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Table of Content

    10 August 2023, Volume 58 Issue 15
    Special Planning—Pulmonary Rehabilitation Nursing Care
    Expert consensus on prone position nursing for conscious adult patients with acute respiratory distress syndrome
    Internal Medicine Professional Committee of Chinese Nursing Association, West China Evidence-Based Nursing Center of Sichuan University(Writing Committee:LUO Yunting, CHEN Yanling, WU Xiaoyan, XIE Wenyi, JIANG Yan, FENG Mei, WU Ying, WANG Cong, QIAN Weiqi, LIU Xiangmin)
    2023, 58(15):  1797-1801.  DOI: 10.3761/j.issn.0254-1769.2023.15.001
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    Objective To compile an expert consensus on prone position nursing for conscious adult patients with acute respiratory distress syndrom(here in after referred to as the “consensus”),aiming to promote and standardize the implementation of awake prone position in hospitals at different levels. Methods The first draft of the consensus was formed by reviewing existing literature,conducting clinical stakeholder interviews and expert meetings,followed by 2 rounds of expert correspondence,and recommendations were revised based on expert opinions,and the evidence and recommendation levels were scientifically graded. Results After 2 rounds of consultations with 20 experts,the recommendations were finally formed. The effective return rate of the questionnaire was 100%,and the expert authority coefficient was 0.90. In the first round of consultation,the frequency of full marks for necessity is 95%~100%,and the coefficient of variation of recommendation approval degree is 0~0.227. In the second round,the average value of the degree of approval rating has increased,ranging from 4.65 to 5.00,and the frequency of full marks for necessity is 100%,and the coefficient of variation is 0~0.201. The Kendall W coefficients of the 2 rounds of inquiry were 0.136 and 0.168,and the difference was statistically significant(P<0.05). The consensus includes the formation of multidisciplinary teams,nursing evaluation,implementation key points,monitoring and management,health education,prevention of adverse events,management of special populations on the obesity people,and nursing quality indicators. Conclusion This consensus combines the existing evidence,clinical needs and the recommendations of medical and nursing experts,and it can provide guidance for patients to carry out conscious prone position as early as possible.

    Study on the construction of a nurse-led pulmonary rehabilitation management program and its application to ventilator-dependent patients in ICU
    HE Bin, YANG Zheng, MO Beirong, HE Guilan
    2023, 58(15):  1802-1807.  DOI: 10.3761/j.issn.0254-1769.2023.15.002
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    Objective To establish a nurse-led pulmonary rehabilitation management program,and to explore its effects on the weaning time,lung function and activity function of ventilator-dependent patients in ICU. Methods By setting up a multidisciplinary pulmonary rehabilitation team and formulating the responsibilities of the nursing assistant,the nurse-led pulmonary rehabilitation management program was established,including the starting standard and weaning standard of pulmonary rehabilitation,respiratory target training,movement target training,target analgesia and sedation. By convenience sampling method,30 ventilators dependent patients admitted to ICU from June 2021 to October 2022 were selected as the experimental group,and 30 ventilators dependent patients admitted from June 2019 to May 2021 were selected as the control group. The experimental group received a nurse-led pulmonary rehabilitation management program on the basis of routine nursing. The control group was given routine airway care and early rehabilitation training. The differences of success rate,weaning time,ICU stay,oxygenation index,6-min walking distance and scores of ICU activity scale were compared between the 2 groups. Results The ICU stay time and weaning time of the experimental group were shorter than those of the control group;the scores of the ICU activity scale and the 6-min walking distance of the patients were better than those of the control group(P<0.05). There was no significant difference in weaning success rate and oxygenation index between the 2 groups (P>0.05). Conclusion The nurse-led pulmonary rehabilitation management program can effectively shorten the withdrawal process of ventilator-dependent patients,improve lung function and activity function,and provide guidance for clinical nursing practice.

