Table of Content

10 May 2023, Volume 58 Issue 9

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Research Paper

Construction and application of a rehabilitation management programme for urinary incontinence after prostate cancer surgery

GU Jie, MA Qianyun, GAO Xu, LI Huizhen, MENG Xiaohong, XIE Shuangyi, FAN Fan, ZHOU Yi, CAO Jie

2023, 58(9):  1029-1036.  DOI: 10.3761/j.issn.0254-1769.2023.09.001

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Objective This study aims to construct a rehabilitation management programme for urinary incontinence after prostate cancer surgery，and to apply the programme to clinical practice，so as to provide references for future work. Methods Through evidence-based literature search and qualitative research，a grief rehabilitation management programme for urinary incontinence after prostate cancer surgery was formed. From January to March 2022，15 experts were consulted using Delphi method，and a rehabilitation management programme for urinary incontinence after prostate cancer surgery was formed. From May to July 2022，the convenience sampling was used to select patients with urinary incontinence after prostate cancer surgery in the urology clinic of a hospital in Shanghai. The experimental group was given the urinary incontinence rehabilitation management program，while the control group was given the routine nursing. The application effect of the programme was evaluated by the International Consultation on Incontinence Questionnaire-Short Form and 24-hour urinary pad test. Results The final programme included 6 first-level items，15 second-level items，and 43 third-level items. The expert authority coefficients were 0.88 and 0.98，and the Kendall harmony coefficients were 0.17 and 0.12（P<0.001）. The ICIQ-SF scores and 24-hour pad weight at 1 month and 3 months after surgery in the intervention group were lower than the control group（P<0.05）. Conclusion The application of the rehabilitation management programme improved the recovery of postoperative incontinence and reduced the 24-hour pad weight of patients at 1 month and 3 months after surgery. The programme can be popularized and applied after further verification.

Special Planning—Nursing Informatization and Intelligent Construc-tion

Construction and application of a clinical decision support system for delirium management in ICU patients

XUE Jin, WANG Qing, JIANG Ling, CHENG Niankai, HUANG Qin, NI Xingmei, GU Xiao, CHEN Yilei, XIA Lianzi

2023, 58(9):  1037-1042.  DOI: 10.3761/j.issn.0254-1769.2023.09.002

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Objective To construct a clinical decision support system for delirium risk in ICU patients，and to provide a reference for its application in ICU patients. Methods A clinical decision support system for delirium management in ICU was constructed，including risk assessment and identification，intelligent decision making，effect evaluation，and other functions，which will be officially used in the ICU ward of a tertiary A hospital in Jiangsu Province from June 2022 to August 2022. The incidence of delirium，the first time for patients to receive delirium prevention measures，the time for writing nursing records，and the defect rate of nursing records before and after the system application were compared，and the satisfaction rate of nurses to the system was collected. Results After the application of the clinical decision support system for delirium management in ICU patients，the incidence of delirium，the first time to receive delirium prevention measures，the time to write nursing record sheets，and the nursing record defect rate of patients were all reduced，with statistical significance（P<0.05）. The overall satisfaction score of nursing staff with the system was（100.88±4.06）. Conclusion The clinical decision support system for delirium management in ICU patients can provide a scientific decision basis for nurses and improve the quality of delirium prevention and management in ICU patients.

Construction and preliminary application of a non-drug management decision support system for gestational diabetes mellitus

