Table of Content

15 July 2019, Volume 54 Issue 7

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Research Paper

Longitudinal study of post-traumatic stress disorder and social support in amputated patients

LIU Dongmiao, LI Xin, LI Shu, CHENG Qiaomei

2019, 54(7):  965-969.  DOI: 10.3761/j.issn.0254-1769.2019.07.001

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Objective To investigate the status of post-traumatic stress disorder （PTSD） and social support in amputated patients at different time points,and to analyze the trajectory of change and relationship between them,so as to provide a scientific theoretical basis for psychological nursing of patients.Methods Forty-seven patients with amputation were selected by convenience sampling. The general information questionnaire,Social Support Scaling Questionnaire and Post-traumatic Stress Checklist-Civilian Version（PCL-C） were used to investigate and analyze the patients on the 3rd day,28th day,84th day,and 168th day after amputation.Results The detection rates of PTSD at four time points were 42.59%,51.06%,53.19% and 38.30%,respectively. The scales of PCL-C in 3rd day,28th day and 84th day showed an upward trend,with a significant decrease at 168th day（P<0.05）. The positive social support at four time points was always higher than the negative social support（P<0.05）,and both positive social support and negative social support were decreasing（P<0.05）. PTSD was negatively correlated with the positive social support at all time points,and positively correlated with the negative social support at all time points. There was a significant negative correlation between positive social support and negative social support.Conclusion The positive rate of PTSD among amputated patients is relatively high and patients bear a higher level of negative social support. The more negative social support patients perceive,the less positive social support they have,and the more likely they show PTSD symptoms.

Construction and application of classification health care programme in pregnant and puerperal period

GENG Zhijie, YUAN Xiaohua, JIA Hong, GENG Xiuchen, Tian Li

2019, 54(7):  970-974.  DOI: 10.3761/j.issn.0254-1769.2019.07.002

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Objective To explore the effects of classification health care programme in pregnant and puerperal period on improving maternal and infant health service quality and improve pregnancy outcomes.Methods Based on information system construction,through collaboration with the community hospital,the model of classification health care programme in pregnant and perinatal period was constructed. Totally 312 pregnant in the medical association community hospitals were selected and randomly divided into the experimental group and the control group. The experimental group received classification health care,the control group was given routine health service. Relevant indicators were collected,analyzed and compared.Results The coverage rate of midwives,the coverage rate of midwives in early and middle pregnancy,the average score of maternal health knowledge,the rate of natural delivery,the rate of exclusive breastfeeding within six months,the rate of weight gain,and the satisfaction of pregnant women in the experimental group were all higher than those in the control group（P<0.05）. The rate of hospital service loss,the rate of gestational diabetes,and the rate of gestational anemia in the experimental group were significantly lower than those in the control group（P<0.05）.Conclusion Classification health care programme can effectively improve the quality of health care services,promote natural delivery and reduce adverse pregnancy outcomes.

Special Planning-Stroke Nursing

Development and application of dietary nursing scheme for patients with dysphagia after first stroke

