Table of Content

20 January 2023, Volume 58 Issue 2

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Research Paper

Evidence-based nursing practice of airway obstruction prevention and management in patients undergoing cervical spinal surgery

WU Minglong, ZHOU Yanrong, ZHAN Xue, LIU Hongjuan, TAN Jing, ZHAO Ya, GAO Yun, CHEN Yuan, PAN Meiqi, WANG Weidi, WANG Lan

2023, 58(2):  133-140.  DOI: 10.3761/j.issn.0254-1769.2023.02.001

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Objective To summarize the best evidence of airway obstruction prevention and management in patients undergoing cervical spinal surgery，and to apply evidence-based nursing practice and evaluate the effects. Methods The best evidence for prevention and management of airway obstruction in patients undergoing cervical surgery was summarized using an evidence-based care approach，and an evidence-based practice protocol was developed. The best evidence application strategy was constructed after baseline review and analysis of barriers，and it was implemented in the department of orthopedics in a tertiary hospital in Hubei Province from August 2020 to December 2021. The knowledge level of nurses about airway obstruction and the implementation rate of the reviewed indicators were compared before and after the application of evidence. Results After the application of best evidence, the implementation rate of 19 review indicators out of 23 significantly improved compared with baseline review（P<0.05）. The score of nurses’ knowledge level of airway obstruction after cervical spine surgery increased from（48.38±9.40） to （53.49±9.67），with a statistically significant difference（P<0.001）. Conclusion The application of the best evidence for prevention and management of airway obstruction after cervical spine surgery can improve nurses’ implementation rate，improve their knowledge level，and ensure patient safety.

Construction and application of a lifestyle management scheme for infertile women with polycystic ovary syndrome during medical treatment

LU Shan, SUN Xiaoling, WANG Jing, WANG Yingjie, YANG Haiming, ZHOU Jianjun, YANG Yan, ZHANG Ning, LIU Caiqi, LIU Liang, SHEN Diwen

2023, 58(2):  141-149.  DOI: 10.3761/j.issn.0254-1769.2023.02.002

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Objective To construct a lifestyle management scheme for infertile women with polycystic ovary syndrome（PCOS） during outpatient medical treatment，and to evaluate its clinical effects. Methods Based on the evidence summary and qualitative interviews，a lifestyle management scheme for infertile women with PCOS during medical treatment was constructed. The infertile women at childbearing age with PCOS from the health management center and reproductive medicine center of a tertiary A hospital in Nanjing were recruited through convenience sampling. 27 patients who visited the above mentioned 2 centers from September 15 to 30，2021 were recruited in an experimental group successively，while another 27 patients who visited there from February 15 to 28，2021 were recruited in a control group successively. Next，the lifestyle management scheme was implemented in the experimental group in 9 key steps，including evaluation，screening，status analysis，formulation of body mass management objectives，diet management，exercise management，behavior management，health guidance，and evaluation. Meanwhile，27 patients in the control group were given the routine healthy lifestyle guidance. After 3 months，the figure of BMI，insulin resistance index，serum testosterone，anxiety，depression and quality of life of the 2 groups were analysed. Results After the intervention，the BMI of the experimental group was 24.43±2.99，which was lower than （26.48±3.49） in the control group. The insulin resistance index was 2.42±0.98，which was lower than 3.52±0.97 in the control group. The level of testosterone was（0.55±0.19） ng/ml，which was lower than（1.20±0.42） ng/ml in the control group. The anxiety level was（5.73±2.13） and the depression level was（5.12±2.66），which were lower than（9.40±2.36） and（10.60±2.58） of the control group. The score of disease-related quality of life was（140.38±7.25），which was higher than（115.56±7.99） of the control group，and the differences were statistically significant （P<0.05）. Conclusion The implementation of the lifestyle management scheme for infertile women with PCOS during medical treatment is conducive to adjust patients’ endocrine and metabolic status，alleviate their anxiety and depression and improve quality of life.

