Table of Content

10 November 2023, Volume 58 Issue 21

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Special Planning—Breast Cancer Care

Construction and application of a perioperative management program of breast reconstruction with deep inferior epigastric perforator flap in patients with breast cancer

LI Ying, YU Xiaofen, MEI Xiaofeng, ZHANG Lufei

2023, 58(21):  2565-2574.  DOI: 10.3761/j.issn.0254-1769.2023.21.001

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Objective To construct a perioperative management program for breast reconstruction with deep inferior epigastric perforator flap with breast cancer，and to provide references for clinical practice. Methods The databases at home and abroad were searched to obtain the relevant literature，and the perioperative management program of breast reconstruction with inferior epigastric artery perforator flap for breast cancer was preliminarily constructed. 3 rounds of expert inquiries were conducted by Delphi method from October 2022 to January 2023 to determine the final content of the program. 14 patients who received breast reconstruction with deep inferior epigastric perforator flap in a tertiary hospital in Zhejiang Province from January to May in 2023 were selected as application subjects to implement the modified program and evaluate the clinical effect. Results A total of 15 experts completed 3 rounds of consultation. In the third round of consultation，the Kendall’s concordance coefficient of the importance of the first-level indicators was 0.347（P<0.05）；the Kendall’s concordance coefficients of the importance of the second and third-level indicators were 0.388 and 0.200（P<0.001）；the coefficient of variation of each indicator was 0~0.224. The final program included 3 first-level indicators，18 second-level indicators and 67 third-level indicators. The incidence of flap complications in 14 patients decreased by 11.9%. Conclusion The perioperative management program of breast reconstruction with deep inferior epigastric perforator flap for breast cancer is preliminarily applied in clinical practice，which is scientific，reliable and practical，and it can provide references for clinical nursing.

Construction and preliminary application of a skin care program in breast cancer patients with radiodermatitis

LIU Lu, GAN Jiawei, JIANG Tongtong, SHI Tieying

2023, 58(21):  2575-2582.  DOI: 10.3761/j.issn.0254-1769.2023.21.002

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Objective In this research，we constructed a skin care program for radiodermatitis in breast cancer patients and explore its clinical application effect. Methods The skin care program for radiodermatitis of breast cancer patients was constructed by the evidence summary and expert meeting. By the convenient sampling method，the patients admitted from July 2022 to September 2022 were selected as the control group for routine nursing，and the patients admitted from October 2022 to December 2022 were selected as the intervention group. The severity of radiodermatitis and quality of life of patients were compared between the 2 groups. Results The Radiation-Induced Skin Reaction Assesment Scale score of the intervention group was（4.63 ± 2.12） after intervention，which was lower than （9.88 ± 2.35） of the control group. After intervention，ou. Results determined by RTOG showed that 16 patients in the control group had grade Ⅰ dermatitis（66.7%）；8 patients had grade Ⅱ dermatitis（33.3%）；22 patients in the intervention group had grade Ⅰ dermatitis（91.7%），and 2 patients in the intervention group had grade Ⅱ dermatitis（8.33%）. The score of quality of life after intervention was（102.04±18.20） in the intervention group and（78.29±13.18） in the control group. The differences were statistically significant（P<0.001）. Conclusion The skin care program for radiodermatitis can effectively reduce the severity of radiodermatitis of breast cancer patients，and the quality of life of breast cancer patients during radiotherapy can be effectively improved.

Application of a graded management program of hand-foot syndrome in patients with breast cancer who received chemotherapy

CHU Yanxiang, DENG Yan, XIONG Huan

2023, 58(21):  2583-2588.  DOI: 10.3761/j.issn.0254-1769.2023.21.003

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Objective To investigate the application effect of a graded management program of hand-foot syndrome（HFS） in patients with breast cancer who received chemotherapy. Methods Convenience sampling method was adopted to select breast cancer patients who received chemotherapy in the breast surgery department of a tertiary A hospital in Wuhan. According to the time of admission，55 patients admitted from April 2022 to September 2022 were included in the experimental group，in which the graded management program was carried out according to the occurrence of HFS. 55 patients admitted from October 2021 to March 2022 were included in the control group，in which the routine chemotherapy care was carried out. Interventions in both groups lasted until 3 days after the last chemotherapy. The incidence of HFS and its impact on quality of life 3 days after the final chemotherapy were compared between the 2 groups. Results The incidence of HFS was 34.55% in the experimental group and 58.18% in the control group，and there were significant differences in the incidence and grade of HFS between the 2 groups（P<0.05）. The total score of life quality scale in the experimental group was 15.00（13.00，17.00） and 19.00（17.00，22.00） in the control group. The life quality of patients in the experimental group was significantly higher than that in the control group（P<0.001）. Conclusion The graded management program for breast cancer patients with HFS can reduce the incidence and grade of HFS，and can help to improve the quality of life in breast cancer patients who received chemotherapy.