FANG Yuan, ZHOU Yingfeng, LI Li, XING Nianlu, CHEN Shuyu, WANG Na, YIN Chuanmin

2023, 58(9):  1043-1049.  DOI: 10.3761/j.issn.0254-1769.2023.09.003

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Objective This study aims to develop a decision support system for the non-drug management of gestational diabetes mellitus（GDM），conduct a preliminary application study，evaluate its usability and accuracy in clinical practice，and lay the foundation for a randomized controlled trial to explore its application effects. Methods A research group on GDM was established to construct a decision support system for non-drug management of GDM. The man-machine interaction technology was employed to develop 5 modules，including patients’ personal information，monitoring and feedback of blood glucose，diet，weight，and exercise records.The convenience sampling method was used to select GDM patients in the obstetrics nutrition clinic of a obstetrics and gynecology hospital in Shanghai in March 2022 as the research objects, and the systematic preliminary application was carried out. The data on using the system were analyzed，and surveys were conducted to evaluate the usability and structured evaluation of the system among medical staff，research groups，and patients. Results After initial application，the system was 100% effective in identifying abnormal blood glucose levels and sending immediate treatment tips，and 51% effective in generating blood glucose warning and prevention reports. The usability evaluation scores of GDM patients for the system and the structured evaluation scores of the system construction team members and health care workers were 88.15 and 90.63，respectively，which were both at a high level. Conclusion The system can provide accurate and objective decisions for medical staff and patients，and the preliminary application results reveal high accuracy and good usability. Additional studies can be conducted to investigate its effect on improving patients’ blood glucose levels and pregnancy outcomes to enhance the existing non-drug management model for GDM.

Application of virtual reality technology in early activities of ICU patients

XIA Yanling, PAN Wenyan, ZHAO Yangyang, CHEN Zhiwei, CAI Shining, TANG Yingjia, JIN Zhe

2023, 58(9):  1050-1055.  DOI: 10.3761/j.issn.0254-1769.2023.09.004

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Objective To investigate the application effects of virtual reality technology in early activities of critically ill patients. Methods From November 2021 to January 2022，76 patients in the surgical intensive care unit of a tertiary A hospital in Shanghai were selected as the research subjects and divided into an experimental group and a control group according to the random number table method. The control group was given routine early activities，and the experimental group was given early activity intervention through virtual reality technology. The Medical Research Council score，grip strength，the duration of exercise，the length of ICU stay and risk events were observed and compared between the 2 groups. Results 68 ICU patients completed the study. The incidence of ICU-acquired weakness in the experimental group（13.50%） was lower than that in the control group（35.50%），and the muscle strength score of（57.08±3.24） by Medical Research Council in the experimental group was higher than that of（55.74±4.28） in the control group. The duration of exercise in the experimental group was （19.78±4.90） minutes，which was higher than that of （14.94±6.78） minutes in the control group. The length of ICU stay in the experimental group was（4.65±2.82） days，which was lower than that of（6.90±2.40） days in the control group，and the differences were statistically significant（P<0.05）. There was no significant difference in grip strength between the experimental group and the control group（P=0.393）. Conclusion Virtual reality technology can help ICU patients with their early activities，improve their muscle strength，prevent ICU-acquired weakness，reduce length of ICU stay， and promote rehabilitation of patients.

Effectiveness of “Internet+” nursing intervention model on pain in cancer patients：a Meta-analysis

LUO Xiaoyan, CUI Renshan, XU Xiumei, CUI Miaomiao, GUO Lingru, ZHOU Dan

2023, 58(9):  1056-1062.  DOI: 10.3761/j.issn.0254-1769.2023.09.005

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Objective To systematically evaluate the impact of the nursing intervention model based on “Internet +” with cancer pain patients，and to explore the best intervention based on “Internet +” to alleviate their pain. Methods A systematic search of PubMed，Embase，Web of Science，Cochrane Library，CNKI，VIP，WanFang Data and CBM，was carried out to collect randomized controlled trials on nursing intervention model based on “Internet +” on cancer pain patients from inception to May 2022. There were 2 researchers who screened the literature，extracted data and evaluated the methodological quality. Meta-analysis was conducted with Revman 5.4 software. Results A total of 9 randomized controlled studies were included，involving 1049 patients. The results of the Meta-analysis showed that，compared to the conventional care，the nursing intervention model based on “Internet +” was effective in improving pain intensity in cancer patients[MD=-0.70，95%CI（-1.29，-0.11），P=0.03]，pain interference [MD=-0.71，95%CI（-1.08，-0.33），P=0.04]. In different “Internet +” intervention forms of each group，patients in the interactive health education group had the lowest pain intensity score，with significant statistical differences[MD=-0.23，95%CI（-0.43，-0.02），I²=0，P=0.03]. In addition，nursing intervention based on “Internet +” has a more significant improvement effect on pain intensity in cancer patients aged 50 to 60 years[MD=-0.26，95%CI（-0.46，-0.06），I²=0，P=0.01]. Conclusion The nursing intervention model based on “Internet+” can effectively improve the pain intensity and pain interference in cancer patients. Interactive health education is the best form of intervention.