Special Planning-Cardiovascular Nursing

Cardiovascular disease risk perception and overall risk：correlation and solutions

GUO Zhiting, CHEN Jie, GUO Erling, SHEN Guoli, DING Chuanqi, HUANG Yuxiang, ZHANG Yuping, JIN Jingfen

2023, 58(2):  150-157.  DOI: 10.3761/j.issn.0254-1769.2023.02.003

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Objective To explore the relationship between cardiovascular disease（CVD） risk perception and overall risk，and to provide evidence for formulating targeted intervention strategies. Methods A total of 735 participants including physical examination subjects and patients with diabetes or hypertension from a tertiary Grade A hospital in Hangzhou were recruited from March to July 2022. The general information questionnaire，CVD overall risk assessment model and risk perception assessment tool were used to investigate the correlation between the absolute risk perception and the overall risk value of different demographic characteristics，and to compare the difference between the absolute risk perception and the overall risk. Results A total of 692 valid questionnaires were collected with a recovery rate of 94.1%. The median（P₂₅，P₇₅） of CVD overall risk was 1.0%（0.2%，6.4%），and the median（P₂₅，P₇₅） of absolute risk perception was 2.0 （1.0，3.0）. The absolute risk perception of CVD was positively correlated with the total risk value（r_s=0.181，P<0.001）；stratified analysis showed that there was no significant correlation between risk perception and objective CVD risk among people aged 40~59，with low weight or obesity，ethnic minorities，education level of primary school or below，single，smokers，drinkers，diabetes or not，taking anti-diabetic or not，hypertension，blood pressure medications，and hypercholesterolemia（P>0.05）. There was a significant difference between the absolute risk perception classification and the overall risk classification（χ²=16.17，P=0.003）. The risk underestimation，accurate perception and overestimation rates were 30.3%，56.5% and 13.2%，respectively. Conclusion CVD risk underestimation is common. Medical staff should focus on the characteristic population whose risk perception is inconsistent with the overall risk，and formulate targeted intervention strategies to improve their risk perception and reduce the risk of CVD.

Investigation of symptom clusters recognition and its influencing factors in patients after coronary artery bypass grafting

MA Hongya, ZHENG Donglian, GUO Shuping, MAO Yajiao, WANG Huiru, MI Guangli

2023, 58(2):  158-164.  DOI: 10.3761/j.issn.0254-1769.2023.02.004

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Objective To understand the severity and distress of symptoms in patients after coronary artery bypass grafting（CABG），to identify postoperative symptom clusters of patients，and to analyze their influencing factors，so as to provide references for formulating accurate symptom management strategies. Methods 135 patients after CABG were conveniently selected in the cardiac macrovascular surgery department of a tertiary A general hospital in Ningxia from June 2021 to February 2022. The cross-sectional survey was conducted using a self-designed general data questionnaire and symptom questionnaire. Exploratory factor analysis was used to extract symptom clusters，and multiple linear regression analysis was used to determine the influencing factors. Results 130 cases were finally included. The 5 symptoms with the highest incidence rate after CABG were surgical incision pain（98.5%），sleep disturbance（96.9%），fatigue（96.2%），pain at the drain（92.3%），and shortness of breath（79.2%），and the incidence of symptoms would go up with the greater severity and distress. Exploratory factor analysis revealed 5 symptom groups，which were physical and mental stress symptom cluster，physical activity disorder symptom cluster，gastrointestinal discomfort symptom cluster，fatigue symptom cluster and wound pain symptom cluster. Previous history，primary caregiver，and smoking history were independent predictors of symptom cluster occurrence（P<0.05）. Conclusion After CABG，patients will experience a variety of symptoms，which are interrelated and exist in the form of symptom clusters. Clinical nursing staff should focus on the leading symptoms within the symptom cluster，formulate intervention measures based on the severity and distress of symptoms and symptom cluster，improve symptom management efficiency and promote the quality of life in the convalescent period.

Construction of an evaluation index system for remote care in patients with chronic heart failure

LU Xiuyan, CHI Kun, HUAN Shanshan, GONGYE Huijuan, WU Ke, XIE Fangyu, SUN Xiujie, LIANG Tao

2023, 58(2):  165-170.  DOI: 10.3761/j.issn.0254-1769.2023.02.005

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Objective To establish an evaluation index system of remote care in patients with chronic heart failure （CHF），in order to provide an evaluation tool of remote care，promote and improve the health support system for patients with CHF. Methods Based on literature analysis and semi-structured interview，nursing evaluation questions related to remote care for patients with CHF were extracted. Omaha question classification system was used to normalize the expression of questions，and finally Delphi method was used from May to Sep 2021 to form the evaluation index system for remote care in patients with CHF. Results The authority coefficient of experts was 0.923；the positive coefficients of experts in 2 rounds were 73.33% and 100%；the coordination coefficients were 0.219 and 0.247，respectively（P<0.01）. The standardized nursing questions evaluation system of remote care for patients with CHF was finally determined as 4 first-level indicators，24 second-level indicators and 58 third-level indicators. Conclusion The evaluation index system of remote care for patients with CHF constructed in this study is scientific，practical and instructional，which is of great significance to promote the implementation of remote care for patients with heart failure and formulation of health support system.