    The application of internet based whole health education of pulmonary rehabilitation in patients undergoing lung cancer surgery
    QIN Mengxia, QIAN Yan, XU Rong, DONG Cuiping, CAI Chun
    2023, 58(15):  1808-1814.  DOI: 10.3761/j.issn.0254-1769.2023.15.003
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    Objective To explore the application of internet based whole health education of pulmonary rehabilitation in patients undergoing lung cancer surgery,and to explore the practicability of such innovative health education in clinical settings. Methods Patients undergoing lung cancer surgery from the Department of Thoracic Surgery of a tertiary hospital from Wuhan in May to November 2022 were selected by convenience sampling and included as the study subjects. With a prospective non-concurrent control design,50 patients undergoing surgery in September to November 2022 were included as the experimental group,and 50 patients undergoing surgery in May to July 2022 were included as the control group. The experimental group received internet based whole health education of pulmonary rehabilitation,while the control group received routine pulmonary rehabilitation health education. The differences between the 2 groups in postoperative scores of the Knowledge-Attitude-Practice(KAP) questionnaire of pulmonary rehabilitation,postoperative chest tube indwelling time,Six-Minute Walk Distance(6MWD),hospital stay and patient satisfaction. Results The score of the KAP questionnaire of pulmonary rehabilitation in the experimental group was(107.76±5.05),which was significantly higher than that in the control group of(98.78±5.11)(P<0.001). The postoperative chest tube indwelling time in the experimental group was 71.00(51.00,101.25) h,which was significantly lower than that in the control group of 84.50(63.75,131.50) h(P=0.035). The △6MWD in the experimental group was (141.80±29.93) m,which was significantly lower than that in the control group of(155.80±33.54) m(P=0.030). Again,the satisfaction survey score in the experimental group was 95.00(90.00,98.00),which was significantly higher than that in the control group of 89.00(86.25,94.00)(P<0.001). Conclusion The internet based whole health education of pulmonary rehabilitation can improve the score of KAP questionnaire of pulmonary rehabilitation post lung cancer surgery,boost the compliance of pulmonary rehabilitation exercises,shorten the chest tube indwelling time,mitigate the decline of postoperative exercise capacity,and improve patient satisfaction. The innovative whole health education of pulmonary rehabilitation is practical in clinical settings.

    Experiences and coping styles of dyspnea-related fear among patients with chronic obstructive pulmonary disease:a qualitative research
    MIAO Xiaolang, NIU Mei’e, HAN Yanxia, ZHANG Beilei, ZHAO Qian, LU Xiangmin
    2023, 58(15):  1815-1820.  DOI: 10.3761/j.issn.0254-1769.2023.15.004
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    Objective This qualitative research aimed to explore the experiences of dyspnea-related fear among patients with COPD. Methods We performed in-depth interviews guided of behavioral-event-interview and analyzed the experiences of 18 inpatients who underwent dyspnea-related fear that came from a tertiary hospital in Suzhou from June to September 2022. Results 3 themes and 7 sub-themes were analyzed and summarized,including experiences of dyspnea-related fear(dyspnea-related fear affected daily routines,and symptoms perception exacerbated experiences of dyspnea-related fear),coping styles of dyspnea-related fear(positive coping and negative coping),support demands to alleviate dyspnea-related fear(eager to receive professional support,looking forward to family support,urgent demands for social support). Conclusion Nursing staff should pay attention to patients’ experiences of dyspnea-related fear,weaken their fear experiences by accepting themselves and reducing their perception of dyspnea,promote positive coping by improving cognition and enhancing self-efficiency,meet the diverse demands to alleviate dyspnea-related fear by strengthening hospital-community-family support,ultimately improve their qualities of life and outcomes.

    Research review of fatigue recognition and management in patients with interstitial lung disease
    SHANG Yameng, LIU Fangli, LI Jiaxin, LIU Ziwei, WANG Yingying, LI Yuege, XI Fang
    2023, 58(15):  1821-1825.  DOI: 10.3761/j.issn.0254-1769.2023.15.005
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    Fatigue is one of the most common complaints in patients with interstitial lung disease(ILD) and seriously affects their prognosis and quality of survival. The study introduces the hazards of fatigue in patients with interstitial lung disease,and describes the common measurement tools for fatigue symptoms in ILD. Management measures to improve their symptoms are summarized in order to provide a basis for the development of comprehensive,multidisciplinary and individualized ILD fatigue management programs in the clinical settings.