Progress on the application of artificial intelligence in chronic disease health management

XU Xuefen, WANG Hongyan, GUO Pingping, WANG Yulu, FENG Suwen

2023, 58(9):  1063-1067.  DOI: 10.3761/j.issn.0254-1769.2023.09.006

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Chronic disease is one of the public health problems that threatens the health of patients，with long-term and incurable characteristics. The development of artificial intelligence provides the possibility for achieving efficient health management of chronic diseases. This paper introduces the overview of artificial intelligence and its application in the chronic disease health management，including disease-risk prediction，lifestyle optimization，disease monitoring，drug management，rehabilitation training and daily care. Meanwhile，the existing challenges and expectations were summarized，in order to provide references for the application of artificial intelligence in chronic disease health management in China.

The construction of self-management information systems for patients with chronic diseases based on Persuasive Systems Design Model：a scoping review

LIU Yang, HUANG Xiting, JIANG Zhili, WANG Zhiqian, TAO Guofang, XING Meiyuan, HUANG Lihua

2023, 58(9):  1068-1075.  DOI: 10.3761/j.issn.0254-1769.2023.09.007

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Objective To conduct a scoping review of the research on the Persuasive Systems Design Model in self-management information systems for patients with chronic diseases，so as to clarify the related concepts of the persuasive systems，identify the elements of the persuasive systems，and provide guidance for future research in this field. Methods Based on the methodological framework of the Australia Joanna Briggs Institute Scoping Review Guide，CNKI，Wanfang，VIP，Sinomed，PubMed，Web of Science，PsycINFO，Cochrane Library，CINAHL and Embase databases were retrieved from the date of establishment of the databases to September 2022，and the included studies were analyzed. Results A total of 22 pieces of literature published from 2010 to 2022 in English were included. The included 22 studies were all themed on the construction of self-management information systems for patients with chronic diseases based on the Persuasive Systems Design Model. The content included physical activities，dietary habits，medication management，weight management and symptoms monitoring. Conclusion The self-management information systems for patients with chronic diseases based on the Persuasive Systems Design Model can influence the attitude and behavior of patients，motivate patients to engage in self-management and trigger health behavior change，which play a significant role in guiding patients with chronic diseases and show a positive application effect.

Specialist Practice and Research

Application of airway clearance program based on lung ultrasound in patients with mechanical ventilation in ICU

NI Xiumei, XU Fengling, CHEN Hao, GONG Juan, ZHANG Chong, WANG Cui, LI Baoqin, HU Shaohua

2023, 58(9):  1076-1081.  DOI: 10.3761/j.issn.0254-1769.2023.09.008

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Objective To investigate the application effect of airway clearance program based on lung ultrasound in patients with mechanical ventilation in ICU. Methods A total of 106 mechanical ventilation patients admitted to the ICU of a tertiary A hospital in Hefei from January 2021 to June 2022 were selected by objective sampling method，and they were divided into an experimental group and a control group according to random number table method. The control group was given routine airway clearance program and the intervention group was given airway clearance program based on lung ultrasound. Pulmonary ultrasound scores，oxygenation index，diaphragm function and mechanical ventilation duration were compared between the 2 groups at the first，third and fifth days of intervention. Results A total of 123 cases were included in this study，among which 17 cases were excluded due to automatic withdrawal of less than 5 days in ICU. A total of 106 cases were finally included，including 56 cases in the experimental group and 50 cases in the control group. The results of repeated measurement analysis of variance showed that the pulmonary ultrasound score，oxygenation index， diaphragm thickness and thickness variation rate had statistical significance between groups， interaction and time effects（P<0.05）. There was no statistical significance in the mechanical ventilation time between the 2 groups（P=0.902）. Conclusion Airway clearance technique based on lung ultrasound can improve the oxygenation status and enhance the diaphragm function.