Chinese version of the medication adherence scale for patients with hypertension：a systematic review of psychometric properties

CHEN Huan, HOU Chaoming, GAO Jing, BAI Dingxi, WU Chenxi, YANG Zhi, LUO Huan

2023, 58(2):  171-178.  DOI: 10.3761/j.issn.0254-1769.2023.02.006

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Objective To evaluate the quality of psychometric properties and methodological quality of the Chinese version of the medication adherence scale for patients with hypertension，so as to provide references for the selection of high-quality research tools. Methods PubMed，EmBase and Web of Science，CNKI，Wanfang Data knowledge service，VIP database，Chinese Biomedical Literature database were retrieved to collect the literature on the evaluation of psychometric properties of medication adherence scales for patients with hypertension from the time of database establishment to February 3，2022. There were 2 reviewers who independently screened the literature，and extracted data of included studies. Based on the consensus-based standards for the selection of health measurement instruments（COSMIN） guideline，the methodological and measurement properties quality of the included assessment tools were evaluated by the COSMIN risk of bias checklist and quality criteria. Results A total of 10 studies were included，involving 9 Chinese version of the medication adherence scales for patients with hypertension. None of the 9 assessment tools reported cross-cultural validity，measurement error，hypothesis testing or responsiveness. As the content validity were inadequate or uncertain，and the quality of evidence were moderate or low，9 assessment tools were recommended by grade B. Conclusion Compared with the other 8 assessment tools，MASES-R is the assessment tool with the relatively balanced psychometric properties with good reliability and validity，which can be temporarily recommended for use，but it needs further testing.

Research progress of risk factors and prediction models of postoperative delirium after aortic dissection

GONG Cuiying, WANG Jianning, LI Liqun, HUANG Qiuxia, HU Jiaojiao, LIANG Hui

2023, 58(2):  179-185.  DOI: 10.3761/j.issn.0254-1769.2023.02.007

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Postoperative delirium is one of the common complications in patients with aortic dissection，with a high incidence and strong harm. In this study，the types，characteristics，risk factors and risk prediction models of delirium after aortic dissection were reviewed，in order to provide references for clinical medical staff to identify the risk of delirium in aortic dissection patients as soon as possible and formulate effective prevention and management programs，and finally improve the survival outcome of aortic dissection patients.

Research progress of assessment tools for medication literacy in patients with cardiovascular disease

QIN Ning, DUAN Yinglong, SHI Shuangjiao, ZHENG Feng, ZHONG Zhuqing

2023, 58(2):  186-191.  DOI: 10.3761/j.issn.0254-1769.2023.02.008

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At present，the medication safety of patients with cardiovascular disease was full of hidden dangers. The assessment of medication literacy can measure the ability of individuals to take medications，and assist to promote medication safety management and ensure the medication safety of patients. This article reviews the content，characteristics，application and limitations of medication literacy assessment tools for patients with cardiovascular disease at home and abroad. It can provide a reference for the development and application of medication literacy assessment tools for patients with cardiovascular disease in China，and provide a basis for scientific assessment of medication literacy levels and the formulation of effective medication safety promotion strategies.

Specialist Practice and Research

A qualitative study on the self-disclosure willingness and expectation of adolescents’ non-suicidal self-injury behavior