Lü Mengju, LIU Junjie, WANG Yandong

2019, 54(7):  975-980.  DOI: 10.3761/j.issn.0254-1769.2019.07.003

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Objective To develop dietary nursing scheme for patients with dysphagia after first stroke,and to explore the effects of application.Methods From July 2017 to June 2018,60 patients with grade 3 or 4 dysphagia after the first stroke were conveniently selected from neurology department of a tertiary hospital. Thirty patients in Ward One were included in the experimental group,and 30 patients in Ward Two were included in the control group. The experimental group was given a home-based dietary nursing scheme,and the control group was given routine dietary guidance. Three months after discharge,incidence of inhaled pneumonia,swallowing function and quality of life in two groups were compared.Results Three months after discharge,there was a significant difference in the incidence of pneumonia between two groups（P<0.05）. The score of swallowing function was significantly higher in the experimental group than that in the control group at 1 month and 3 months after discharge（P<0.05）. One month after discharge,quality of life in terms of eating time,symptom rate,food selection,fear,mental health,fatigue degree,psychological burden,eating desire and social interaction in the experimental group were better than those in the control group,and the differences were statistically significant（P<0.05）,but there were no significant differences in language communication and sleep between two groups（P>0.05）. At 3 months after discharge,the experimental group was superior to the control group in eating time,symptom rate,food selection,fear,mental health,fatigue degree,psychological burden,eating desire,social interaction and sleep,and the differences were statistically significant（P<0.05）. There was no significant difference in language communication between two groups（P>0.05）.Conclusion The home-based dietary nursing scheme for patients with dysphagia after first stroke can effectively prevent the occurrence of inhaled pneumonia and improve swallowing function and quality of life.

Association between 24-hour blood pressure and bleeding complications in patients underwent intravenous thrombolysis

ZHAO Jie, CHANG Hong, WANG Xiaojuan, ZHANG Jiajia, YAO Hui

2019, 54(7):  981-984.  DOI: 10.3761/j.issn.0254-1769.2019.07.004

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Objective To monitor and analyze the association between 24-hour blood pressure and bleeding complications in patients with acute ischemic stroke after intravenous thrombolysis,for predicting bleeding complications with possible blood pressure range and monitoring time.Methods Totally 487 patients with acute ischemic stroke who were admitted to four stroke centers in Beijing from June 2015 to December 2017 were enrolled and received rt-PA intravenous thrombolysis. Demographic data,blood pressure before thrombolysis,blood pressure within 24 hours after thrombolysis,imaging examination during bleeding,and laboratory inspection data were collected and analyzed.Results A total of 168 patients（34.5%） had bleeding complications. The baseline blood pressure of patients with bleeding complications was higher than that of patients with non-bleeding complications,and the difference was statistically significant（P<0.05）. The optimal blood pressure monitoring time for systemic hemorrhage,intracranial hemorrhage and gingival hemorrhage was before thrombolysis or during thrombolysis. Respiratory hemorrhage occurred early after thrombolysis,while nasal and urinary hemorrhage occurred about 12 hours after thrombolysis. The threshold values of blood pressure were 146/81.5 mmHg（systemic hemorrhage）,159.5/108.5 mmHg（intracranial hemorrhage）,159.5/85 mmHg（gingival hemorrhage）,184/87.5 mmHg（nasal hemorrhage）,143.5/100.5 mmHg（respiratory hemorrhage）,136.5./91.5 mmHg（urinary hemorrhage）,respectively.Conclusion High blood pressure within 24 hours after thrombolysis is risk factor for hemorrhage. Bleeding complications with possible blood pressure range and monitoring time provide basis for nursing observation.

Effects of guided imagery relaxation therapy in stroke patients

CHEN Changxiang, JIANG Hong, LIANG Yujuan

2019, 54(7):  985-988.  DOI: 10.3761/j.issn.0254-1769.2019.07.005

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Objective To explore the effects of guided imagery relaxation therapy on sleep disorders and pain in stroke patients.Methods A total of 150 stroke patients in department of internal neurology in a tertiary hospital were recruited from August 2017 to June 2018,and randomly divided into the guided imagery relaxation therapy group,the music group,and the control group. The guided imagery relaxation therapy group received music training therapy and guided imagery relaxation therapy,the music group received music training therapy,and the control group received routine nursing. The Pittsburgh Sleep Quality Index Scale（PSQI） was used to evaluate sleep quality,the Visual Analogue Scale（VAS） was used to evaluate pain,before intervention and 2 weeks,6 weeks after intervention.Results Two weeks and 6 weeks after intervention,differences in the scores of PSQI and VAS in three groups were all statistically significant（P<0.05）. The effects of guided imagery relaxation therapy were better than music training therapy.Repeated ANOVA indicated that time effect,inter-group effect,and interaction were all statistically significant（P<0.05）.Conclusion The guided imagery relaxation therapy can effectively ameliorate sleep disorders and relieve pain in stroke patients.

