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Table of Content

    15 November 2021, Volume 56 Issue 11
    Research Paper
    Effect of resistance exercise program on muscle strength and cardiopulmonary function in elderly bedridden patients
    WANG Yingjie, QIAO Ran, YU Tong, WANG Shuai, WANG Xiaojing
    2021, 56(11):  1605-1611.  DOI: 10.3761/j.issn.0254-1769.2021.11.001
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    Objective The aim of this study is to establish resistance exercise in the bedridden elderly in China and to study its effect on muscle strength and cardiopulmonary function. Methods This RCT consecutively enrolled 64 patients aged 80 years and above with stable diseases at a tertiary hospital during March to April 2020. The patients were randomly divided into a control group(received routine treatment and nursing care) and a training group(undergoing 6 months of low-load resistance training with routine treatment and nursing care). The differences in muscle strength and cardiopulmonary function between the patients of 2 groups were analyzed. Results 64 patients were included in the study,while 59 patients(with 29 in the training group and 30 in the control group) completed the study. In terms of muscle strength,the patients of the training group had better grip strength compared with that of the control group at 3 and 6 months(P<0.05),and better supine leg lifts and 30 s sit-to-stand actions than those of the control group at 6 months(P<0.05). In terms of cardiopulmonary function,the patients in the training group had better lung capacity compared with that in the control group at 6 months(P<0.05). There were no significant differences in blood pressure,heart rate and left ventricular ejection fraction between the 2 groups(P>0.05). Conclusion The low-load and low-intensity resistance training using elastic band and ball can effectively improve the muscle strength of the bedridden elderly,as well as the lung function to a certain extent. However,the effect on improving the cardiac function is not obvious.

    The development and validation of a risk prediction model for peristomal moisture-associated skin damage
    LIU Yingge, WU Yan, CAO Qiujun, QIU Qun, LÜ Guifen, XU Honglian, GAO Jian
    2021, 56(11):  1612-1617.  DOI: 10.3761/j.issn.0254-1769.2021.11.002
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    Objective To develop a risk prediction model of peristomal moisture-associated skin damage(PMASD),and to apply to clinical practice to validate its prediction performance. Methods The prospective study design and the convenience sampling method were adopted. A total of 329 patients from 4 hospitals in Shanghai were enrolled from November 2019 to September 2020,and predictors between the complication group(141 cases)and the non-complication group(188 cases) were compared using Logistic regression based on Lasso selection for model development. The goodness of fit of the model was verified by Hosmer-Lemeshow test. The discrimination was evaluated by the area under the ROC curve(AUC). The Bootstrap resampling was used for internal validation. From October to November 2020,109 patients were recruited for external validation. Results The incidence of complication in the development cohort was 42.9%(141/329),and 37.6%(41/109) in the validation cohort. The predictors that ultimately entered the prediction model were gender(OR=0.497),type of stoma(OR=4.338),height of stoma(OR=0.304),surgical wound in plate area(OR=3.479),plate attachment(OR=2.399),soft diet(OR=3.155),and semi-fluid diet(OR=3.325). The H-L test P=0.274;the AUC was 0.812. The Youden index was 0.500,with the sensiti-vity of 0.688 and the specificity of 0.798. While the external validation H-L test P=0.515,the AUC was 0.860 with the sensitivity of 0.610 and the specificity of 0.882. Conclusion The prediction model developed in this study has a good performance,which can provide a reference for clinical screening of high-risk patients with PMASD.

    Special Planning-Pediatrics Nursing Care
    Construction and application of family-positive behavior support programme for preschool children with malignant tumors
    PAN Xiaorong, MO Lin, LIU Qian, ZHANG Shiqun, GUO Xiaoli, YAO Juan, HUANG Xiaoyan
    2021, 56(11):  1618-1626.  DOI: 10.3761/j.issn.0254-1769.2021.11.003
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    Objective To construct a family-positive behavior support programme based on Family System Theory for preschool children with malignant tumors,and to explore effects of its application. Methods From March 2019 to February 2020,100 preschool children with malignant tumors were selected and randomly allocated into an experimental group(n=50) and a control group(n=50). The experimental group was given interventions of the family- positive behavior support,while the control group was given the routine psychological care. The scores of Family Adaptation and Cohesion Evaluation Scales Ⅱ(FACES Ⅱ),Parental Psychological Flexibility Questionnaire(PPFQ)and Strengths and Difficulties Questionnaire(SDQ) before and after the intervention between 2 groups were compared. Results After intervention,the total scores of SDQ in the experimental group and the control group were lower than those before intervention(P<0.001),and the total scores of FACES Ⅱ were higher than those before intervention(P<0.001);the total score of PPFQ in the experimental group after intervention was higher than it before intervention(P<0.001). After intervention,the total score of SDQ in the experimental group was lower than those in the control group(P<0.001);the total scores of FACES Ⅱ and PPFQ in the experimental group were higher than those in the control group(P<0.05). Conclusion Regardless of whether the children with malignant tumors have emotional and behavioral problems,the family-positive behavior support programme can reduce the incidence of emotional behavior problems,improve family intimacy and adaptability and parental psychological flexibility.