QIU Lingjing, MIAO Qunfang, SHU Wan, LI Jingyi

2023, 58(2):  192-197.  DOI: 10.3761/j.issn.0254-1769.2023.02.009

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Objective To deeply understand the willingness and expectation of self-disclosure of non-suicidal self-injury behavior in adolescents，so as to provide reference strategies for prevention and intervention of clinical nurses. Methods Phenomenology in qualitative research was adopted，and 23 adolescents with non-suicidal self-injury behaviors admitted to a combined outpatient clinic of children and adolescents in a hospital in Zhejiang Province from February to May 2022 were interviewed by semi-structured interviews，and the data was analyzed by Colaizzi seven-step method. Results 4 themes are extracted. Theme 1：adolescents with self-disclosure willingness and behavior have diverse emotional experiences. Theme 2：adolescents with self-disclosure willingness but no disclosure behavior have different contradictions. Theme 3：adolescents with no self-disclosure willingness and behavior experience radicalization. Theme 4：adolescents with non-suicidal self-injury expect positive responses from disclosure subjects. Conclusion The cognition of adolescents with non-suicidal self-injury and the response of disclosure subjects play an important role in their self-disclosure willingness，and adolescents have many expectations for the response of disclosure subjects. Clinical nurses should enhance the cognition of adolescents and related groups on non-suicidal self-injury behaviors，encourage adolescents to take the initiative to disclose，and give positive responses.

Investigation on the pediatric nurses’ cognition and practice of pediatric early warning system in 29 tertiary hospitals

HUANG Zixuan, LENG Hongyao, SHEN Qiao, YI Min, ZHENG Xianlan

2023, 58(2):  198-204.  DOI: 10.3761/j.issn.0254-1769.2023.02.010

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Objective To investigate the cognition and attitude of pediatric early warning system（PEWS） among pediatric nurses in tertiary hospitals in China and to clarify the implementation status，aiming to provide a reference for the construction of pediatric early warning management program for clinical deterioration in patients. Methods Pediatric nurses from tertiary hospitals across 26 provinces and cities throughout the country were selected by convenience sampling between January and February 2022 to respond to a self-designed questionnaire. Results A total of 29 hospitals participated in the study，including 15 children’s specialized hospitals，9 general hospitals，and 5 maternal and children’s hospitals. 2 583 subjects filled out the questionnaire with a response rate of 98.80%. The cognition scores of pediatric nurses on PEWS are（36.92±4.54），with the score rate of 85.86%. The attitude scores are（54.72±8.24），with the score rate of 84.18%. There are statistically significant differences in the usage of early warning scores among pediatric nurses in different hospitals（P=0.013），and pediatric nurses in the children’s specialized hospitals have a higher proportion（73.30%） of using early warning scores. The top 3 used early warning scores are Brighton Pediatric Early Warning Score，Neonatal Early Warning Score，and Cardiac Children’s Hospital Early Warning Score. In the management of pediatric early warning systems among different hospitals，merely 16（55.17%） hospitals developed a risk management procedure or related regulation for clinical deterioration；17（58.62%） hospitals formulated a standardized shift management program；15（51.72%） hospitals developed an early warn-ing information system. Conclusion Pediatric nurses have a great cognition and positive attitude towards PEWS，but they do not fully understand it yet，and their practice needs to be strengthened. Hospitals with practical experience can jointly develop a scientific，standardized PEWS procedure and play a leading role in guiding and promoting its implementation in lower-level medical institutions.

The current situation and influential factors of frailty in elderly patients with vertigo

WANG Hongmei, LI Na, WANG Hong, ZHANG Honglei, ZHU Guixiang, XIA Xiaomei

2023, 58(2):  205-210.  DOI: 10.3761/j.issn.0254-1769.2023.02.011

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Objective To investigate the current situation of frailty and its influencing factors in elderly patients with vertigo，so as to provide references for nursing interventions. Methods Totally 200 elderly patients with vertigo were selected from a tertiary hospital in Jinan via convenience sampling method，and they were investigated by self-designed general information questionnaire，Tilburg Frailty Indicator，Dizziness Handicap Inventory，Pittsburgh Sleep Quality Index，the Barthel Index and Nutrition Risk Screening 2002. Results A total of 121 elderly patients with vertigo suffered from frailty with the prevalence of 64.36%. The mean score of total frailty was（6.69±4.51），and the scores for each dimension were as follows：physical frailty（3.14±2.69），psychological frailty（1.95±1.63） and social frailty（1.60±0.94）. Multiple linear regression showed that aging，exercise habits，readmission，albumin，the number of commodities，nutritional risk，degree of dizziness handicap，and sleep quality were the influencing factors of frailty in elderly patients with vertigo（P<0.05）. Conclusion The prevalence of frailty in elderly patients with vertigo was at a high level，containing different degrees of physical，psychological and social frailty. Medical staff should pay attention to the assessment of frailty in elderly patients with vertigo，and take timely and targeted nursing interventions to prevent or delay the occurrence and development of frailty.