Risk factors of deep venous thrombosis in stroke patients：a Meta-analysis

TANG Wenjuan, SHI Zhenxian, ZHANG Caiyun, HU Zhe

2019, 54(7):  989-993.  DOI: 10.3761/j.issn.0254-1769.2019.07.006

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Objective To identify risk factors of deep venous thrombosis in stroke patients,providing early warning for prevention of deep vein thrombosis in stroke patients.Methods We searched databases including The Cochrane Library,PubMed,Embase,CNKI,Wanfang Data,VIP and CBM from inception to August 2018,to collect studies on risk factors for deep venous thrombosis of stroke patients. RevMan 5.3 software was used for Meta-analysis.Results Fourteen studies were included,and 22 related risk factors were analyzed. The statistically significant risk factors were age≥65 years（OR=1.93）,diabetes（OR=1.63）,coronary heart disease（OR=2.31）,atrial fibrillation（OR=1.55）,paralysis（OR=7.14）,deep vein puncture（OR=3.08）,being bedridden（OR=7.36）,heart failure（OR=1.96）,infection（OR=2.48）,admission NIHSS score（OR=5.78） and lower limb NIHSS score≥2 points（OR=2.28）.Conclusion The risk factors of deep vein thrombosis in stroke patients include age≥65 years,diabetes,coronary heart disease,atrial fibrillation,paralysis,deep vein puncture,being bedridden,heart failure,infection,admission NIHSS score and lower limb NIHSS score≥2.

Special Planning-Cognitive Impairment Nursing

Evaluation of effect of nurse-led integrated care on long-term management of patients with Alzheimer’s disease

CHEN Chunying, LU Ziqin, MENG Liping, LI Jun, LIU Caixia, XU Ying, XIE Yanhong

2019, 54(7):  999-1004.  DOI: 10.3761/j.issn.0254-1769.2019.07.008

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Objective To evaluate the effect of long-term multidisciplinary care in patients with Alzheimer’s disease（AD）.Methods A total of 88 patients with AD were enrolled between March 2016 and March 2018 in Hangzhou,and received multidisciplinary care intervention,including training of caregivers,case management,environmental arrangement,group activities,etc. The Activities of Daily Living Questionnaire（ADLQ）,Zarit Burden Interview（ZBI）,and quality of life（QOL） measurements were used to measure changes of patients with AD.Results The multidisciplinary care greatly increased patients’ ADLQ and QOL scores,alleviated the burden on caregivers after 3 and 6 months of intervention,and the differences were significant（P<0.05）.Conclusion The present study provides evidence that the multidisciplinary care is beneficial to the long-term management in patients with AD in terms of increasing activities of daily living and quality of life,as well as reducing care burden.

Development and validation of risk assessment model of abuse tendency among caregivers of elders with dementia in long-term care facilities

CHEN Weichen, CHEN Yu, GAO Yuanmin, YANG Wenjiao, WANG Jing

2019, 54(7):  1005-1011.  DOI: 10.3761/j.issn.0254-1769.2019.07.009

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Objective To analyze the related factors of abuse tendency among caregivers of elders with dementia in long-term care facilities,and to construct a risk assessment model,so as to provide evidence for early identification of abusive population in high-risk and formulation of intervention measures to prevent elder abuse.Methods A total of 307 caregivers of elders with dementia in 8 long-term care facilities were conveniently sampled and investigated from July to December 2018 by general information survey questionnaire,the Caregiver Abuse Screen for the Elderly(CASE),Neuroticism Extraversion Openness Five-Factor Inventory(NEO-FFI),Simplified Coping Style Questionnaire(SCSQ),Positive Aspects of Caregiver(PAC),General Health Questionnaire(GHQ-12).Results Self-rated difficulty of care and care recipients’ psycho-behavioral symptoms were the risk factors of abuse tendency among caregivers(OR=8.668,4.412). The protective factors of abuse tendency among caregivers were their agreeableness and openness(OR=0.888,0.940). The risk assessment model was Y=15 × X₁+10 × X₂-8 × X₃-4 × X₄(X₁：self-rated difficulty of care;X₂：psycho-behavioral symptoms;X₃：agreeableness;X₄：openness). The area under ROC curve was 0.856,the sensitivity was 81.0%,the specificity was 68.2%,the total coincidence rate was 74.6%. Hosmer-Lemeshow goodness of fit test showed that P=0.515 and the model fit was good.Conclusion Various related factors are involved in the occurrence of caregivers’ abuse tendency. The risk assessment model is effective in predicting caregivers’ abuse tendency,and has certain clinical application value.

