a timeframe of the database establishment to June 2021. Research team members independently evaluated the quality of the various types of the literature,extracted information that met the criteria,and graded each piece of evidence. Results A total of 11 papers were involved,including 3 guidelines,6 systematic reviews and 2 expert consensuses. The final summary of 21 pieces of best evidence on the management of the limb of transradial coronary intervention covers 4 topics,including preoperative preparation and assessment,postoperative handover and observation,postoperative compression and decompression,activity occasion and patterns. Conclusion This study provides the best evidence for the limb management of the transradial coronary intervention. When translating the evidence,the best evidence should be selected in relation to hospital characteristics and clinical scenarios,in order to improve the quality of perioperative care of the radial artery puncture limb and enhance the comfort and safety of patients.

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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
    Abstract1584)   HTML17)    PDF (1197KB)(75)       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.

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    Expert consensus on postoperative pulmonary rehabilitation nursing for lung transplant patients
    Respiratory Nursing Committee of Zhejiang Nursing Association(Writing Committee:ZENG Fei, LAN Meijuan, LIANG Jiangshuyuan, GU Peipei, CAI Lingyun, GUO Luyao)
    Chinese Journal of Nursing    2024, 59 (1): 10-14.   DOI: 10.3761/j.issn.0254-1769.2024.01.001
    Abstract522)   HTML7)    PDF (1272KB)(75)       Save

    Objective To form the expert consensus on postoperative pulmonary rehabilitation nursing for lung transplant patients,standardize the nursing care of pulmonary rehabilitation after lung transplantation in medical institutions,and promote the early postoperative rehabilitation of lung transplant patients. Methods The clinical guideline,expert consensus,systematic review,evidence summary and original research on postoperative pulmonary rehabilitation of lung transplant patients were comprehensively searched in domestic and foreign databases. The time limit for retrieval was from the establishment of databases until February 2023. The draft of the Consensus was formed based on clinical practice experience. From April to June 2023,17 experts were invited to conduct 2 rounds of expert consultation,in order to revise and improve the content of the first draft,and then conduct expert demonstration,and finally form the final draft of the consensus. Results Totally 16 experts responded,and the expert positive coefficient was 94.12%. The effective recovery rates of the 2 rounds of expert consultation were both 100%;the expert authority coefficients were both 0.941;the judgment coefficients were both 0.963;and the familiarity degree were both 0.900. The Kendall coefficients of the 2 rounds of expert consultation were 0.133 and 0.123,respectively,which were statistically significant. The consensus includes 13 themes,involving the formation and management of a pulmonary rehabilitation team, fluid management, mechanical ventilation,sequential assisted ventilation,respiratory function exercise,airway clearance,pain management,exercise management,nutritional support,immunosuppressive management,prevention and control of pulmonary complications,psychological support,and follow-up management. Conclusion The consensus is highly scientific,and can provide references and bases for clinical nursing staff to carry out pulmonary rehabilitation for lung transplant patients.

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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
    Abstract867)   HTML9)    PDF (729KB)(70)       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.

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    Summary of best evidence for prevention and control of multidrug-resistant organism infection in adult ICU
    SHI Xiaoliu, SHI Jinmei, SHEN Hongwu, ZHANG Qian, ZHANG Yan
    Chinese Journal of Nursing    2024, 59 (6): 727-735.   DOI: 10.3761/j.issn.0254-1769.2024.06.013
    Abstract441)   HTML7)    PDF (1352KB)(68)       Save