Co-word clustering analysis of cognitive dysfunction research hotspots in colorectal cancer patients

HUANG Siting, YU Xinyuan, WU Yuxuan, KE Xi, HUANG Youxiu, LIU Hekun, LIU Dun

2023, 58(2):  211-216.  DOI: 10.3761/j.issn.0254-1769.2023.02.012

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Objective To analyze the research hotspots and trends of colorectal cancer cognitive dysfunction at home and abroad，and to provide a reference for the research. Methods The relevant literature on cognitive dysfunction of colorectal cancer collected from CNKI and Web of Science was retrieved and visually analyzed by CiteSpace software from the establishment of the databases to February 2022. Results CNKI and Web of Sciene finally included 245 and 203 articles respectively，and the overall number of published articles showed an upward trend. CNKI database obtained a total of 8 clusters and 11 emerging keywords，and Web of Sciene database obtained a total of 17 clusters and 4 emerging keywords. Conclusion The cognitive function of elderly colorectal cancer patients undergoing laparoscopic surgery has been a research hotspot at home and abroad in the past 13 years. Predictive models are constructed through risk factors. Folic acid levels are improved through dietary nursing care，and the exercise intervention program integrated with multidisciplines is a possible trend in the future.

TCM Nursing

Construction of a standardized management scheme of traditional Chinese medicine nursing technology in Zhejiang Province

XU Min, HUANG Xinrui, LIU Ting, YE Huiling, SHUAI Wei, SUN Qiuhua

2023, 58(2):  217-223.  DOI: 10.3761/j.issn.0254-1769.2023.02.013

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Objective To construct a standardized management scheme for traditional Chinese medicine nursing technology in Zhejiang Province，to further unify the names and classifications of traditional Chinese medicine nursing technology，to formulate technical classification principles and personnel qualification access conditions，and to promote the homogeneous management and quality improvement of traditional Chinese medicine nursing technology. Methods From August 2020 to March 2022，a research group was set up，and the first draft of the standardized management scheme of traditional Chinese medicine nursing technology in Zhejiang Province was formed with the combination with literature research and investigation results. The scheme was formulated by Delphi expert consultation and expert discussions，and it was validated by technology graded predictive models. Results A total of 35 experts were consulted by the Delphi method，and the effective recovery rate of the questionnaire was 100%；the expert familiarity coefficient Cs was 0.917；the judgment coefficient Ca was 0.909，and the expert authority coefficient Cr was 0.913. There are 80 items in 11 categories，and a technical grading principle has been formulated including 3 dimensions，namely safety，difficulty in learning and mastering，and difficulty in operating methods. 2 prediction models were constructed according to the technical grading influencing variables and the ROC curve was drawn，and the area under the ROC curve was obtained as 0.904. In the end，a total of 56 items of 8 categories of Chinese medicine nursing technology in Zhejiang Province were determined through the expert discussion meeting，and the qualification access conditions of Chinese medicine nursing technology personnel were formulated according to the grading principle. Conclusion The standardized management scheme of traditional Chinese medicine nursing technology has a high scientific nature，which provides a guarantee for the quality of clinical practice of traditional Chinese medicine nursing，and at the same time helps to promote the development of traditional Chinese medicine nursing.

Evidence Synthesis Research

Effects of virtual reality-based rehabilitation training for people with chronic obstructive pulmonary disease：a systematic review

CHEN Xiali, XING Limin, FAN Ying, ZHOU Yumei, GAO Shuping

2023, 58(2):  224-231.  DOI: 10.3761/j.issn.0254-1769.2023.02.014

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Objective To evaluate the effect of virtual reality rehabilitation training in patients with chronic obstructive pulmonary disease（COPD）. Methods 11 electronic databases，such as PubMed，Embase，CINAHL etc，were searched for related English and Chinese articles published from inception until June 2022. We retrieved experiment studies focused on VR-based rehabilitation training in adults with COPD. Literature screening，study selection，data extraction and methodological quality evaluation were conducted by 2 reviewers independently. Meta-analysis was performed by RevMan 5.3. Results 13 studies involving 836 patients were included. Meta-analysis indicated that VR-based rehabilitation training enhanced exercise tolerance，6MWT [MD=20.31，95%CI（8.74，31.89），P<0.001]，pulmonary function（SPO₂[MD=0.86，95%CI（0.33，1.39），P=0.002]，FEV1%[MD=6.85，95%CI（4.13，9.58），P<0.001]，FEV1/FVC%[MD=9.81，95%CI（5.16，14.46），P<0.001]），and cognitive function[MD=4.04，95%CI（3.36，4.72），P<0.001]. The breathing difficulties was improved by the MRC and CAT[MD=-0.20，95%CI（-0.36，-0.04），P=0.010]/[MD=-3.21，95%CI（-3.49，-2.93），P<0.001]. There was no significant difference in breathing difficulties by the Borg[MD=0.06，95%CI（-0.11，0.22），P=0.490].There was no significant difference in quality of life[MD=-0.45，95%CI（-6.24，5.34），P=0.880]；application effects on negative emotion were unclear. Conclusion This meta-analysis suggests that VR-based rehabilitation training can improve exercise tolerance，lung function and cognitive function in people with COPD，but the impact on dyspnea，negative emotions and quality of life is still uncertain，and high-quality research is still needed for further demonstration.