    Caring experiences of parents of neonates with enterostomy:a qualitative study
    WU Jinhua, NI Zhihong, ZHAO Xueping, ZHANG Qing, WANG Fang
    2021, 56(11):  1627-1632.  DOI: 10.3761/j.issn.0254-1769.2021.11.004
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    Objective To investigate the caring experiences of parents of neonates with enterostomy in different phases based on “Timing It Right” framework. Methods Phenomenological method was used in this study. 43 parents of neonates with enterostomy in different caring phases participated in the non-structured interviews. Data was analyzed by Colaizzi phenomenon analyzing methods. Results Based on “Timing It Right” framework,different caring experiences in 5 phases of neonates with enterostomy were extracted. They experienced the complicated emotion reaction in the diagnosis period,the increased uncertainty and strong demand for support in the stable period,the insufficiency of confidence,anxiety and helplessness in the discharge preparation period,the eager for professional support in the adjustment period,the positive engagement and the sense of growth in the adaptation period. Conclusion The caring experiences of parents of neonates with enterostomy in different phases of disease are dynamic,and medical staff should provide personalized services to help parents get through the hard times smoothly and enhance the continuity of home care.

    Nursing care of 3 children with Langerhans cell Histiocytosis after liver transplantation
    REN Fangfei, XU Qixin
    2021, 56(11):  1633-1637.  DOI: 10.3761/j.issn.0254-1769.2021.11.005
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    This article summarizes the nursing experience of 3 cases of Langerhans cell histiocytosis after liver transplantation. The main points of nursing include:multi-organ function monitoring,timely reporting of abnormal conditions;to conduct protective isolation to reduce postoperative infections;to strengthen skin care;to develop individualized rehabilitation exercise plans and provide rehabilitation exercise guidance;to use immunosuppressive drugs correctly,to conduct immune induction therapy,and prevent the occurrence of rejection;to start nutritional support as soon as possible;to provide psychological care to relieve anxiety;to do a good job of discharge guidance,to establish a follow-up system,and conduct regular follow-ups. After careful treatment and care,all 3 children recovered and were discharged.

    The long-term follow-up experience of childhood cancer survivors:a qualitative meta-synthesis
    WANG Yongli, CHEN Yiqian, LI Xiaodan, YU Hailing, JIA Dongmei
    2021, 56(11):  1638-1643.  DOI: 10.3761/j.issn.0254-1769.2021.11.006
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    Objective To systematically review the experience of childhood cancer survivors(CCS) in long-term follow-up (LTFU) care,in order to provide a reference for the improvement of high-quality follow-up care for CCS in China. Methods We searched databases,including the PubMed,Embase,Web of Science,Cochrane Library,CINAHL,CNKI,CBM,VIP and Wanfang from inception to June 2021,to collect qualitative studies on the experience of LTFU care of CCS. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. Meta-synthesis was used to integrate results. Results A total of 12 studies were included,and 60 complete findings were summarized into 10 categories. These categories resulted in 3 synthesized findings. CCS were exhausted physically and mentally,and interpersonal relationships were strained,but they were still eager to get family and social support;the unmet disease management needs and poor communication with health care providers for CCS have caused limitations in their daily lives; although CCS have insufficient cognition of LTFU,they have strong motivation to participate and look forward to comprehensive LTFU nursing service. Conclusion The medical staff should pay attention to the CCS,give much attention to their follow-up experience,give them medical information,emotional and social support in time. It is also necessary to strengthen the standardized training of professionals,enrich the follow-up service content and participation forms,so as to ensure the sustainability of long-term follow-up and help CCS better adapt to the society.

    Research progress of assessment tools for the level of pediatric sedation
    ZHANG Wanying, DAI Yanhong, JIN Hua, LU Lu, LU Fangyan
    2021, 56(11):  1644-1648.  DOI: 10.3761/j.issn.0254-1769.2021.11.007
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    Evaluation of sedation level guides sedation behavior and it is an important basis for formulating sedation management plans for children. This paper mainly reviews the contents,features,advantages and limitations of the assessment tools for pediatric sedation,compares the basic conditions and clinical applications of the scales,and attempts to provide a reference for clinical nurses to choose appropriate assessment tools and improvement of sedation assessment accuracy.