Applicability of Barthel Index in long-term care facility of institutionalized patients with dementia

DING Lin, CHEN Suhong, WU Jialan, YI Yayan, LIAO Xiaoyan

2019, 54(7):  1012-1016.  DOI: 10.3761/j.issn.0254-1769.2019.07.010

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Objective To investigate the applicability of the original Barthel Index（BI） in long-term care facility of institutionalized patients with dementia,to provide a reference for the Barthel Index of the overall difficulty of the scale and the actual ability of institutionalized patients with dementia.Methods A total of 160 patients with dementia were included in this cross-sectional study from a nursing home in Guangzhou. The BI was administered among patients and data was analyzed by Rasch analysis.Results The Rasch first dimension explained 91% of the variance,while the second dimension explained 0.6%. Local dependence and item bias had not been detected. The item“mobility”（infit MNSQ=1.53,Z=3.8） showed misfit to the Rasch model. The item-person maps demonstrated that the mistargeting of the BI to the patient. The items had narrow intervals between response categories（<1.4 logits）. DIF had not been detected between gender subgroups,as well as subgroups among severity of dementia. The reliability of the Barthel Index person reliability was 0.91,item reliability was 0.99.Conclusion Although the Barthel Index is an unidimensional and reliable scale,however,the overall difficulty of the scale is not consistent with the actual ability of dementia patients. The revision of the Barthel Index,such as decreasing the item difficulty and adjusting the intervals between response categories,is necessary to improve the applicability of the scale in institutionalized patients with dementia.

Specialist Practice and Research

Effects of group-based exercise on mood disturbance symptoms in pediatric cancer patients

OUYANG Na, ZHOU Xuezhen, CAI Ruiqin, LIU Meiling, HUANG Haiying, QIU Xing, LIU Ke

2019, 54(7):  1028-1031.  DOI: 10.3761/j.issn.0254-1769.2019.07.013

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Objective To examine the effects of group-based exercise on mood disturbance symptoms and quality of life for pediatric cancer patients.Methods Fifty-seven pediatric cancer patients admitted in the cancer departmentin a tertiary hospital in Guangzhou were included in the intervention group,who were provided with routine nursing as well as group-based exercise. Matched by age,gender and diagnosis,57 pediatric cancer patients in other two tertiary hospitals were included in the control group receiving routine nursing. Mood disturbance symptoms and quality of life were measured using mood disturbance symptom questionnaire and the Pediatric Quality of Life Inventory Generic Core Scales before and after intervention.Results After intervention,the score of mood disturbance symptoms in the intervention group was significantly lower than that in the control group（P<0.05）;after intervention,the score of quality of life and scores of all dimensions in the intervention group were significantly higher than those in the control group（P<0.05）.Conclusion Group-based exercise can release mood disturbance symptoms and improve quality of life for pediatric cancer patients.