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

2023, 58(2):  232-237.  DOI: 10.3761/j.issn.0254-1769.2023.02.015

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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.

Review

Application progress of preoperative pre-habilitation in gynecological oncology patients

XU Lili, HU Yin, WANG Hongyan, FENG Suwen

2023, 58(2):  238-242.  DOI: 10.3761/j.issn.0254-1769.2023.02.016

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Pre-rehabilitation is a new strategy that could improve patients’ function and metabolic reserve to further accelerate surgical recovery by preoperative intervention，which has been applied in many disciplines. This article reviews the necessity，main contents，implementation status and barriers to the implementing of performing pre-habilitation for patients with gynecological malignant tumor，which provides a reference for further promotion and implementation of pre-habilitation.

Application progress of immersive virtual reality technology in wound procedural pain management

ZHANG Yuan, GUO Jinli

2023, 58(2):  243-249.  DOI: 10.3761/j.issn.0254-1769.2023.02.017

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The wound procedural pain has an important effect on the physiological health，psychological health and wound healing of patients；therefore，effectively relieving the wound procedural pain during dressing change is an urgent problem to be solved. Immersive virtual reality（IVR） technology has a significant effect on wound procedural pain management. This paper introduces the analgesic mechanism of IVR and its application form in wound procedural pain management，including 3 IVR systems based on computer，smartphone and virtual all-in-one machine，summarizes the advantages of IVR technology in wound procedural pain management，and analyzes the shortcomings in the current research and application. The prospect was put forward，in order to promote the application of IVR technology in wound procedural pain management in China.

Overseas Knowledge

Validity and reliability test of the Chinese version of the COMFORTneo Scale for postoperative pain assessment in neonates

LIN Siya, LI Li, CHEN Jingxia, REN Xuyan

2023, 58(2):  250-256.  DOI: 10.3761/j.issn.0254-1769.2023.02.018

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Objective To test the reliability and validity of the COMFORTneo Scale for postoperative pain assessment in Chinese neonates. Methods Through translation，back translation，expert review and pretest，the Chinese version of the COMFORTneo Scale was formed. 52 neonates at the Neonatal Intensive Care Unit in a tertiary general hospital of Guangzhou were recruited from September 2021 to June 2022. Neonates were observed 7 times（preoperatively and 48 hours postoperatively），and recorded for 2 minutes at each encounter including facial expressions and body movements. 2 researchers scored the Chinese COMFORTneo Scale and the Numeric Rating Scale independently while viewing the video clips. 2 weeks later，one of the researchers randomly selected 10 of the neonates’ video clips，viewed and scored them again. The reliability and validity of the scale were evaluated. Results 48 neonates were included，with 4 dropouts. The Chinese COMFORTneo Scale was composed of alertness，calmness/agitation，respiratory response（only in mechanically ventilated neonates），crying（only in spontaneously breathing neonates），body movement，facial tension，and muscle tone（observation only）. In mechanically ventilated and spontaneously breathing neonates，exploratory factor analysis extracted one factor of each，and the factor cumulative variance contribution rates were 57.042% and 66.378%，respectively. The Cronbach’s α coefficients of the scale were 0.819 and 0.885；test-retest reliability was 0.977 and 0.968，respectively. The scores of the Chinese COMFORTneo Scale were significantly positively correlated with the Numeric Rating Scale（r=0.920）. The cut-off value of the Chinese COMFORTneo Scale was 15 and 20 for moderate and severe pain，respectively. Conclusion The Chinese COMFORTneo Scale had good validity and reliability when used to assess postoperative pain in neonates.