    Specialist Practice and Research
    Construction and application of artificial intelligence follow-up system for multiple myeloma patients
    ZHAO Wenwen, LI Peng, LU Fei, TIAN Ruxiang, JIANG Huihui, WANG Jingtao, ZHANG Tongtong, ZHAO Wanlu, LI Qiuhuan
    2023, 58(15):  1826-1830.  DOI: 10.3761/j.issn.0254-1769.2023.15.006
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    Objective To construct an artificial intelligence follow-up system for multiple myeloma patients based on patient needs,and to evaluate its application effect. Methods From March to May 2022,308 patients with multiple myeloma were selected from 3 tertiary hospitals in Shandong via convenience sampling method,and they were investigated by the cognition and demand content questionnaire of the artificial intelligence follow-up system,and the module of the follow-up system was developed,and its functions were combined with the initial application of the follow-up system for patients with hematologic diseases. From July to December 2022,patients’ symptom management level and satisfaction before and after application of the system were evaluated by the cancer patient self-management assessment scale and the continuous Care Smart platform using the questionnaire. The continuous Care Smart platform was used to evaluate the application satisfaction of medical staff with the questionnaire. Results The artificial intelligence follow-up system for multiple myeloma patients consisted of 2 modules and 9 functions. After the system was applied,the self-management level of 83 patients with multiple myeloma was higher than that before application(P<0.05);the satisfaction score of patients was (67.36±8.27) points;the timely completion rate of follow-up was higher than that before the application (P<0.01). The satisfaction of medical staff on the practicability,convenience,reliability and accuracy of the system was more than 95%,and the satisfaction of intelligence was 84.6%. Conclusion The artificial intelligence follow-up system for multiple myeloma patients has a scientific construction process,good practicability and convenience,and patients have high satisfaction with it.

    Construction of a nursing quality evaluation index system for inter-hospital transfer of emergency critically ill patients
    SUN Pengxia, LI Shuya, HUA Xiaoxue, GAO Jian, CAI Mengxin, LI Fan
    2023, 58(15):  1831-1837.  DOI: 10.3761/j.issn.0254-1769.2023.15.007
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    Objective To construct a quality evaluation index system for inter-hospital transfer of emergency critically ill patients,so as to evaluate the quality of inter-hospital transfer of emergency critically ill patients. Methods Based on structure-process-outcome theory and the “expert consensus on inter-hospital transfer of critically ill patients”,the index definition and weight were identified and the quality evaluation index was constructed by literature review,panel interviews,Delphi method and Hierarchy analysis. Results The effective recovery rates of questionnaires in the first and second round of expert consultations were 85.0%(17/20) and 100% (17/17);the expert authority coefficients were 0.900,0.897;the Kendall harmony coefficients were 0.193(χ2=316.295,P<0.001),0.159(χ2=257.103,P<0.001),respectively. The finalized evaluation index included 3 first-level indicators,17 second-level indicators and 81 third-level indicators. Conclusion The constructed evaluation index is scientific,reliable,reasonable,comprehensive,and clinically practical. It can provide continuous scientific evaluation for inter-hospital transfer of emergency critically ill patients.

    Construction of a self-management program for diabetic foot amputees
    ZHU Hongjuan, WANG Qian, YU Hongli, YUE Peng
    2023, 58(15):  1838-1844.  DOI: 10.3761/j.issn.0254-1769.2023.15.008
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    Objective To construct a scientific and standardized self-management program for diabetic foot amputation patients. Methods On the theoretical basis of Bandura theory and Anderson’s behavioral diagnosis model,literature retrieval and semi-structured interview were used to formulate a draft of self-management plan focusing on diabetic foot amputees. From September to November 2022,2 rounds of correspondence were conducted with 31 experts by Delphi method,and indicators at all levels were screened and modified. Results A total of 31 questionnaires were distributed in the 2 rounds of expert consultations,and 31 were recovered. The effective recovery rate of the questionnaires was 100%. The authority coefficient of consulting experts was 0.971;Kendall’s coefficient of harmony was 0.146 and 0.205(P<0.001). In the second round of consultation,the coefficient of variation of experts was 0~0.15,and all items were 0.25. The final scheme included 3 first-level indicators,23 second-level indicators,and 64 third-level indicators. Conclusion The self-management program with diabetic foot amputation patients as the main position is scientific,targeted and feasible,and can provide bases and guidance for diabetic foot amputation patients to carry out effective and standardized self-management.