Effects of biofeedback training on prevention of anterior resection syndrome in rectal cancer patients underwent anus-preserving surgery

ZHENG Meichun, WU Xiaodan, JIANG Wu, WEN Yongshan, YANG Xia, PAN Zhizhong

2019, 54(7):  1032-1037.  DOI: 10.3761/j.issn.0254-1769.2019.07.014

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Objective To evaluate the effects of biofeedback training on prevention of anterior resection syndrome in rectal cancer patients underwent anus-preserving surgery.Methods Using randomized controlled trial design,71 rectal cancer patients were randomly divided into the pelvic floor muscle exercise group and biofeedback training group. High resolution anorectal manometry was used for 6 longitudinal traces in 18 months.Results Rectal maximal tolerable volume and rectal compliance in the biofeedback training group were significant higher than those in the pelvic floor muscle exercise group（P<0.05）,and biofeedback training decreased the occurrence of anterior resection syndrome（P<0.05）.Conclusion The biofeedback training can significantly improve the sensory indicators of patients with middle and low rectal cancer,promote recovery and prevent anterior resection syndrome.

Rumination status and influencing factors in young and middle-aged cancer patients during hospitalization

LI Qiuhuan, ZHAO Wenwen, TIAN Ruxiang, LUAN Xiaorong

2019, 54(7):  1038-1043.  DOI: 10.3761/j.issn.0254-1769.2019.07.015

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Objective To investigate the level and influencing factors of rumination in young and middle-aged cancer patients,to provide a basis for clinical medical staff to implement personalized intervention.Methods Totally 373 cancer patients in the department of oncology at a tertiary hospital in Shandong Province were investigated using general information questionnaire,Chinese Version of Event Related Rumination Inventory,and Emotion Regulation Scale.Results The score of rumination of cancer patients was（28.64±12.13）,intrusive rumination score was（13.92±6.42）,the purpose of rumination score was（14.72±6.80）. Expression suppression and religion could explain 14.2% of the total variance of invasive rumination. Expression suppression,family relationship and education level could explain 22.1% of the total variance of purposive rumination.Conclusion The rumination level was low in cancer patients. Expression suppression,religion,family relationship and educational level are important influencing factors of rumination in cancer patients. To promote the development of positive cognitive processing and the recovery of physical and mental,personalized intervention should be taken by clinical medical staff in cancer patients with different characteristics.

Investigation on needs of patients undergoing percutaneous coronary intervention for preoperative visit

YANG Zengzhen, BAI Xiaoling, LIANG Qinglong, PANG Jin, XING Yi

2019, 54(7):  1044-1047.  DOI: 10.3761/j.issn.0254-1769.2019.07.016

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Objective To investigate the needs of patients undergoing percutaneous coronary intervention（PCI） for preoperative visits and analyze its influencing factors.Methods A total of 271 patients from two hospitals in Guiyang were investigated by self-designed questionnaire.Results The total score of preoperative visits needs for PCI patients was（145.76±21.20）,the dimension score of related costs was the highest,followed by psychological support,environment information and procedure was the lowest. Multiple linear regression analysis showed that the total score of needs for PCI patients were associated with education,residence,medical insurance.Conclusion PCI patients have high demand for preoperative visits,especially for related costs and psychological support. It is suggested that nurses should give personalized and diversified preoperative guidance and psychological intervention according to the specific conditions and needs of patients,so as to reduce patients’ stress response and improve their experience during hospital visit.

Nursing care of pediatric patients receiving procedural feeding with complicated congenital heart disease underwent delayed chest closure

FU Weijia, GU Ying, MI Yaping, XU Yulu, PAN Yun

2019, 54(7):  1048-1051.  DOI: 10.3761/j.issn.0254-1769.2019.07.017

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This article summarized nursing experience of procedural feeding for five pediatric patients with complicated congenital heart disease underwent post-operative delayed chest closure. Key nursing points included: a procedural feeding program was developed together with pediatric cardiologists,cardiac surgeons,cardiac specialist nurse,nutritionists,gastroenterologists and rehabilitation specialists; minimal feeding was performed to maintain intestinal function; enteral nutrition was initiated as early as possible after full assessment of intestinal function,and initial feeding volume was set at 1 to 2 ml/（kg·h）; feeding intolerance was assessed by abdominal circumference measurement（once/12 h）,bowel sounds and gastrointestinal symptoms; implementation of enteral nutrition was advanced in an orderly and regular manner,and nutritional status of pediatric patients was continuously monitored,weight was assessed twice a week,and length of body was assessed once a week. All pediatric patients in this group successfully received chest closure,and all reached the full amount of oral feeding,who were discharged after the disease was relieved.