A summary of the best evidence for manual rehabilitation therapy in patients with breast cancer related lymphedema

XING Naifang, WANG Guorong, YANG Jing, ChaoHsing Yeh, ZHANG Tian, TIAN Changying, CHEN Si

2023, 58(21):  2589-2597.  DOI: 10.3761/j.issn.0254-1769.2023.21.004

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Objective To extract and summarize the best evidence of manual rehabilitation therapy in patients with breast cancer related lymphedema. It aims to provide evidence-based basis for clinical nursing staff intervention. Methods According to the “6S evidence resource pyramid model”，we systematically retrieved from UpToDate，BMJ best clinical practice，JBI evidence-based medicine center database of Joanna Briggs Institute in Australia，Embase，Cochrane Library，Pubmed，GIN，New Zealand Guidelines collaboration group，SIGN，American Cancer Society，American Association for Physical Therapy，American Society for Lymphatic，American Lymphedema Website，Ontario Association of Registered Nurses of Canada，Yimaitong，CNKI，VIP，CBM，WanFang，CHINAL，Web of Science and OVID databases from establishment of database to January 2023. It mainly includes guidelines，consensuses，evidence summaries，clinical decision-making，systematic evaluation and primitive research. There were 2 researchers who independently evaluated the quality of the literature and extracted evidence. Results A total of 19 pieces of the literature were involved，including 4 guidelines，4 consensuses，3 system reviews，1 recommended practice，2 clinical decision-making，1 summary of evidence，4 primitive research. Finally，26 pieces of best evidence are summarized from the 5 aspects of indications，contraindications，treatment points，treatment effects and precautions of manual rehabilitation. Conclusion This study summarized the evidence of manual rehabilitation therapy in breast cancer related lymphedema. It can provide practical basis for clinical nursing staff. In clinical practice，it is important to strictly evaluate whether patients have contraindications to treatment，to follow the recommended treatment plan and monitor complications during treatment.

Research progress on ambivalence over emotional expression in patients with breast cancer

CAO Xiaozhen, BAO Yangqiu, LUO Jia, ZENG Lingjuan, CHEN Guo

2023, 58(21):  2598-2603.  DOI: 10.3761/j.issn.0254-1769.2023.21.005

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Reducing the level of emotional expression conflict of patients is of great significance to promote the functional recovery of breast cancer patients，improve their prognosis and improve their quality of life. We introduce the research progress of ambivalence over emotional expression in breast cancer patients in terms of the connotation，measurement tools，influencing factors，and interventio. Methods. There is still a lack of research on measuring the emotional expression conflict of breast cancer patients in China，and it is still necessary to develop a measurement tool with cultural characteristics to obtain the true level of emotional expression conflict of patients. In clinical practice，complementary and alternative medicine，cognitive behavioral intervention，mindfulness training，expressive writing intervention，and other intervention strategies have achieved certai. Results in improving patients’ negative emotions，but personalized intervention strategies still need further exploration.

Specialist Practice and Research

Improvement of high dose blood transfusion procedure and its application in the treatment of patients with traumatic hemorrhagic shock

DING Youya, WANG Yuwei, YAN Danping, WANG Sa

2023, 58(21):  2604-2609.  DOI: 10.3761/j.issn.0254-1769.2023.21.006

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Objective In order to improve the "high-dose blood transfusion procedure"，shorten the preparation time for blood transfusion in patients with clinical traumatic hemorrhagic shock，and improve the outcome of patients. Methods Patients with emergency traumatic hemorrhagic shock from January to December 2021 were selected as the study subjects. Patients who received improved high-dose transfusion procedures from July to December were selected as the experimental group，and patients who received conventional transfusion procedures from January to June were selected as the control group. The timeliness indexes and outcome indexes of the 2 groups were compared. Results The delivery time for blood type and routine examination was shortened from 15 min to 8 min（U=143.50，P=0.024）；transfusion preparation time was shortened from 31 min to 19 min（U=126.50，P=0.026）；the time for decision-making blood preparation was shortened from 44 min to 18 min（U=152.50，P=0.007）；emergency stay time was shortened from 135 min to 114 min（U=91.50，P=0.036）；the outcome distribution of patients（χ²=10.64，P=0.031） was improved. Conclusion The improved high-dose blood transfusion procedure can significantly shorten the blood transfusion preparation time for patients with traumatic hemorrhagic shock and improve the treatment rate of patients.