    The development and application of a risk prediction model for extracorporeal circuit clotting during continuous renal replacement therapy
    HU Lulu, NIU Hongyan, HAN Xiaoyun, ZHU Xiying, LIU Jinfeng
    2023, 58(15):  1845-1851.  DOI: 10.3761/j.issn.0254-1769.2023.15.009
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    Objective To construct and verify a predictive model to assess the risk of extracorporeal circuit clotting during continuous renal replacement therapy(CRRT). Methods A total of 320 patients with CRRT were enrolled from April 2021 to January 2022,and risk factors between a blockage group(222 cases) and a non-blockage group(98 cases) were compared using logistic regression for model construction. The goodness of fit of the model was verified by Hosmer-Lemeshow test. The predictive validity of the model was evaluated by the area under the ROC curve. From February to June 2022,160 patients were recruited for application of the model. Results The incidence of coagulation in this study was 30.6%. The factors that ultimately entered the predictive model were CVVHD mode of treatment(OR=2.482),CVVH mode of treatment(OR=2.724),citrate anticoagulation(OR=3.425),argatroban(OR=3.150),without anticoagulation(OR=9.103),pump interruption(OR=4.114),access outflow dysfunction(OR=2.769),the platelet count(OR=1.005),and APTT(OR=0.859). The model formula was P=1/[1+exp(-0.866+0.909 × CVVHD+1.002 × CVVH+1.231×citrate anticoagulation+1.147 × argatroban+2.209 × without anticoagulation+1.415 × pump interruption+1.018 × access outflow dysfunction+0.005 × the platelet count-0.152 × APTT)]. The area under the ROC curve was 0.865,while the Youden index was 0.584,with sensitivity of 75.50% and specificity of 82.90%. The model verification results showed the sensitivity of 84.10%,the specificity of 79.31%,and the accuracy of 80.63%. Conclusion The risk prediction model has satisfactory prediction effects. The risk prediction can be completed at the beginning of CRRT,which can provide references for preventative treatment and nursing measures for high-risk patients.

    Nursing Management
    Correlation analysis of psychological resilience and leadership of nursing managers in 21 provinces
    ZHAO Qinqin, LIU Yun, CUI Huixia, YAO Xiuyu, WU Xinjuan, LI Zheng, LIU Huaping
    2023, 58(15):  1852-1857.  DOI: 10.3761/j.issn.0254-1769.2023.15.010
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    Objective To investigate the status of psychological resilience and leadership of nursing managers and analyze the relationship between them and provide references for developing strategies related to enhance leadership of nursing managers. Methods A total of 1806 nursing managers from 21 provinces were investigated by general questionnaire,Connor-Davidson Resilience Scale(CD-RISC) and Multi-factor Leadership Questionnaire (MLQ-5X) from November 2022 to February 2023. Pearson correlation and multiple regression were used to analyze the relationship between psychological resilience and leadership of nursing managers. Results 1 804 questionnaires were collected,with a valid recovery rate of 99.89%. The score of CD-RISC(3.88±0.56) and MLQ-5X(2.46±0.41) were at a relatively high level,and there was a positive correlation between them(r=0.669,P<0.001). The results of multiple regression analysis showed that among job characteristics,in addition to age,hospital level,participation in academic organization were the main influencing factors on leadership. In addition,psychological resilience(β=0.483,P<0.001) could exert positive influence on leadership. Psychological resilience and job characteristics together could explain 46.0% of the total variance in leadership. Conclusion Leadership of nursing managers was at a medium to high level,and psychological resilience positively influence on leadership. The study suggests that there is still room for improvement in leadership levels,and the improvement of resilience will be helpful for the enhancing of leadership.

    Correlation analysis between nursing practice environment and turnover rate in 188 tertiary A public general hospitals
    HUANG Xin, SHANG Wenhan, AN Lei, YAO Li
    2023, 58(15):  1858-1863.  DOI: 10.3761/j.issn.0254-1769.2023.15.011
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    Objective To explore the relationship between nursing practice environment and turnover rate in tertiary A public general hospitals in China,so as to improve the nursing practice environment and enhance the stability of the nursing team. Methods From 2017 to 2021,nurses in 188 tertiary A public general hospitals in China were investigated by the Nurse Practice Environment Assessment Scale,and the evaluation scores and hospital turnover rate results were analyzed by trend test and correlation analysis. Results The evaluation of nursing practice environment in 188 hospitals was from(74.31±6.66) points in 2017 to(82.62±6.59) points in 2021,and the overall evaluation and the scores of each dimension showed an upward trend(P<0.001). Among them,the scores of ‘quality management’,‘medical cooperation’ and ‘clinical nursing professionalism’ have been in the top 3 for 5 consecutive years;the scores of ‘hospital management and participation’,‘salary’ and ‘social status’ are the last 3. The turnover rate of nurses ranged from 1.27% to 1.57%,and there was a difference among the nurses from the eastern,central and western region of the country(P<0.05). In the nurse practice environment,the 3 dimensions of ‘quality management’,‘healthcare cooperation’,and ‘clinical nursing professionalism’ were the most significantly associated with nurse resignation(P<0.05). Conclusion In the environment construction of nursing practice,we should base on hospital quality and organizational management,improve nursing professionalism,create a good working atmosphere for medical and nursing teams,build a participatory nursing management model,improve the nurse salary distribution plan,and ultimately improve the satisfaction of nursing practice environment and reduce the rate of nurse turnover.