Nursing cooperation for robot-assisted total hip arthroplasty

HAN Jing, LI Xueyun

2019, 54(7):  1052-1055.  DOI: 10.3761/j.issn.0254-1769.2019.07.018

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We summarized key points of nursing cooperation for robot-assisted total hip arthroplasty in 14 cases,which were ① Participate in preoperative discussion,be familiar with surgery plan,and prepare surgical instruments and prosthesis according to preoperative modeling results;② Place the surgical facilities properly to assist information feedbacks of bone markers and camera of the robot,to reduce position adjustment of the equipment during surgery;③ Instrument nurse should clean their hands in advance to check performance of the mechanical arm,install the reference frame and power equipment,and register and validate the robot arm;④ Surgical counting was performed strictly,including electrocardiogram electrode stuck in the center of patella,bone needle placed in the anterior superior iliac spine,marking nails fixed in the femoral great trochanter and outer upper margin of acetabulum; ⑤ Strengthen sterile management of the mechanical arm to ensure the effective intraoperative range of operation; ⑥ Place surgical position properly according to the surgical approach,to maintain the function position of patients and fully exposure surgical field;⑦ Maintain the equipment regularly and keep the base of the machine arm in the state of electricity storage. All 14 patients successfully received surgery. No complications such as dislocation,infection,vascular and nerve injury occurred in postoperative follow-up.

Nursing Management

The establishment and implementation of neonatal care clinic

WEN Xiulan, LIN Yan, SUN Li, HE Fang, WANG Xiaojie, GUO Xiaoping, ZHOU Yan, CHEN Mei, LIU Meiyi

2019, 54(7):  1056-1059.  DOI: 10.3761/j.issn.0254-1769.2019.07.019

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Objective To establish and implement a neonatal care clinic for meeting the needs of neonatal continuing nursing service. Methods Regulations were set up,nurses were selected,and the neonatal care clinic was established for screening of neonatal jaundice and parenting guidance. Nurses,doctors and parents were investigated for evaluation of the clinic. Results A total of 16 nurses were selected for the clinic. From March to August 2017,there were 2,543 cases for neonatal care visits,and the number of cases for neonatal jaundice was the highest which was 2038（80.14%）. All nurses believed that the clinic improved parents’ satisfaction with hospital and nursing work,and they agreed that specialist nursing capacity was improved;66.67% of the doctors considered that specialist nursing clinic was helpful to the diagnosis and treatment of patients;80% of the parents had a total score of 90 to 100 on evaluation of the neonatal care clinic. Conclusion The neonatal care clinic can effectively identify pathological jaundice and solve parenting problems from parents,improve professional and social status of neonatal specialist nurses and their confidence to be clinical nursing specialists,and received recognition from doctors and parents.

A multicenter survey of knowledge and attitude about physical environment among ICU medical staffs

HE Jinyi, Li Hong, CHEN Xiaohuan, JIN Shuang, CHEN Lili, CHEN Meirong, LI Na

2019, 54(7):  1060-1064.  DOI: 10.3761/j.issn.0254-1769.2019.07.020

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Objective To investigate the knowledge and attitude of ICU physicians and nurses on physical environment in ICU setting and to explore the influencing factors.Methods A self-made questionnaire was used to survey 487 physicians and nurses from 8 tertiary hospitals and 14 secondary hospitals in Fujian Province.Results The ICU physicians and nurses’ knowledge and attitude scores were （33.25±7.14） and （42.17±3.26）. Multiple regre-ssion analysis showed that educational background and level of hospitals were influencing factors for knowledge scores for physical environment in ICU medical staffs（P<0.01）. Job title,position and level of hospitals were influencing factors for attitude score for physical environment in ICU medical staffs（P<0.01）.Conclusion ICU physicians and nurses took a positive attitude about physical environment,while the level of knowledge should be improved.