    The sinicization of Parenting Support for Mothers of Infants and the test of its reliability and validity
    XIA Xingge, ZHAO Lijie, ZHANG Biyu, LIU Yanhui, DENG Qiuxiang
    2021, 56(11):  1649-1654.  DOI: 10.3761/j.issn.0254-1769.2021.11.008
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    Objective To develop the Chinese version of Parenting Support for Mothers of Infants,and to examine its reliability and validity. Methods According to the Brislin translation model of translation,back-translation,cultural adjustment,and semantical analysis,the Chinese version of the questionnaire was determined. Reliability and validity of the questionnaire were explored through investigation among 740 mothers of infants from March to April 2020 and January to February 2021 in Guangdong Province. Results The Chinese version of the questionnaire has 57 items. The exploratory factor analysis extracted 5 common factors,and the cumulative variance contribution rate was 50.294%. The Cronbach’s α coefficient of scale-level was 0.954;the dimension-level was 0.833~0.925. The test-retest reliability of the scale-level was 0.945;the dimension-level was 0.805~0.911. SCVI value of the questionnaire was 0.89,and the average SCVI was 0.96. Conclusion The Chinese version of the questionnaire was proved to be an effective tool for assessing the current status of parenting support for mothers of infants. The scores of the questionnaire can predict whether the infant’s mother has child-raising anxiety or child-raising difficulties,which is helpful for clinicians to promote the physical and mental health of infants and their families through interventions.

    Specialist Practice and Research
    Clinical practice of objective management project to reduce the incidence of catheter-related urinary tract infection
    ZHANG Lan, WANG Jingjing, LI Jing, WEI Wengui, YUAN Jiqing, SUN Yan, ZHANG Nan, LIN Mei
    2021, 56(11):  1655-1660.  DOI: 10.3761/j.issn.0254-1769.2021.11.009
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    Objective To improve the project of reducing the incidence of catheter-associated urinary tract infection(CAUTI)through the management by objectives(MBO),so as to enhance the quality by setting,implementing and completing goals. Methods The data of patients with indwelling catheters hospitalized in a tertiary Grade A General Hospital from April 2020 to September 2020 were analyzed. The project objectives and plans were developed through MBO. Besides,the project was implemented according to the plans,and an assessment of the process was carried out. Actions were taken to improve the project based on the feedback of assessment results. A month is set as a quality cycle. The quality of the first cycle is the baseline,and then the quality of each cycle is compared with the baseline data and the quality of the previous cycle. Results Compared with the baseline quality of 12 process indexes,6 indexes were statistically significant in the second cycle(P<0.05). The results that were better than the baseline quality and the quality of the second cycle were statistically significant,compared with the baseline quality(P<0.001). The baseline completion rate of 5 process indexes has reached a greater extent. Similar measurement data were obtained after that,indicating that high-quality nursing care was given. The indexes of the incidence of CAUTI at the end of the project were statistically significantly lower than the baseline(P<0.05). The completion rate of the process indexes was over 95%,indicating that objectives were met. Conclusion MBO can be used for improvement in projects and goal-oriented management of indexes. It can also verify the effectiveness and further improve the quality by objectively measuring and scientifically comparing the quality of nursing care.

    Risk factors of stroke and fear of stroke recurrence in elderly stroke patients with semi disability
    BAO Jinlei, YANG Qingai, ZHANG Jun, WANG Yang
    2021, 56(11):  1661-1665.  DOI: 10.3761/j.issn.0254-1769.2021.11.010
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    Objective To investigate the current situation of fear of stroke recurrence in elderly stroke patients with semi disability,and to analyze its influencing factors. Methods A total of 584 stroke patients from 23 communities in Jinan City,Shandong Province from May to December 2020 were randomly investigated by the general information questionnaire,Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Brief Illness Perception Questionnaire(BIPQ) and Barthel Index Scale. Results The level of fear of stroke recurrence was higher in elderly patients with stroke and semi disability. The score of fear of stroke recurrence in 584 elderly patients with stroke and semi disability was (38.89±7.13),among which 498 patients(85.27%) scored ≥34. The score of BIPQ was (50.12±7.65) and Barthel Index was (43.86±6.16). Multiple stepwise regression analysis showed that age,Barthel Index Score,course of disease,recurrence times and disease perception were the influencing factors of fear of stroke recurrence(P<0.05). Conclusion The fear of stroke recurrence is more common in elderly stroke patients with semi disability,and the incidence rate is relatively high. Medical staff should make intervention measures according to the influencing factors of the fear of stroke recurrence,so as to improve the cognition of stroke patients to the disease,improve the basic daily living ability of stroke patients,and reduce the fear of stroke recurrence in elderly stroke patients with semi disability.