    Objective To search and summarize the best evidence for the prevention and control of multidrug-resistant organism infection in adult ICUs,and to provide evidence-based basis for clinical standard control. Methods We systematically searched relevant guideline websites and professional association websites,UpToDate,BMJ best practice,National Institute for Health and Care Excellence,National Guidelines Clearinghouse,Registered Nurses’ Association of Ontario,Yimaitong,the Cochrane Library,Embase,PubMed,Web of Science,CNKI,Wanfang,VIP and SinoMed to collect all the clinical guidelines,system reviews,expert consensuses,evidence summaries and original research related to prevention and control of multidrug-resistant organism infection in adult intensive care units. The search period was from the establishment of the database to April 30,2023. 2 researchers independently conducted the literature quality evaluation and data extraction. Results A total of 19 articles were included,including 1 guideline,8 expert consensuses,1 expert opinion,2 systematic evaluations,and 7 original studies. Ultimately,10 evidence themes and 41 pieces of best evidence were formed,including risk factors,hand hygiene,decolonization,active monitoring,equipment related strategies,contact protection,patient isolation,environmental cleaning,personnel training management supervision,and multidisciplinary collaborative management. Conclusion This study summarizes 41 pieces of best evidence for the prevention and control of multidrug-resistant organism infections in adult ICUs,which can provide resource preparation for clinical transformation and clinical decision-making basis for nursing staff to conduct scientific and effective nursing practices. Specialized nursing staff should reasonably select the best evidence for localized application,continuously update the best evidence,standardize nursing practices,and improve nursing quality.

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    Analysis and recommendations for issues in scale-based research papers in the field of nursing
    WANG Kefang, XU Dongjuan, WANG Yaqi
    Chinese Journal of Nursing    2024, 59 (3): 287-291.   DOI: 10.3761/j.jssn.0254-1769.2024.03.006
    Abstract527)   HTML0)    PDF (5406KB)(63)       Save

    Scales are crucial instruments for measuring variables in the field of nursing research. Its development process needs to follow the basic procedures strictly. This paper describes the basic steps involved in nursing scale development,with a focus on ensuring accuracy and reliability at each stage where issues may arise. It also provides a comprehensive analysis of common problems found in current nursing scale development papers and offers suggestions and solutions. The aim is to provide a reference for nursing professionals engaged in scale-related research and to enhance the quality of nursing scale development papers.

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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
    Abstract789)   HTML11)    PDF (1227KB)(62)       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.

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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
    Abstract648)   HTML2)    PDF (5313KB)(57)       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.

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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
    Abstract690)   HTML4)    PDF (1199KB)(57)       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.

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    Systematic review of risk prediction models for intradialytic hypotension in patients with maintenance hemodialysis
    ZHU Dongge, WANG Juzi, ZHAO Qian, HE Yapeng, ZHANG Zhuanzhuan, YANG Yutong
    Chinese Journal of Nursing    2024, 59 (2): 174-183.   DOI: 10.3761/j.issn.0254-1769.2024.02.007
    Abstract263)   HTML1)    PDF (1350KB)(54)       Save

    Objective To systematically review the risk prediction models for intradialytic hypotension in maintenance hemodialysis patients,with a view to provide references for clinical practice. Methods PubMed,Embase,Web of Science,Cochrane Library,CINAHL,CNKI,VIP,Wanfang and CBM were searched from inception to May 29,2023. 2 reviewers independently screened the literature,extracted information and assessed methodological quality using the Prediction Model Risk of Bias Assessment Tool. Results A total of 20 studies and 25 models were included with the sample size of 68~9 292 cases and the incidence of outcome events of 2.1~51%. Baseline systolic blood pressure,age,ultrafiltration rate,diabetes and dialysis duration were the top 5 predictors of repeated reporting of the models. 20 models reported the area under the curve of ranging from 0.649 to 0.969,and 5 models reported calibration metrics. There were 9 internal validations and 4 combined internal and external validation models. The overall applicability of the 20 studies was good,but all had a high risk of bias,mainly in data analysis. Conclusion Research on risk prediction models for intradialytic hypotension in maintenance hemodialysis patients is still in the developmental stage. Future studies should improve the research design and reporting process,and validation studies of existing models should be carried out to further evaluate the effectiveness and feasibility in clinical practice.