Risk assessment and influencing factors of fall in hospitalized patients with acute coronary syndrome

XIANG Shuang, WANG Bin, MIAO Hua, HAN Jing, JIANG Jingjing, ZHENG Wen, YAN Yan, WANG Xiao, GONG Wei, AI Hui, QUE Bin, NIE Shaoping, ZHANG Lixin

2023, 58(9):  1082-1087.  DOI: 10.3761/j.issn.0254-1769.2023.09.009

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Objective To investigate the current status of fall risk in hospitalized patients with acute coronary syndrome（ACS） based on Morse Score Scale，and to analyze the influencing factors. Methods A single-center，prospective cohort study was carried out for investigation. Between June 2015 to January 2020，consecutive ACS patients hospitalized at a tertiary A general hospital in Beijing were enrolled. All patients underwent portable sleep breathing monitoring，and they were then divided into a low-risk fall group（score<25） and a medium/high-risk fall group（score≥25） by Morse Fall Score administered by trained nurses in charge. Multivariate stepwise Logistic regression was used to analyze the influencing factors. Results A total of 1 732 ACS patients were enrolled. Medium/high-risk fall was present in 1 576 patients （91.0%），and 156 patients（9.0%） were in the low risk fall group. The proportion of patients with medium/high-risk of fall combined with hypoglycemic therapy，cardiovascular related drugs（anti-platelet，anti-hypertensive，lipid-lowering） was higher than the low-risk group（P<0.05）. The difference of mean SaO₂ between the 2 groups was statistically significant（P=0.019）. Compared with the medium/high risk fall group，the proportion of patients receiving PCI，coronary rotational atherectomy and multiple PCI was higher in the low-risk fall group（P<0.05）. Multiple linear regression analysis showed that mean SaO₂（RR=1.035， 95%CI 1.020~1.048，P=0.043），age（RR=1.040，95%CI 1.021~1.059，P<0.001），prior hypertension（RR=3.177，95%CI 2.215~4.557，P<0.001），prior myocardial infarction（RR=1.751，95%CI 1.009~3.037，P=0.046），diabetes mellitus （RR=1.633，95%CI 1.073~2.579，P=0.046），and body mass index（RR=1.064，95%CI 1.011~1.120，P=0.018） were the risk factors for medium/high risk falls. Conclusion Among hospitalized ACS patients，the incidence of medium/high risk falls was as high as 91.0%. The risk of falls was higher in patients with older age，higher body mass index，history of hypertension，diabetes，myocardial infarction，and lower the average oxygen saturation at night.

Study on the frailty trajectory and influencing factors of lung transplantation patients

HUANG Keyao, DING Siyan, ZHOU Haiqin, CAI Yinghua

2023, 58(9):  1088-1095.  DOI: 10.3761/j.issn.0254-1769.2023.09.010

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Objective To investigate the status and trajectory of frailty among lung transplantation patients from preoperation to 1 year after operation，and to analyze the predictive role of demographic and disease-related factors on the change trajectory of frailty. Methods A prospective study design was used. Lung transplant patients who met the criteria and were admitted to a tertiary A hospital in Wuxi City from July 2019 to December 2020 were selected by convenience sampling method，and the socio-demographic and clinical data of patients were collected. The frailty of patients was assessed by the Short Physical Performance Battery（SPPB） and Fried Frailty Phenotype（FFP） at 1 week before operation（T1），2 weeks after operation（T2），1 month after operation（T3），3 months after operation（T4），6 months after operation（T5） and 1 year after operation（T6），and the related nutritional and exercise indexes were collected. The linear mixed effect model was established to identify the track categories，and the binomial classification Logistic regression model was used to analyze the influencing factors of the frailty score track. Results 190 cases were included in T1 stage；17，9，12，15，16 cases were lost for follow-up in T2~T6 stage；121 cases were finally included. The SPPB scores of T1-T6 patients were（7.93±3.30）， （5.65±3.40）， （9.22±2.95）， （10.69±2.59）， （11.06±2.57）， （11.36±2.20）， respectively. The FFP scores were（3.32±1.21）， （3.74±1.01）， （2.81±1.11）， （1.86±1.23）， （1.54±1.16）， （1.11±1.14）， respectively. Univariate binomial logistic regression analysis showed that age，time of ICU stay，time of postoperative hospital stay，number of postoperative complications，first time out of bed，operation and education method were the influencing factors of frailty trajectory in lung transplantation patients. Conclusion Frailty of lung transplantation patients is gradually improved after lung transplantation. Clinical attention should be paid to the frailty assessment of lung transplantation patients with old age，more complications and long hospital stay，so as to develop targeted preoperative rehabilitation and postoperative rapid rehabilitation strategies.