    Development and psychometric test of Recurrence Risk Perception Scale for Patients with Stroke
    LIN Beilei, ZHANG Zhenxiang, GUO Yunfei, WANG Wenna, KONG Peipei, LIU Fang, ZHANG Yaqin, ZHANG Chunhui
    2021, 56(11):  1666-1671.  DOI: 10.3761/j.issn.0254-1769.2021.11.011
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    Objective To develop an instrument for measuring recurrence risk perception of stroke patients and to test its reliability and validity. Methods The research was completed under the guidance of Health Belief Model and Risk Perception Attitude Framework. The initial measurement was developed after literature review and qualitative interviews. The items were formed and adjusted after Delphi technique and cognitive reviews. 327 stroke patients were conveniently selected and investigated to test the reliability and validity of the scale. Results The stroke recurrence risk perception scale included 2 parts:the first part was consisted of 3 items,and the second part was consisted of 3 domains and 17 items with the accumulated variance contribution rate of 61.103%. The content validity index of the scale ranged from 0.926 to 0.954. The Cronbach’s α coefficient of the second part was 0.850;the split-half reliability was 0.656;the two-week test-retest reliability was 0.710,and the one-month test-retest reliability was 0.635. Conclusion The stroke recurrence risk perception scale has good reliability and validity,which is a suitable tool for the evaluation of recurrence risk perception of stroke patients.

    The development and psychometric testing of Nutritional Care Competence Scale for Clinical Nurses
    ZHU Xinyi, ZHAO Mei, YANG Ya, QING Qiting
    2021, 56(11):  1672-1678.  DOI: 10.3761/j.issn.0254-1769.2021.11.012
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    Objective To develop the Nutritional Care Competence Scale for Clinical Nurses and to test its reliability and validity. Methods On the basis of literature analysis and semi-structured interviews,the evaluation index system of clinical nurses’ nutritional care competence was constructed through 2 rounds of Delphi expert correspondence,and the pre-test scale was prepared. From December 2020 to February 2021,367 clinical nurses were selected for item analysis and exploratory factor analysis of the pre-test scale. In the second stage,762 clinical nurses from 4 hospitals were selected for confirmatory factor analysis,reliability and validity analysis of the scale to form a formal scale. The competence inventory for Chinese registered nurse(CIRN) was used as the criterion related validity reference. Results The formal Nutritional Care Competence Scale of Clinical Nurses with 5 dimensions and 63 items was formed. 7 common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 75.409%;confirmatory factor analysis showed that the fitting index of the scale structure model was good. The overall content validity index of the scale was 0.968,and the content validity index of each item was 0.833~1;the correlation coefficient between the total score of the scale and the total score of CIRN was 0.788,and the correlation coefficient between each dimension was 0.582~0.809(P<0.05). The overall Cronbach’s α was 0.991;the split half reliability was 0.926,and the test-retest reliability was 0.876(P<0.001). Conclusion The Nutritional Care Competence Scale for Clinical Nurses has good reliability and validity,and it can be used as a tool to evaluate the nutritional care competence of clinical nurses.

    Nursing Management
    Implementation leadership of head nurses in Chinese tertiary and secondary hospitals:a cross-sectional study in Hunan
    HU Shuang, CHEN Jia, CHEN Wenjun, HU Zhonghao, HU Huiping, JIANG Renzhou
    2021, 56(11):  1679-1684.  DOI: 10.3761/j.issn.0254-1769.2021.11.013
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    Objectives To investigate and analyze the status quo of head nurses’ implementation leadership in tertiary and secondary hospitals in Hunan Province,so as to provide references for the formulation of implementation leadership training programs. Methods From October to December 2020,2 cluster random sampling methods were used to sample 5 tertiary hospitals and 5 secondary hospitals in Hunan Province,with head nurses and nurses from 10 departments in each hospital,using implementation leadership scale(ILS) to investigate the leadership of head nurses in evidence-based practice. SPSS 25.0 was used for statistical description and inference of data. Results The score of implementation leadership of head nurses is(2.85±1.15) in self-evaluation and(3.23±0.96) in observer evaluation. Supportive leadership scores are the highest in both self-evaluation and observer evaluations;knowledge leadership scores are the lowest in self-evaluation;proactive leadership scores are the lowest in observer evaluations. The 3 dimensions of proactive leadership,knowledge-based leadership,and enduring leadership,as well as the overall scores of observer evaluation,are all higher than those of self-evaluation(P<0.05). Conclusion The implementation leadership of head nurse needs to be further improved,and its knowledge leadership is particularly important,which needs the attention of nursing educators and researchers. Managers should provide an open and supportive environment for the development of evidence-based practice,promote the implemen-tation leadership of head nurses,and finally optimize the implementation of clinical evidence-based practice.