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    Evidence-based practice of lymphedema prevention and nursing care after breast cancer surgery
    GUO Yuanzhi, ZHANG Hongmei, ZHAO Pei, WANG Qi, LI Yuhuan, WANG Shufen, YU Yang
    Chinese Journal of Nursing    2023, 58 (7): 773-780.   DOI: 10.3761/j.issn.0254-1769.2023.07.001
    Abstract1118)   HTML4)    PDF (1852KB)(53)       Save

    Objective Evidence-based practice of lymphedema prevention and nursing after breast cancer surgery was carried out with knowledge transformation theory,and its application effect was discussed. Methods The group standard “Prevention and Care of Lymphedema after Breast Cancer Surgery” was applied into clinical practice from August 2021 to June 2022 by searching for evidence,introducing evidence into clinical scenarios,developing evidence-based protocols,baseline review,evaluating and analyzing the promoting and obstructive factors. The prevention and nursing knowledge and skills of breast cancer lymphedema among medical staff and lymphedema prevention behavior scores of breast cancer patients before and after the application of the Group Standard were compared and the implementation rate of the review items were compared. Results After the implementation of the evidence-based practice,the knowledge and skills of medical staff was significantly higher than that before the implementation,and the difference was statistically significant(t=4.074,P<0.001). The self-care behavioral ability of lymphedema in breast cancer patients was significantly higher than before,with statistical significance(t=11.459,P<0.001). The implementation rate of the examined items increased from 33.33%~100% to 77.14%~100%. Conclusion The Group Standard should be applied to clinical practice,which can promote the improvement of relevant systems and norms,improve the knowledge and skills of medical staff,and improve the prevention awareness and behavioral ability of breast cancer patients with lymphedema.

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    Construction of the hierarchical diet management plan of swallowing function in patients with swallowing disorders
    LU Mengju, LIU Junjie, LI Xuelin
    Chinese Journal of Nursing    2022, 57 (12): 1427-1434.   DOI: 10.3761/j.issn.0254-1769.2022.12.003
    Abstract980)   HTML5)    PDF (1082KB)(52)       Save

    Objective According to the food hierarchical standard of the International Dysphagia Diet Standardisation Initiative(IDDSI),the food management plan for patients with swallowing disorders was constructed based on the swallowing function classification. Methods From January to March 2021, clinical practice guidelines,manuals,expert consensuses,evidence summaries,and systematic evaluation of dietary nutrition management in patients with swallowing disorders were systemically retrieved,and then the evidence was extracted and integrated. The first draft of the diet management plan was formulated by the research group,using Delphi method for 2 rounds of expert consultations,and expert opinions were modified by group discussion. Results 15 experts participated in 2 rounds of consultations,and the effective recovery rate of questionnaire was 100%. The expert authority scores of 2 rounds were 0.88,and the importance and operability of the second round of expert opinions Kendall harmony were 0.396 and 0.412. The diet management plan for patients with swallowing disorders,includes 5 first-level items(failed,level 4,level 3,level 2,level 1) and 41 second-level items. Conclusion There were high levels of coordination,enthusiasm,and authority in experts. The diet management plan of patients with swallowing disorders is scientific and feasible,which can provide references for the diet management of patients with swallowing disorders.

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    Perioperative nursing care of a newborn with bacterial corneal ulcer undergoing corneal transplantation
    WANG Huan, WANG Jingjing, DOU Wenyan, WU Xuhong
    Chinese Journal of Nursing    2024, 59 (4): 465-468.   DOI: 10.3761/j.issn.0254-1769.2024.04.012
    Abstract226)   HTML4)    PDF (723KB)(52)       Save

    To summarize the perioperative nursing experience of a newborn with bacterial corneal ulcer undergoing corneal transplantation. Preoperative nursing points:to strengthen eye observation and protection to avoid corneal perforation;to properly administer systemic and eye medication to control infection. Postoperative nursing points:to closely observe the condition of corneal grafts to prevent postoperative complications;to provide eye drops on time after surgery to ensure medication safety;to emphasize pain management and provide nutritional support;to provide targeted health education to parents to ensure that the patient receives continuous care. Through multidisciplinary team collaboration,meticulous treatment and care,the corneal graft of the patient was clear,the suture was not loose,and there was no bleeding in the anterior chamber after 1 week of corneal transplantation. The vital signs were stable,and the patient was discharged from the hospital,and ophthalmic follow-up was conducted. After 7 weeks of surgery,the suture was successfully removed and the corneal transplantation was successful.