    Case Study
    Nursing care of a patient with skull base osteonecrosis after radiotherapy for chordoma
    CHEN Liou, LIU Junqi, WANG Zhenlin, YANG Na, QI Sai, YING Bo
    2023, 58(15):  1864-1868.  DOI: 10.3761/j.issn.0254-1769.2023.15.012
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    This study summarises the care provided in a case undergoing general anaesthesia for endoscopic transnasal skull base necrotic bone removal + composite tissue flap skull base reconstruction with sequential secondary aspiration pneumonia,fungemia,intracranial infection,cerebrospinal fluid leak,and air cranium. Key points of care:early swallowing assessment and perioperative ingestion management,the reduction of the risk of mis-aspiration,the rapid recovery of oral feeding;prone position ventilation in combination with vibratory drainage techniques of the infected lung lobes promoted purulent drainage and enhanced ventilation. The key to the care of a massive cerebrospinal fluid leak with pneumocephalus included proper placement of the patient based on the position of the leak,control of head and body movement,and monitoring of the volume of secretions on the tracheotomy bag. The position of the nasal cannula was observed,and nasal skin care was performed to ensure the position of the cannula and the integrity of the nasal skin. The patient was discharged after 45 days of hospitalisation with meticulous treatment and care.

    Nursing care of the first case of patient undergoing double-branch aortic stent implantation in the world
    SUN Caiyun, ZHONG Jun
    2023, 58(15):  1869-1873.  DOI: 10.3761/j.issn.0254-1769.2023.15.013
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    To summarize the nursing care of an elderly patient with acute aortic dissection who underwent double-branch aortic stent implantation. The main points of nursing include preoperative education and psychological nursing,intraoperative cooperation and body temperature nursing,close monitoring of hemodynamics and blood coagulation function after operation,standardization of airway and blood glucose management. At the same time,we should pay attention to the changes of condition and consciousness,strengthen the monitoring of renal function,carry out nutritional support and rehabilitation exercise to prevent related complications. After treatment and nursing,the patient was cured and discharged from hospital 11 days after operation.

    Nursing care of a case of perianal abscess with necrotizing fasciitis in the fifth stage of diabetic nephropathy
    TANG Weiping, SHANG Xiaoyuan, XIA Wenjun, TAN Jinmei, CHEN Bin
    2023, 58(15):  1874-1877.  DOI: 10.3761/j.issn.0254-1769.2023.15.014
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    To summarize the nursing experience of a case of perianal abscess with necrotizing fasciitis in the fifth stage of diabetic nephropathy. Nursing points include:Local care of wound surface:the application of TIME principle,the application of negative pressure closed drainage and lavage combined with ostomy nursing technology,and the application of platelet-rich plasma(PRP) technology;Early warning,identification and nursing of potassium metabolic disorder;Early warning nursing of shock;Individualized nutritional support nursing;Follow-up health guidance strategies and extended nursing were implemented after discharge. After 2 months of active treatment and nursing care,the patient’s wound healed.