    Nursing Education
    Construction of a death education program for nursing staff based on constructivism learning theory
    LI Fengxia, LIU Zhengzheng, HU Chengwen, ZHU Xiaoming, WANG Xiaoqian, SUN Juan, HUANG Yang
    2021, 56(11):  1685-1690.  DOI: 10.3761/j.issn.0254-1769.2021.11.014
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    Objective From the perspective of constructivism learning theory,a death education program for nursing staff is constructed to provide references for the implementation of death education in nursing staff. Methods Since July 2020,through literature content analysis,the draft of the death education program was preliminarily formulated,and 23 experts were selected to carry out 2 rounds of expert letter consultations to form the first draft of the death education program. Finally,the final draft of the death education program was further revised through preliminary experiments. Results The expert judgment basis,expert familiarity coefficient and expert authority coefficient of the second round expert letter consultation are 0.92,0.89 and 0.91. The final version of the intervention program consisted of 4 themes,8 education methods and 22 items,including 7 items in hearing death(lecture+topic discussion),5 items in seeing death(watching experience + experience sharing),5 items in touching death(scenario simulation + value clarification),and 5 items in beyond death(life review + near-death experience). The importance score of each item was >3.5,and the coefficient of variation was between 0.04 and 0.18. The coordination coefficient(W) of the 2 rounds of expert consultations was 0.174 and 0.465,respectively (all P<0.001). Conclusion From the perspective of constructivism learning theory,this study constructed a death education program for nurses,which is scientific,practical and feasible. The training themes and objectives are progressive,and the teaching methods are flexible and open,which are easy for nurses to accept. It can provide references for the implementation of death education in nursing staff.

    Community Care
    Home rehabilitation experience for individuals with spinal cord injury:a qualitative study
    GAO Xin, LI Lunlan, DAI Qing, ZHANG Fan, QI Jinmei, TAO Lei, LIAO Chenxia, WANG Jing
    2021, 56(11):  1691-1697.  DOI: 10.3761/j.issn.0254-1769.2021.11.015
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    Objective To explore the home rehabilitation experience of individuals with spinal cord injuries. Methods From June 2020 to April 2021,12 individuals with spinal cord injury during postoperative rehabilitation period were recruited from a tertiary hospital in Anhui Province by purposive sampling. Semi-structured interviews were performed to collect data,and qualitative content analysis was conducted to analyze the data. Results 3 themes regarding the experience of home rehabilitation for individuals with spinal cord injury were extracted,including the attitude towards rehabilitation(more inclined to home rehabilitation and the attitude towards rehabilitation exercise),problems and coping styles in home rehabilitation(existing problems and coping styles),the need for home rehabili-tation(the need for continuity of care services,the need for emotional relief,the need for external support). Conclusion The choice of rehabilitation modes and the attitude of rehabilitation exercise of individuals with spinal cord injury are affected by many factors,and there are many problems and needs in the process of home rehabilitation. Medical staff should explore effective methods to help patients improve the quality of home rehabilitation based on their problems and needs. The improvement of continuous care system for individuals with spinal cord injury is the focus of future attention.

    Clinical Practice
    Nursing care of a diabetic patient with chronic neck ulcer accompanied by hyperosmolar hyperglycemia syndrome combined with septic shock
    LUO Xueli, ZHUANG Yiyu, DONG Lianlian
    2021, 56(11):  1698-1702.  DOI: 10.3761/j.issn.0254-1769.2021.11.016
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    To summarize the nursing care experience for a patient with diabetic chronic neck ulcer with hyperosmolar hyperglycemia syndrome combined with septic shock. Key points of nursing care include:preoperative bundle management of early septic shock,precise liquid control,correction of hypertonic and hyperglycemia levels,anticoagulant management to prevent thrombosis,and management of wound bleeding and exudation to win the opportunity for surgical treatment. A multidisciplinary wound management team was established after surgery to focus on postural management and prevent the occurrence of device-related pressure injuries. Early nutrition support,early mobilization and psychological support were given during hospitalization to accelerate the patient’s recovery. After multidisciplinary treatment and nursing care,the patient’s endotracheal intubation was removed 15 days after admission,vital signs were stable,and blood glucose level became normal. The wound surface changed from yellow and black to red,and tended to heal. No serious complications occurred,and the patient was in good nutrition status. The patient was transferred to the general ward 16 days after admission and discharged 26 days after admission. 3 months follow-up after discharge showed that the wound was healed,the neck skin was intact,and there were no other symptoms of discomfort.