Monitoring of intra-abdominal pressure：a survey of ICU nurses’ practice and cognition in 31 hospitals in Shandong Province

LIU Beibei, LI Yuanyuan, ZHANG Jicheng, YANG Hongna, CHEN Fengzhi, BAI Xue

2023, 58(21):  2610-2616.  DOI: 10.3761/j.issn.0254-1769.2023.21.007

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Objective To understand the current situation of practice and cognition of ICU nurses on intra-abdominal pressure monitoring in tertiary general hospitals in Shandong Province，and to analyze the factors affecting their cognition，so as to provide references for formulating intra-abdominal pressure monitoring standards and procedures，and carrying out targeted training in the future. Methods A convenience sampling method was used，and a self-designed questionnaire on practice and cognition of intra-abdominal pressure monitoring was used to survey ICU nurses from tertiary general hospitals in 16 prefecture-level cities in Shandong Province from September to November 2022. Results A total of 627 valid questionnaires were collected，involving 31 tertiary general hospitals（24 tertiary A hospitals，77.42%；7 tertiary B hospitals，22.58%）. The operation rate of intra-abdominal pressure monitoring was low（73.37%），and the main reasons were that they had not received intra-abdominal pressure monitoring related training（61.08%），with only 111（24.94%） nurses choosing the intersection of the mid-axillary line and the iliac crest as the reference zero point measurement，274（61.57%） nurses not taking an reading at the end of expiration. The intra-abdominal pressure monitoring cognition score was 0~16（7.88±2.79） points，and only 5 questions had a correct answer rate of ≥50%. Conclusion The standardization of intra-abdominal pressure monitoring practice by ICU nurses in tertiary general hospitals in Shandong Province needs to be strengthened，and their cognition needs further training. It is suggested to unify and implement the standards and procedures of intra-abdominal pressure monitoring，further accelerate the training of intra-abdominal pressure monitoring technology，and improve the standard execution rate and cognitive level of ICU nurses on intra-abdominal pressure monitoring.

Investigation and analysis of nursing prevention and control of ventilator-associated pneumonia in ICUs of 194 tertiary hospitals

SHAO Xin, WANG Xia, LIU Chenxia, LIU Juyuan, CAI Meng, BU Na, KUANG Lu

2023, 58(21):  2617-2623.  DOI: 10.3761/j.issn.0254-1769.2023.21.008

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Objective To investigate the nursing clinical practice of ICU ventilator-associated pneumonia （VAP） prevention and control of tertiary hospitals in China，and analyze relevant countermeasures. Methods A self-designed questionnaire consisted of 3 parts and 26 items. A questionnaire survey was conducted among nurses in 380 ICUs in 194 tertiary hospitals in 26 provinces from September 1 to 15，2021，using the convenient sampling method. Results A total of 380 valid questionnaires were collected，with an effective rate of 100%. In the system process，369（97.11%） ICUs had files to prevent VAP；291（76.58%） ICUs had a checklist of measures to prevent VAP clustering；274（72.11%） ICUs had continuous improvement projects about VAP in the last 3 years. In the aspect of body position management，semi-decubitus position was the first choice for the patients with invasive mechanical ventilation of 338（88.95%） ICUs. For nursing operation，224（58.95%） ICUs used Subglottic suction，and 128（33.68%） among them used air shock to remove the retention on the balloon；normal saline is still routinely injected before sputum aspiration in 72（18.95%） ICUs. In terms of balloon pressure monitoring，253（66.58%） ICUs did the oral care 3-4 times a day. In the balloon pressure monitoring，313（82.37%） ICUs use airbag pressure gauges to intermittently monitor airbag pressure；293（77.11%） ICUs replaced the ventilator pipeline once a week.There are significant differences in the current practice status of different types of ICUs in terms of compliance strategies for bed head lifting, subglottic secretion drainage, airbag pressure monitoring, and oral care（P<0.05）. Conclusion At present，the relevant systems and procedures to prevent VAP have been improved，but the specific prevention and control measures need to be further unified. Therefore，it is suggested to analyze the weak links of VAP nursing prevention and control practice in various medical structures，carry out relevant training and quality control for the weak links，and further improve the working mechanism of continuous quality improvement，thus effectively reduce the incidence of VAP.