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    The effect of reducing frequency of gastric residual volume monitoring on enteral nutrition in ICU patients
    YU Kunrong, LI Fan, HOU Qingmin, XU Yingzhen, LI Xiaorong, MA Jun, CHEN Yan, GUAN Yuxia
    Chinese Journal of Nursing    2024, 59 (5): 582-587.   DOI: 10.3761/j.issn.0254-1769.2024.05.010
    Abstract273)   HTML13)    PDF (940KB)(52)       Save

    Objective To evaluate the effect of reducing frequency of gastric residual volume monitoring on enteral feeding-related complication and caloric intake in ICU patients. Methods Patients who admitted to medical ICU,respiratory ICU and emergency ICU of a tertiary A teaching hospital in Beijing during October 2020 to January 2023 and undergoing mechanical ventilation and continuous enteral feeding via nasogastric tube in 24~48 hours were enrolled. According to the random number table method,they were divided into a control group and an intervention group,with 52 cases in each group. Gastric residual volume was monitored daily 12h after enteral nutrition initiation in the intervention group,and every 4 hours in the control group. The enteral feeding-related complication and caloric intake of the 2 groups were recorded after enteral nutrition initiated and until 7th day in ICU. Results 52 cases completed the study in each group respectively. During the first 7 days,the incidence of vomiting and the maximum of gastric residual volume in the experimental group were higher than those in the control group,with no statistically significant differences. No nasogastric tube occlusion was observed in any patients in either group. Compared to the control group,both the caloric intake of 7th day in ICU and the proportion of patients achieving calorie target on 7th day in ICU were significantly higher in the experimental group,with statistically significant differences. Conclusion Reducing the frequency of gastric residual volume monitoring to once a day could significantly increase caloric intake of patients without an increase in enteral feeding-related complication.

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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
    Abstract1141)   HTML14)    PDF (1365KB)(52)       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.

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    Research on the developmental trajectory of rehabilitation exercise adherence and its potential classes predictors in stroke patients
    LÜ Yumei, GUO Yucheng, ZHOU Yuqiu
    Chinese Journal of Nursing    2023, 58 (17): 2103-2111.   DOI: 10.3761/j.issn.0254-1769.2023.17.008
    Abstract570)   HTML4)    PDF (1127KB)(51)       Save

    Objective To explore the development trajectory of rehabilitation exercise adherence and its potential classes predictors in stroke patients. Methods By the convenience sampling method,252 stroke patients who were hospitalized in 2 tertiary hospitals in Daqing from September 2020 to May 2021 were selected.The general situation questionnaire,questionnaire of exercise adherence for stroke patients,the brief illness perception questionnaire,Herth hope index,and hospital anxiety and depression scale were used to collect the baseline data of patients,and the rehabilitation exercise adherence was assessed at 6,14 and 24 weeks after stroke. Latent growth mixed model was used to identify the development trajectory of rehabilitation exercise adherence among stroke patients,and multivariate logistic regression analysis was used to explore the predictors of different latent trajectories classes. Results A total of 4 developmental trajectories of rehabilitation exercise adherence among stroke patients were identified:low adherence-improvement group(7.5%),sustained moderate adherence group(21.4%),moderate adhere-nce-decline group(46.5%)and low adherence-decline group(24.6%). Multivariate Logistic regression analysis showed that stroke type,number of stroke attacks,baseline hope,anxiety and depression levels were independent predictors of different developmental trajectory of rehabilitation exercise adherence among stroke patients(P<0.05). Conclusion There is significant group heterogeneity in the developmental trajectory of rehabilitation exercise adherence in stroke patients within 24 weeks of onset. Only a small number of patients’ adherence continued to be at a high level or improved from a low level,and about 1/4 of the patients continued to be at a low level and tending to decline. Medical staff should identify patients in the low adherence-decline group early on the basis of predictive factors,and implement targeted,specific and efficient adherence interventions to improve the development trend of adherence.

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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
    Abstract928)   HTML9)    PDF (964KB)(50)       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.