    Evidence Synthesis Research
    Effects of structured individual cognitive stimulation therapy on patients with mild to moderate dementia:a meta-analysis
    LIU Zeyu, LING Yan, TU Ping, YAO Ying, HUA Yaqi, WANG Xin, HU Min
    2023, 58(15):  1878-1884.  DOI: 10.3761/j.issn.0254-1769.2023.15.015
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    Objective To evaluate the effect of structured individual cognitive stimulation therapy in patients with mild to moderate dementia. Methods Pubmed,Embase,Web of science,Cochrane library,CINAHL,APA PsycInfo and CNKI,Wanfang Database,CBM were searched by computers for the research on the efficacy of structured individual cognitive stimulation therapy for patients with dementia from inception to September of 2022. 2 researchers conducted literature screening,data extraction and quality evaluation independently,and meta-analysis was performed by RevMan 5.4 software. Results A total of 9 pieces of literature were included,in which 617 patients with mild to moderate dementia were studied. The results of meta-analysis showed that the test group was better than the control group in Mini-Mental State Examination scale scores[MD=1.15,95%CI(0.34,1.96),P=0.005] and Montreal Cognitive Assessment scale scores[MD=4.88,95%CI(2.16,7.60),P<0.001],but there was no significant difference in ADAS-cognitive portion scale scores[MD=-1.20,95%CI(-3.02,0.62),P=0.200]. The improvement on depression in the test group is better than that of control group[MD=-0.81,95%CI(-1.31,-0.31),P=0.001].However,there is no statistically significant differences in the quality of life[MD=1.65, 95%CI(-0.58, 3.88), P=0.150) and neuropsychological symptoms[MD=-0.23,95%CI(-2.77,2.32),P=0.860] between 2 groups. Conclusion The existing evidence shows that the structured individual cognitive stimulation therapy could alleviate the depression of patients with mild to moderate dementia,and improve the cognitive ability to a certain extent,but the effect on improving the quality of life and neuropsychological symptoms is not evident,which needs to be further studied with high-quality randomized controlled trials in a larger sample size.

    Evidence summary of assessing sleep disorders and nursing interventions in patients with Parkinson’s disease
    ZHOU Lanlan, XU Qunli, SHEN Lanjun, LI Tingting, YING Yuai, HONG Sisi
    2023, 58(15):  1885-1891.  DOI: 10.3761/j.issn.0254-1769.2023.15.016
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    Objective To summarize the best evidence of sleep disorder assessment and nursing intervention in patients with Parkinson’s disease,and to provide references for clinical work to help improve sleep disorders in patients with Parkinson’s disease. Methods All evidence on Parkinson’s sleep disorder from domestic and foreign data and related websites were systematically searched,including guidelines,expert consensuses,clinical decision-making,evidence summaries and systematic reviews. The retrieval period is from the establishment of databases to November 1,2022. There were 2 researchers who evaluated the quality of the literature,extracted and summarized the evidence according to the subject. Results A total of 10 pieces of literature were included,involving 3 clinical decisions,2 guidelines,3 systematic reviews and 2 expert consensuses. 23 pieces of evidence covering 4 categories of sleep disorder screening and assessment,care interventions,and education and support systems were summarized. Conclusion This study comprehensively and scientifically summarizes the best evidence for the assessment and nursing interventions of sleep disorders in patients with Parkinson’s disease,which can provide evidence-based evidence for clinicians to manage sleep disorders in a scientific way and improve patients’ quality of life.

    Evidence summary of assessment and nursing for hemorrhagic cystitis patients undergoing hematopoietic stem cell transplantation
    XIE Caiqin, ZENG Jie, ZHENG Haiyan, WU Linshan, BAO Han, XU Qi, ZHAO Yueqiu, JIANG Qiuping, ZHU Yan
    2023, 58(15):  1892-1898.  DOI: 10.3761/j.issn.0254-1769.2023.15.017
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    Objective To search,evaluate and summarize the best evidence of assessment and nursing for hemorrhagic cystitis patients undergoing hematopoietic stem cell transplantation,so as to provide a reference for clinical practice. Methods Evidence-based method was used to search the relevant literature according to the "6S" evidence pyramid model. The time limit for the literature search is from the inception of databases until May 30,2022. Results A total of 14 pieces of literature were included,including 1 clinical decisional support,2 guidelines,1 best practice report,3 consensuses,7 systematic reviews. Totally 23 pieces of evidence were summarized with 6 topics,including assessment of risk factors,auxiliary examination assessment,symptom assessment,lifestyle guidance,medication-based prevention,and comprehensive intervention. Conclusion This study summarizes the best available evidence for the assessment and nursing for hemorrhagic cystitis patients undergoing hematopoietic stem cell transplantation. It is recommended that health care providers should fully consider the actual situation of patients,in order to correct assessment and effective intervention.