    Nursing care of a patient with severe Shapiro syndrome complicated with pancreatitis
    WANG Yujiao, GAO Lan, WANG Yonghong, WANG Pengju, LIU Guangping
    2021, 56(11):  1703-1706.  DOI: 10.3761/j.issn.0254-1769.2021.11.017
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    To summarize the nursing experience of a rare case of severe Shapiro syndrome complicated with pancreatitis. The key points of nursing care are as following. Rehydration and sodium supplement can correct pre- renal hypovolemia and hyponatremia,and maintain stable internal environment. The tympanic membrane temperature is monitored as the core temperature reference,which provides a reliable basis for diagnosis,treatment and nursing. Bundle heat preservation measures are taken to prevent complications of hypothermia. Super early enteral nutrition sequential therapy and family participation nursing care can promote memory recovery and reconstruction. The health education is strengthened to improve the quality of life of patients. After careful treatment and nursing care by medical staff,the patient recovered and was discharged.

    Postoperative nursing care of a patient with heart failure treated by left ventricular assist device combined with central extracorporeal membrane oxygenation
    HU Yaling, LAN Meijuan, WANG Chunhai, SONG Jianping, HUANG Jinying
    2021, 56(11):  1707-1709.  DOI: 10.3761/j.issn.0254-1769.2021.11.018
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    To summarize the nursing experience of 1 case of left ventricular assist device(LVAD) combined with central extracorporeal membrane oxygenation(CECMO) for right heart support. Nursing key points include:throm-bosis prevention and bleeding control,nursing cooperation of cardiac function monitoring under ultrasound guidance,infection prevention,early exercise rehabilitation nursing care,and targeted psychological care. Through careful nursing care and treatment,the patients was transferred from ICU to the general ward 25 days later.

    Perioperative nursing care of a patient with Brucella infection of abdominal aortic pseudoaneurysm
    YU Nannan, ZHAO Xiaomin, YU Ying
    2021, 56(11):  1710-1713.  DOI: 10.3761/j.issn.0254-1769.2021.11.019
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    To summarize the perioperative nursing experience of a patient with Brucella infection of abdominal aortic pseudoaneurysm. Nursing points:do well in isolation,protection,management and psychological construction of infectious disease patients;blood pressure,pain and body temperature should be controlled before the operation. The blood pressure and intra-abdominal pressure were strictly controlled after the operation,and the predictive observation and nursing care of abdominal wall hernia and lower limb arterial thrombus were performed according to characteristics of the disease,as well as the drainage tube management and the guidance of prevention of brucellosis recurrence. After 40 days of careful treatment and nursing care,the patient recovered and was discharged. Followed up on WeChat and telephone for 1 year,the patient recovered well.

    Evidence Synthesis Research
    Summary of the best evidence for the management of emotional disorders in patients with Alzheimer’s disease
    DENG Zenan, MA Qiuping, WU Bin, LI Qiong, TAN Silan, WEI Min, LIN Wenqiong, TANG Haishan, WEI Guoxin, LI Xuemin, YIN Xingfeng, LAN Yi, FENG Chao, SHI Wenqing, LI Ruilin, LI Jianyun
    2021, 56(11):  1714-1720.  DOI: 10.3761/j.issn.0254-1769.2021.11.020
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    Objective To search and summarize the best evidence for the management of emotional disorders in patients with Alzheimer’s disease,so as to provide references for clinical practice and to help improve the emotional disorders of patients with Alzheimer’s disease. Methods Following the "6S" evidence model,we searched the high-level evidence about the management of mood disorders in patients with Alzheimer’s disease in databases such as International Guide Collaboration Network,American Guide Network,National Institute for Clinical Optimization of UK,Scottish Intercollegiate Guide Network,Ontario Nurse Registration Network of Canada,China Guide Network,UpToDate,JBI Library,CNKI and so on. The retrieval period is from the establishment of the databases to May 2021. Results A total of 12 articles were included,including 7 clinical guidelines,4 expert consensuses and 1 systematic review. Finally,23 pieces of best evidence were summarized from 5 aspects. Conclusion The best evidence summary of the management of emotional disorders in patients with Alzheimer’s disease provides evidence-based references for clinical medical staff to manage the emotional disorders of patients with Alzheimer’s disease in a scientific way,which is helpful to improve their quality of life.