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    Construction of a non-manual airway care program for the prevention of stroke-associated pneumonia
    HU Enhui, SHEN Xiaofang, LI Hongyan, XU Yanyan, QIN Xuejuan
    Chinese Journal of Nursing    2023, 58 (1): 15-22.   DOI: 10.3761/j.issn.0254-1769.2023.01.002
    Abstract799)   HTML10)    PDF (1102KB)(50)       Save

    Objective In order to construct a non-artificial airway care scheme for the prevention of stroke-associated pneumonia and to provide references for effectively preventing stroke-associated pneumonia. Methods A group was set up to preliminarily formulate a non-artificial airway management program based on literature research and clinical experience. Through 2 rounds of expert consultations,the items were modified and the final scheme was determined. Results The return rates of questionnaires in 2 rounds were 88.24% and 100%,respectively. The expert authority coefficient is 0.940. After the second round of expert consultation,the variation coefficients of importance and feasibility of each item were 0-0.224 and 0-0.245,and the Kendall harmony coefficients were 0.139 and 0.241,respectively,with statistically significant differences(P<0.001).The final scheme consists of 4 first-level items with risk assessment,dietary management,respiratory management,and oral health management,16 second-level items and 54 third-level items. Conclusion Experts have a high degree of enthusiasm and authority,and their opinions are well coordinated. The non-artificial airway care scheme constructed in this study for the prevention of stroke-associated pneumonia is reliable,specific and practical.

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    Nursing care of a patient with pulmonary arteriovenous fistula and postoperative acute ischemic stroke
    XIE Xuping, YU Limei, CHEN Mingxiang, LI Fuping, LI Zhiping
    Chinese Journal of Nursing    2024, 59 (6): 719-722.   DOI: 10.3761/j.issn.0254-1769.2024.06.011
    Abstract499)   HTML1)    PDF (776KB)(49)       Save

    To summarize the nursing experience of a patient with pulmonary arteriovenous fistula and secondary acute ischemic stroke after surgery. Nursing points include:implementing predictive care to ensure smooth emergency access;accurate evaluation and early identification to seize golden rescue time;strengthening postoperative management and promoting the recovery of important organs;dynamically adjusting anticoagulation strategies to ensure maximum benefit for patients;actively correcting perioperative anemia and preventing complications;implementing continuous care through an intelligent follow-up system to promote physical and mental recovery. The patient was discharged from hospital after multidisciplinary teamwork and careful nursing.

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    Introduction of palliative care for patients with cardiovascular diseases in Japan and its implication for China
    PENG Mengyun, HARADA Nahoko, SAITO Shinya
    Chinese Journal of Nursing    2024, 59 (5): 533-539.   DOI: 10.3761/j.issn.0254-1769.2024.05.003
    Abstract162)   HTML2)    PDF (1260KB)(48)       Save

    The WHO calls for global healthcare workers to pay attention to hospice practice for non-cancer patients. Currently,domestic palliative care is mainly focused on cancer patients,and the practice and development in chronic disease populations such as cardiovascular disease is relatively weak. In recent years,palliative care for cardiovascular disease in Japan has been proven to be effective in relieving end-stage symptoms of patients with cardiovascular disease and improving the quality of life of patients and family members. The paper introduces the development history,scale and demand,team members and collaboration,intervention time,assessment and screening,service content and process,quality evaluation and dilemmas of palliative care for patients with cardiovascular disease in Japan,and proposes implications for the implementation of palliative care for patients with cardiovascular disease in China,in order to provide a reference for the development of palliative care for patients with cardiovascular disease.

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    Research progress of health-related quality of life assessment tools for patients with deep vein thrombosis
    LU Qiaodan, WANG Lei, DENG Haibo, XU Yuan, WANG Xiaojie, SUN Jianhua, ZHU Liyun, AN Ranxun, ZHOU Xinyi, WANG Yu, MA Yufen
    Chinese Journal of Nursing    2022, 57 (22): 2791-2795.   DOI: 10.3761/j.issn.0254-1769.2022.22.016
    Abstract640)   HTML5)    PDF (597KB)(48)       Save

    This paper reviews the existing assessment tools,outlines the development process,main contents,and application status of universal and disease-specific health-related quality of life assessment tools for patients with DVT,analyzes the characteristics and limitations of existing tools,and aims to provide references for clinical selection of appropriate assessment tools and for the development of health-related quality of life assessment tools for patients with DVT in accordance with the cultural background of China.

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