Nursing Management

Construction and verification of entrustable professional activities for nurses in emergency departments of tertiary general hospitals

HUANG Hao, JIAO Yuchen, JI Yan

2023, 58(9):  1096-1103.  DOI: 10.3761/j.issn.0254-1769.2023.09.011

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Objective To construct indicators of nurse entrustable professional activities（EPAs） in emergency departments of tertiary general hospitals，and to conduct preliminary validation，so as to provide references for evaluating the competence of nurses in emergency departments. Methods EPAs indicators for emergency department nurses were identified through literature research，research group meetings and Delphi consultation. A questionnaire survey was conducted in May 2022 on 40 nurses in an emergency department of a tertiary general hospital in Wuxi using Entrustable Professional Activities Evaluation Indicators Satisfaction Questionnaire to verify the effectiveness of the indicator application. Results 2 rounds of Delphi consultations were conducted with 21 experts. The effective recovery rates for the 2 rounds of Delphi consultation questionnaires were 100%. The authority coefficient values were 0.881 and 0.898，respectively. Kendall concordance coefficients were 0.509 and 0.535，respectively（P<0.01）. Finally，a set of 18 indicators and descriptions of EPAs in emergency department nurses were formed，and the expected entrust level of each indicator in different years were determined. Emergency department nurses were satisfied with the indicators of EPAs evaluation，with a score of（22.25±3.04）. Conclusion The indicators of nurse EPAs in emergency department are scientific and practical，which can provide a better reference for the evaluation of nurses’ competence in emergency department of tertiary hospitals.

A study on the perceptions and behaviors of ICU nursing staff on thirst in mechanically ventilated patients in Guizhou Province

CHEN Fang, JIANG Zhixia, YANG Mingjing, LUO Qian, ZHANG Xia

2023, 58(9):  1104-1111.  DOI: 10.3761/j.issn.0254-1769.2023.09.012

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Objective To invstigate the knowledge，attitudes and practices（KAP） of ICU nurses toward thirst in patients with mechanical ventilation in Guizhou Province，and to analyze the influencing factors. Methods The convenience sampling method was used to investigate the knowledge，attitudes and practices of ICU nurses on thirst in patients with mechanical ventilation in 67 hospitals in Guizhou Province. The questionnaire included 38 items in 3 dimensions，namely knowledge，attitudes and practices. Results A total of 392 ICU nurses were surveyed，with the total score of （85.92±13.65），knowledge dimension of（13.42±2.54），attitude dimension of（40.86±7.41） and behavior dimension of（31.65±7.30）. Multiple linear regression analysis showed that training，literature learning，hospital grade，age and gender were independent influencing factors of thirst knowledge，attitude and behavior of ICU nurses on mechanical ventilation patients（P<0.001）. Conclusion ICU staffs’ knowledge and attitude towards thirsty in patients with mechanical ventilation were positive，but practices need further improvement. To date，there is a need to strengthen the theoretical and clinical practice training of thirst related knowledge among ICU nurses，especially for those working in primary-level hospitals，to improve the internal motivation of nurses to intervene in thirst of patients with mechanical ventilation，so as to further promote the quality of clinical practice and the recovery of patients.