Investigation on disaster preparedness of male nurses and its influencing factors

DENG Xianfeng, XIONG Lijuan, LIU Yilan, WANG Xianke, YANG Linjie, YUAN Feijun, ZHANG Yue, CHEN Qinghong, LI Xia

2019, 54(7):  1065-1069.  DOI: 10.3761/j.issn.0254-1769.2019.07.021

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Objective To investigate the current status of male nurses’ disaster preparedness and analyze its contributing factors.Methods A total of 270 male nurses from 53 hospitals in Hubei Province were investigated with the Chinese version of Disaster Preparedness Evaluation Tool.Results The total score of disaster preparedness of male nurses was（162.87±40.53）. Among three dimensions of the tool,personal preparedness dimension had the lowest score. Disaster rescue training,experience of disaster rescue,and clinical department were influencing factors of disaster preparedness（P<0.05 for all）.Conclusion Disaster preparedness of male nurses is in the middle level and disaster training should be provided.

Nursing Education

Clinical nursing teachers’ soft skills and their effects on teaching behaviors

FAN Wenhai, DENG Zheng, FENG Xinwei, LI Xiuya

2019, 54(7):  1070-1074.  DOI: 10.3761/j.issn.0254-1769.2019.07.022

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Objective To investigate the current status of clinical nursing teachers’ soft skills and explore their effects on teaching behaviors,and to provide suggestions for training of clinical nursing teachers and improving their comprehensive competency.Methods A total of 340 clinical nursing teachers in four hospitals in Beijing were investigated using general information questionnaire,nursing soft skills assessment scale and clinical nursing teachers’ behavior scale.Results The score of nursing soft skills was （160.24±14.62）,and the score for cognitive skills was relatively lower,the behavior score was （98.88±0.41）. Nursing soft skills and clinical nursing teachers’ behaviors were significantly correlated（P<0.01）. Hierarchical multiple regression showed that 27.9% of the variation in teaching behaviors was explained by soft skills.Conclusion The clinical nursing teachers’ soft skills level is general,teaching behaviors are satisfied,and nursing soft skills are significant influencing factor of teaching behaviors. Nursing administrators can improve soft skills of clinical nursing teachers through targeted measures so as to improve their teaching behaviors.

Application of experiential learning in training of protective restraint skills among psychiatric junior nurses

WANG Jianying, WANG Jinghua, ZHAO Shuqin, LI Shuanrong, ZHI Yanmin, ZHANG Donghong

2019, 54(7):  1075-1079.  DOI: 10.3761/j.issn.0254-1769.2019.07.023

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Objective To explore the effects of application of experiential learning in training of protective constraint skills among psychiatry junior nurses.Methods The training of experiential learning was performed in 60 psychiatry junior nurses for 8 weeks,according to Perception-Experience-Sharing-Communication-Integration-Application. The nursing care behavior scale and patient care perception questionnaire were used to evaluate nurses and patients before and after the training,and the clinical practice effect was investigated after 3 months,compared with the same period last year.Results The score of nursing care behavior scale was significantly higher than that before the training（P<0.001）,and the score of patients’ care perception questionnaire was significantly higher than that before the training （P<0.001）. After training,the restraint rate of patients decreased,but there was no significant difference. The incidence of restrictive nursing complications was significantly lower than that before training,and the difference was statistically significant（P<0.05）.Conclusion Experiential learning can improve the ability of humanistic care,reduce the incidence of restraint and restraint nursing complications.