    Best evidence summary for non-pharmacological management of postoperative nausea and vomiting
    CHEN Xiao, ZHANG Yuxia, ZHOU Haiying, YU Jingxian, ZHANG Qi
    2021, 56(11):  1721-1727.  DOI: 10.3761/j.issn.0254-1769.2021.11.021
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    Objective To evaluate and summarize the best evidence for non-pharmacological management of postoperative nausea and vomiting,and to provide evidence for clinical nurses to prevent postoperative nausea and vomiting. Methods We systematically searched for evidence on postoperative nausea and vomiting in databases such as UptoDate,Chinese Biomedical Literature Database,CNKI,Website of Chinese Medical Association Anesthesia Branch,BMJ Best Practice,the Joanna Briggs Institute,Cochrane Library,etc. The retrieved evidence included clinical decision-making,guidelines,systematic reviews,etc. The search time limit is from the establishment of the databases to December 31,2020. There were 2 researchers evaluating the quality of the literature and extracting the data. Results A total of 20 articles were included in this study,including 1 clinical decision,3 guidelines,and 16 systematic reviews. Finally,8 pieces of evidence were summarized from 4 aspects,including risk assessment,routine management,non-pharmacological interventions,and cost-benefit analysis. Conclusion Our research summed the best evidence on the risk assessment and non-pharmacological management of postoperative nausea and vomiting. In the actual clinical application,it is necessary to fully consider the clinical situation,combine the judgment of professionals and the wishes of patients,follow the principle of individualization,analyze the obstacles and facilitating factors of the application of evidence,and apply the evidence to the clinical practice prudently.

    The experience of midwives’ participating in traumatic birth:a meta-synthesis of qualitative research
    DAI Ling, ZENG Tieying, ZHANG Ke, YUAN Mengmei, WANG Xuejun
    2021, 56(11):  1728-1735.  DOI: 10.3761/j.issn.0254-1769.2021.11.022
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    Objective To conduct a meta-synthesis of the experience of midwives’ participating in traumatic birth and to provide the evidence-based guidance for the development of midwifery. Methods 10 databases(PubMed,CINAHL,Web of Science,Scopus,Embase,SinoMed,CSSCI,CNKI,Wanfang data,VIP) were included to retrieve the literature on the experience of midwives’ participating in traumatic birth from inception until Dec 2021. The quality of included research was evaluated using the JBI Critical Appraisal Tool for qualitative studies from Australia. The results were integrated by a meta-aggregation method. Results A total of 12 studies were included,104 findings were extracted,10 categories were integrated,and 4 synthesis results were summarized. Synthesis result 1:traumatic births have serious physical,mental and professional impacts on midwives. Synthesis result 2:midwives adopt different strategies to deal with traumatic birth. Synthesis result 3:midwifery practices are faced with multiple dilemmas,which affects midwives’ experience of traumatic births. Synthesis result 4:after participating in traumatic birth,midwives are eager for psychological support. Conclusion Traumatic births have serious impacts on midwives. Midwives should face up to the negative emotions and learn to deal with them positively. Medical institutions should rationally allocate obstetric resources to alleviate the difficulties faced by midwifery practice. Managers should pay attention to midwives’ experience of participating in traumatic birth and provide psychological support to promote midwives’ physical and mental health.

    Review
    Research progress of effectiveness evaluation of nursing information system and related theoretical models
    ZHANG Yi, CHEN Xiangping, GAO Qingqing, ZHUANG Yiyu, LAO Yuewen, CHEN Feng, GONG Xiaoyan
    2021, 56(11):  1736-1740.  DOI: 10.3761/j.issn.0254-1769.2021.11.023
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    The scientific and objective evaluation of nursing information system is an important stage to promote the construction of nursing informationization. This article summarizes and describes the background and current situation of the effectiveness evaluation of nursing information system,the role and connotation of different information system evaluation models,and their application in the nursing,in order to provide a reference for the development of nursing informatization.