Evidence Synthesis Research

The real life experience of nontraumatic lower extremity amputations patients：a qualitative Meta-synthesis

ZHANG Qi, CHEN Liyan, LI Yuanyuan, ZHANG Aihua, YANG Lijuan

2023, 58(9):  1112-1119.  DOI: 10.3761/j.issn.0254-1769.2023.09.013

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Objective To systematically review the real life experiences of nontraumatic lower extremity amputa-tions（NLEA） patients. Methods We searched databases，including PubMed，the Cochrane Library，Embase，Web of Science，CINAHL，PsycINFO，CNKI，Wan Fang data，VIP，and CBM from inception to August 2022 to collect qualitative studies on the real life experience of NLEA patients. The quality of included research was evaluated by the JBI Critical Appraisal Tool for qualitative studies from Australia. The results were summarized and integrated by the pooled integration methods. Results A total of 11 studies were included. 43 complete findings were grouped according to their similarities to form 3 integrated categories. The integration results were finally obtained. Integration results 1：facing multiple pressures and challenges，breaking the normalcy of life；integration results 2：there are multiple unmet needs；integration results 3：adopting different strategies to deal with amputation. Conclusion Nurses should pay attention to and understand the patient’s positive psychological state，and cooperate with available support to reduce the unmet needs of patients. It will be easier to reduce the transitional stress of the family，to help patients return to society better and improve their quality of life.

Best evidence summary for skin care in patients with hematopoietic stem cell transplantation complicated by graft-versus-host disease

WANG Lixiu, LI Jianfang, CHENG Hongxia, LUO Yan, YANG Bingxiang, LIU Qian

2023, 58(9):  1120-1126.  DOI: 10.3761/j.issn.0254-1769.2023.09.014

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Objective To search，evaluate and integrate relevant evidence of skin care for patients with hematopoietic stem cell transplantation complicated by graft-versus-host disease（GVHD）. Methods Based on the “6S” pyramid model，the evidence was systematically searched in computer decision support systems，websites of guidelines，relevant professional associations and organizations and comprehensive databases，and evidence of skin care for patients with hematopoietic stem cell transplantation complicated by GVHD were screened from the establishment of databases to May 2022，including guidelines，clinical decisions，evidence summaries，systematic reviews，and expert consensuses. The quality evaluation，evidence extraction and integration of the evidence were conducted by 6 research members. Results A total of 15 pieces of literature were included，including 2 clinical decisions，6 guidelines，5 expert consensuses and 2 systematic reviews. 13 pieces of best evidence were summarized from 4 aspects，including multidisciplinary cooperation，skin assessment，nursing interventions and health education. Conclusion This study systematically integrated the relevant evidence of skin care for patients with hematopoietic stem cell transplantation complicated by GVHD，and provided evidence-based references for the development of relevant guidelines and clinical practice standards. When applying the evidence，nurses are recommended to com-prehensively consider the actual clinical situations and patients’ wishes，and select evidences prudently.

Meta integration of qualitative research on role transition experience of caregivers of cancer patients

ZHANG Ruolin, LOU Yan, WU Wanying, WANG Chunlan, FU Liying, ZHOU Yao, HONG Meirong, XU Yulu, FENG Xinyue

2023, 58(9):  1127-1134.  DOI: 10.3761/j.issn.0254-1769.2023.09.015

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Objective To systematically evaluate the role transition experience of cancer caregivers，thereby identifying their support needs to develop targeted interventions. Methods The databases of PubMed，the Cochrane Library，Embase，EBSCO，Web of Science，CNKI，VIP，Wanfang，and CBM were retrieved for qualitative research about the role transition experience of caregivers of cancer patients. The retrieval period is from the establishment of the databases to March 2022. The quality of the literature was evaluated by JBI Critical Appraisal Tool for qualitative studies. Results A total of 14 studies were included，and 65 research results were extracted，which were grouped into 9 new categories. 3 integrated themes were finally synthesized：the process of cancer diagnosis was lengthy and complicated，and caregivers experienced difficulties in coping and especially had challenges in diagnosis disclosure；caregivers adopted different coping strategies to help patients to better cope with disease-related challenges，and to adapt to the role of caregivers；the newly derived meaning in the caregiving experience and role growth was gained. Conclusion Healthcare workers should be aware of the transitioning experience of cancer caregivers in taking this new role，and develop targeted ability training and psychological intervention programs，so as to promote the successful transition of the caregiver’s role and provide a family-centered transitional care plan in the future.