    Meta-synthesis of qualitative research on the real experience of telerehabilitation for patients with cardiovascular diseases
    ZHANG Xiaoxue, GUO Weiting, LIU Jianping, ZHANG Binbin, YANG Xianxian, WANG Wenjun
    2023, 58(15):  1899-1906.  DOI: 10.3761/j.issn.0254-1769.2023.15.018
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    Objective To systematically evaluate and integrate qualitative studies on the experience and needs of telerehabilitation for patients with cardiovascular diseases,so as to provide references for clinical practice in China. Methods We searched databases including Cochrane Library,JBI,PubMed,Embase,Web of Science,Psyc INFO,CINAHL,CBM,WanFang Data,CNKI and VIP from inception to February 2023,to collect qualitative studies related to the experience and needs of telerehabilitation for patients with cardiovascular diseases. 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 15 studies were included;65 findings were collected;the similar results were grouped into 11 new categories;finally these categories were integrated into 4 synthesis results,including acceptance of telerehabilitation in patients with cardiovascular disease,perceived benefits of telerehabilitation in patients with cardiovascular disease,barriers to telerehabilitation in patients with cardiovascular diseases,telerehabilitation needs and expectations of patients with cardiovascular disease. Conclusion As a convenient alternative to telerehabilitation additional cardiac rehabilitation,telerehabilitation has been recognized by most patients with cardiovascular diseases. However,future research should continue to optimize digital tools,improve rehabilitation models,strengthen team building,provide social support,and improve the accessibility and experience of cardiovascular disease patients using telerehabilitation systems.

    Review
    Digital technology-based cognitive training intervention for patients with cognitive impairment:a scoping review
    WANG Dingkai, GENG Yu, YANG Jingjing, HUANG Weidong
    2023, 58(15):  1907-1912.  DOI: 10.3761/j.issn.0254-1769.2023.15.019
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    Objective To conduct a scoping review of studies on cognitive training interventions for patients with cognitive impairment based on digital technology to identify digital technology,content elements and outcome indicators of cognitive training and to provide guidance for future research. Methods A literature search was performed in the PubMed,Embase,CINAHL,Web of Science,Scopus,Cochrane Library,PsycINFO,CNKI,Wanfang,and CMB databases to identify relevant studies. The search period is from the establishment of databases to November 18,2022. The included studies were summarized and analyzed. Results A total of 19 articles were included,and the digital technology-based cognitive training digital technology included computer technology,virtual reality technology,intelligent robotics,and mixed reality technology. The cognitive training content covered attention,memory,language skills,abstract thinking skills,executive skills,visuospatial orientation,motor balance,logic and computational skills,and daily life skills training. The outcome indicators involve 2 aspects of overall cognitive function and each cognitive function. Conclusion The digital technology-based cognitive training can motivate patients with cognitive impairment to participate and significantly improve their cognitive function. In the future,the use of artificial intelligence technology can be explored to optimize nursing human resources allocation and cultivate specialized nurses of digital technology cognitive training information.

    Critical illness-related diaphragmatic dysfunction assessment:a scoping review
    BAI Yunfeng, CHEN Tianchao, SUN Jianhua, ZHANG Xiaoming, LI Jiamin, LUO Hongbo, LI Zunzhu, XIE Lingli, CAO Jing, DENG Haibo, WU Xinjuan
    2023, 58(15):  1913-1920.  DOI: 10.3761/j.issn.0254-1769.2023.15.020
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    Objective A scoping review of studies on critical diaphragmatic dysfunction at home and abroad was conducted to grasp the current state of research in the topic. Methods In accordance with the scope review’s research methodologies,databases including PubMed,Embase,Web of Science,CNKI,and Wan fang were searched by the computer for relevant studies. The deadline for retrieval is from the establishment of databases to September 4,2022. There was an analysis of the included literature. Results 39 articles were finally included. Two of them were historical cohort studies,while the other 37 were prospective ones. The conceptual spectrum of diaphragm dysfunction includes eventration,frailty,and paralysis of the diaphragm. The evaluation procedures included ultrasound of the diaphragm and bilateral phrenic nerve stimulation. Diaphragm thickness fraction,diaphragm movement,abnormal diaphragm movement,and endotracheal pressure induced by phrenic nerve stimulation are the primary evaluation indicators. Conclusion Domestic nursing researchers should focus on the problems and complications associated with diaphragmatic dysfunction in severely ill patients,select a standardized and unified evaluation method,and use a variety of indicators to comprehensively evaluate the diaphragm function of patients in order to better treat patients and aid in their early recovery.