Vascular Access Nursing

Development and validation of the risk assessment tool for PICC-related thrombosis

LIU Shanshan, FU Yan, LI Junying

2019, 54(7):  1080-1084.  DOI: 10.3761/j.issn.0254-1769.2019.07.024

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Objective To construct and validate a tool for risk assessment of PICC associated venous thrombosis to provide scientific basis for rapidly improving recognition rate of PICC-related thrombosis.Methods Combining with relevant literature,item pool of risk assessment tool for PICC-related thrombosis was established. By Delphi Method and analytic hierarchy process （AHP）,the risk assessment index system of PICC-related thrombosis was established. A total of 130 cancer patients were investigated to test reliability and validity. ROC curve was constructed to identify the critical value and corresponding recognition capacity.Results The risk assessment index system of PICC-related thrombosis included 3 first-level indicators,and 22 second-level indicators. The Cronbach’s alpha of three dimensions,as well as the whole scale were 0.805,0.683,0.751,and 0.794 respectively. The results of ROC curve showed that AUC was 0.728 [P=0.013,95%CI（0.594,0.862）],The best high-risk critical value was 5.5,while corresponding sensitivity was 0.909,and specificity was 0.471.Conclusion The PICC-related venous thrombosis risk assessment scale has good reliability and validity,which can be used as an assessment tool for screening risks of venous thrombosis in PICC patients during clinical practice.

Evidence Synthesis Research

Women’s experience of undergoing reconstructive surgery after breast cancer：a qualitative Meta-synthesis

LI Mengyuan, TIAN Li, WU Ting, ZHANG Qingyue, LI Jiaqian, YAN Ling

2019, 54(7):  1091-1096.  DOI: 10.3761/j.issn.0254-1769.2019.07.027

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Objective To systematically review women’s experience of undergoing reconstructive surgery after breast cancer to fully understand patients’ psychological needs and provide better evidence for clinical work.Methods We searched databases including the Cochrane Library,Joanna Briggs Institute Library,PubMed,EMbase,Scopus,Web of Science,CINAHL,PsycINFO,CNKI,and CMB from inception to September 2018,to collect qualitative studies on women’s experience of undergoing reconstructive surgery after breast cancer. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods.Results A total of ten studies were included. Twenty-nine complete findings were grouped according to similarities to form seven new categories. These categories resulted in three synthesized findings：decision making for breast reconstruction：lack of information and hesitation;painful struggle after breast reconstruction：difficulties insurgical process and frustration with the outcome;adjustment after breast reconstruction：psychological and life style adjustment.Conclusion Healthcare workers should pay attention to psychological changes and information needs of patients with breast reconstruction,provide necessary support to help patients to adapt to life after breast reconstruction,and improve patients’ quality of life.

Best evidence summary on prevention and management of urinary retention after radical resection in cervical cancer patients

Lü Yongli, LI Shasha, LI Xia, WU Pei, WAN Cheng, WANG Peihong, YU Jiaohua, ZENG Ya, WANG Shaohai, YANG Shouhua

2019, 54(7):  1097-1101.  DOI: 10.3761/j.issn.0254-1769.2019.07.028

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Objective To search,evaluate,and summarize best evidence on prevention and management of urinary retention after radical resection in cervical cancer patients,so as to provide reference for clinical work.Methods We searched BMJ Best Practice,UpToDate,Cochrane Library,Joanna Briggs Institute Library,OVID database,China Guideline Clearinghouse,National Guideline Clearinghouse（NGC）,ClincalKey for Nursing,Registered Nurses’ Association of Ontario,PubMed,EMbase,Cumulative Index to Nursing Allied Health Literature to collect all articles on prevention and management of urinary retention after radical resection in cervical cancer patients,including clinical practice guidelines,best practice information sheet,evidence summary,and systematic review. The retrieval period was from the inception to May 2018.Results A total of 16 articles were included,and they were 5 clinical practice guidelines,5 systematic reviews,4 evidence summaries,and 2 clinical decisions. Finally 14 items of best evidence were summarized.Conclusion Clinical departments should select evidence according to cultural background,clinical environment,patients’ intention and preference,and attention should be paid to update of evidence.