Summary of the best evidence for the management of arteriovenous access cannulation in maintenance hemodialysis patients

DONG Yongze, XU Xiujun, SHEN Huajuan, ZHOU Meiling, JIA Yanqing

2023, 58(9):  1135-1141.  DOI: 10.3761/j.issn.0254-1769.2023.09.016

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Objective To retrieve，evaluate and summarize the best evidence for management of arteriovenous access（AVA） cannulation in maintenance hemodialysis （MHD） patients，and to provide references for consolidation of standardized management of AVA cannulation. Methods We searched UpToDate，AHRQ，SIGN，GIN，NICE，RANO，Medlive and other guideline websites，ACP Journal Club，Cochrane Library，PubMed，Web of Science，CINAHL，CNKI，Wanfang，VIP，SinoMed and other databases to collect relevant clinical decisions，guidelines，best practices，evidence summaries，systematic reviews，and expert consensuses related to management of AVA cannulation in MHD patients. The retrieval time was from January 2017 to December 2021. The evidence-based team evaluated，extracted and summarized the evidence. Results A total of 8 articles were included through literature search，including 2 clinical decisions，4 guidelines，1 systematic review and 1 expert consensus. Finally，25 pieces of best evidence were summarized in 8 aspects，including timing of first cannulation，pre-cannulation evaluation and preparation，cannulation techniques，diagnostic method for successful cannulation，treatment of cannulation-related complications，compression after needle withdrawal，the use of cannulation auxiliary equipment，and qualification and training of cannulation personnel. Conclusion In clinical practice，medical staff should select the best evidence based on the characteristics of the hospital and specific clinical situations，to improve the success rate of primary cannulation of AVA，reduce cannulation-related adverse events，and extend the life span of AVA.

Review

The application of mindfulness-based intervention in nurses’ compassion fatigue：a scoping review

WANG Yiman, LI Ruiling, ZHANG Lele, HAN Lingyu, WANG Yuanyuan, LIANG Ran, ZHANG Yurui

2023, 58(9):  1142-1148.  DOI: 10.3761/j.issn.0254-1769.2023.09.017

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Objective To analyze and summarize the strategies to improve nurses’ compassion fatigue through reviewing the application research of mindfulness-based intervention，to provide the guidance for clinical medical staff to carry out mindfulness-based intervention and related research. Methods According to the research method of scoping review， a literature search was performed in the CNKI， Wanfang， CBM， PubMed， Embase， CINAHL， Web of Science，Scopus，ProQuest， the Cochrane Library. The retrieval time limit was from the establishment of the databases to June 15，2022. The included studies were summarized and analyzed. Results A total of 26 articles were included. The main elements of mindfulness-based interventions include curriculum theory introduction，mindfulness skills training，compassion training，stress coping guidance and mindfulness commitment practice. The main forms of mindfulness intervention are offline training，online training and mixed training. The frequency and length of training for the theoretical course of mindfulness intervention is mostly once a week，and 1.0~2.0 h per session；the frequency and length of skill training is mostly 2~4 times per week，and less than 30min per session. The outcome evaluation indicators include application effectiveness，feasibility，and application experience. Conclusion Mindfulness-based intervention has a variety of content elements and implementation strategies，and has positive application effects on nurses’ compassion fatigue. In the future，we need to continuously optimize the content and strategies of mindfulness intervention by combining the Internet and intelligent technologies，and conduct more high-quality randomized controlled studies to verify their long-term intervention effects.

Research progress on medication literacy of adolescent patients with chronic diseases

LUO Tingwei, ZHANG Na, SONG Qingqing, XIANG Yuqiong, JIANG Sishan, ZHANG Zhiqiang, XIA Qingqing, ZHU Lihui

2023, 58(9):  1149-1153.  DOI: 10.3761/j.issn.0254-1769.2023.09.018

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Medication therapy is the main treatment for adolescent chronic disease patients. Insufficient medication literacy will not only reduce their medication compliance，but also may lead to adverse medication events. This article reviewed the concept，status quo，harm of insufficient medication literacy，related influencing factors and intervention strategies of adolescent chronic disease patients，aiming to provide references for improving medication literacy of patients and ensuring medication safety.