    Research progress of exercise management evaluation index in diabetic patients
    FENG Suwen, ZHAO Chunyan, XU Fanglei
    2021, 56(11):  1741-1746.  DOI: 10.3761/j.issn.0254-1769.2021.11.024
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    Exercise can effectively reduce the incidence of diabetes,improve patients’ metabolic indicators such as HbA1c,blood glucose and blood lipid,increase insulin sensitivity,and reduce the risk of complications. Foreign countries give much attention to the evaluation of the effects of exercise management of diabetes,but this field remains relatively blank in China. Based on Donabedian three-dimensional quality structure theory,this paper reviews the evaluation indexes of exercise management for diabetic patients,including structural indexes,process indexes and outcome indexes. Structural indicators include multidisciplinary team construction,environmental material preparation,knowledge and skills training,policy support;process indicators include exercise evaluation,exercise implementation and monitoring;the outcome indexes included blood glucose,blood lipids and physiques,complications and so on,which provided references for the establishment of exercise evaluation index system for diabetic patients.

    The identification and clinical nursing care of patients with Purple Urine Bag Syndrome
    YANG Liangqin, YANG Zijing, CHEN Qian
    2021, 56(11):  1747-1751.  DOI: 10.3761/j.issn.0254-1769.2021.11.025
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    Purple Urine Bag Syndrome(PUBS) is a rare and potentially serious complication of urinary tract infection. It has been widely reported in the literature,while it has not been fully understood in clinical nursing practice. This article reviewed domestic and international literature on the importance of nursing staff’s attention to the PUBS,and the generation mechanism,patient identification,nursing measures of PUBS. It provided references for nursing staff to carry out relevant clinical work.

    A scoping review of risk assessment tools for unplanned endotracheal extubations
    WU Jinhua, HUANG Haixing, LIU Zhili, WANG Yuanyuan, LIU Xiaocheng, YU Jin, ZENG Jielin, PENG Huarong
    2021, 56(11):  1752-1756.  DOI: 10.3761/j.issn.0254-1769.2021.11.026
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    Objective To integrate the relevant original research,evidence-based guidelines and consensuses on the risk assessment tools for unplanned endotracheal extubations(UEE) in China and abroad. Methods Focusing on risk assessment tools for UEE,the authors systematically searched the Chinese and English databases and related guideline websites from the inception to March 1,2021. The extracted information included the author,the year,the country,the target population,the type of tool,the study method,the main assessment content and the high-risk threshold for UEE. Results 13 papers were eventually included,among which 11 were qualitative studies based on expert opinions such as Delphi and 2 were based on quantitative studies such as the case-control studies. The types of tools were categorised as risk assessment scales,risk assessment systems,risk assessment maps,and risk prediction models. Conclusion Patient and catheter factors are important parts of UEE risk assessments. There are various types of UEE risk assessment tools,but their reliability and validity need to be further tested by multi-centred and large-scale clinical application studies.

    Nursing Instruments Innovation
    The production and application of a special warming suit for prostate electrocision operation
    HUANG Lili, WANG Yaping, ZOU Xiaoyue, PAN Xueping, ZHANG Xufeng
    2021, 56(11):  1757-1760.  DOI: 10.3761/j.issn.0254-1769.2021.11.027
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    Objective To make a self-made special warming suit for electrosurgical resection of prostate and to discuss its application effect. Methods The designed thermal suit for electrosurgical resection of the prostate is composed of 2 parts,namely a coat and trousers. A total of 120 patients undergoing prostate resection in a hospital from April 2020 to March 2021 were selected as the research subjects. They were numbered according to the order of their operation notices,and they were divided into a test group and a control group by a random number table with each group of 60 cases. The experimental group used a self-designed special warming suit for the prostate resection operation,and the control group used the traditional hospital gown. The satisfaction of medical staff and patients with the thermal suit in 2 groups during the perioperative period of the prostate resection,and the contact area between the underwear and the skin of the non-surgical part during the perioperative period were observed and compared. Results The medical staff of the experimental group were more satisfied with the warming suit in terms of convenient operation,time-saving and effort-saving,and privacy protection than the control group,and the difference was statistically significant(χ2=9.766,9.003,9.163,P<0.05). The patients in the experimental group were more satisfied with the warming suit forits convenience of wearing,thermal comfort,and privacy protection than the patients in the control group,and the difference was statistically significant(χ2=8.312,8.802,9.869,P<0.05). The contact area of clothes and perioperative non-surgical skin area in the experimental group was more than that in the control group,and the difference was statistically significant(χ2=7.908,P<0.05). Conclusion The special thermal suit for prostate resection is easy to put on and take off,with strong warmth retention and good privacy protection,which can help improve the thermal comfort and satisfaction of patients with prostate resection,and improve the work efficiency of medical staff.