Qualitative research on the barriers of surrogate decision-makers participating in advanced care planning of patients with advanced cancer

HAN Zhihao, FANG Yong, CAI Yanji, LIU Yongsi, MA Xiaoqin

2023, 58(21):  2624-2629.  DOI: 10.3761/j.issn.0254-1769.2023.21.009

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Objective To understand the barriers of surrogate decision-makers participating in the advanced care planning（ACP） for patients with advanced cancer，and to provide references for the construction and intervention of educational programs. Methods Under the guidance of ternary reciprocal determinism，qualitative research method was used to conduct semi-structured interviews with 12 surrogate decision makers of advanced cancer patients in 2 tertiary hospitals of Zhejiang Province，and the data was analyzed using targeted content analysis. Results Based on the theory，the influencing factors of participating in ACP of the surrogate decision-makers of patients with advanced cancer were summarized into 3 themes：individual level-dual restriction of subjective thought and objective ability（value restriction，cognitive understanding deviation，economic condition restriction，patient’s situation control），environment level-synergistic influence of medical environment and social environment（limited medical conditions，pressure from public moral opinion，insufficient policy guarantee，lack of family consensus），behavior level - interaction of external guidance and internal feedback（lack of guidance of medical staff，experience support of medical decision-making）. Conclusion Surrogate decision-makers of patients with advanced cancer face many pressures before participating in the ACP. Under the guidance of the theory of knowledge，belief and practice，medical staff can give them pre-established medical care knowledge to correct their cognitive bias. Medical staff can guide the realization of “family-centered” decision-making mode to strengthen the family support of surrogate decision-makers. Medical staff also can lead the establishment of a surrogate decision-makers support group to share decision-making experience and provide medical decision-making assistance.

Nursing Management

The mediating effect of nurse professional identity between practice environment and safety behavior

XIE Dan, CHEN Jie, WEI Yongting, ZHENG Yining

2023, 58(21):  2630-2636.  DOI: 10.3761/j.issn.0254-1769.2023.21.010

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Objective To explore the mediating effect of nurse professional identity between the practice environment and safety behavior，in order to provide references and bases for managers to formulate scientific，reasonable and standardized interventions for nurse safety behavior. Methods A total of 1381 nurses from 5 tertiary general hospitals in Beijing were adopted for investigation from May to June 2022 by convenience sampling method. They were investigated with general information questionnaire，Nurse Safety Behavior Questionnaire，Nursing Practice Environment Assessment Scale and Nurse Professional Identity Assessment Scale. The structural equation model was used to analyze the mediating effect of nurse professional identity between practice environment and safety behavior. Results Finally，1303 nurses participated in the survey.The total scores of nurse safety behavior scale，nursing practice environment assessment scale and nurse professional identity scale were 59.0（56.0，60.0） points，3 441.0（3 066.0，3 586.0） points，131.0（115.0，150.0） points，which were all above the medium level. Nurse safety behavior was significantly positively correlated with nurse professional identity and the nurse practicing environment assessment（r=0.516，0.421，P<0.01），and was significantly positively correlated with the scores of all dimensions（P<0.01）. The practice environment and professional identity can directly and positively affect the level of nurse safety behavior. The mediating test shows that nurse professional identity plays a partial mediating effect between the practice environment and safety behavior，and the mediating effect is 0.184，accounting for 46.11% of the total effect. Conclusion In this study，nurse professional identity is a mediator between the practice environment and safety behavior. Nursing managers should pay attention to the cultivation of nurses’ professional identity and optimize the working environment of clinical nurses，so as to improve nurse safety behavior and ensure the safety of patients.

Norm construction of Sub-Health Measurement Scale for nurses in Shandong Province

LÜ Xiaoyan, CAO Yingjuan, SANG Shaowei, LI Rong, LI Li, XUE Fuzhong, DU Jing

2023, 58(21):  2637-2644.  DOI: 10.3761/j.issn.0254-1769.2023.21.011

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Objective To establish the norm of Sub-Health Measurement Scale for nurses in Shandong Province，so as to provide a basis for understanding the current situation of sub-health and provide a reference for promoting the health of nurses. Methods From December 2020 to February 2023，14，308 nurses from 23 public tertiary hospitals enrolled in the Nurse Health Cohort Study in Shandong Province were selected as participants by convenience sampling. The sub-health status was assessed by the Sub-Health Measurement Scale，and the sub-health norm of nurses was constructed by establishing the mean，percentile and demarcation norm. Results A total of 10669 nurses were included in the analysis. The total score of Sub-Health Measurement Scale of nurses in Shandong Province was（61.13±12.40），and the scores of physiological sub-health sub-scale，psychological sub-health sub-scale and social sub-health sub-scale were（58.35±11.86），（62.56±15.85） and（63.56±16.73），respectively. The mean norm of sub-health assessment scale was established by gender and age. Based on th. Results of univariate analysis，we selected the characteristics with differences，namely gender，age，marital status，working department，years of working，professional title and employment type to establish a classification norm. P₅，P₂₅，P₅₀，P₇₅ and P₉₅ were select to establish percentile norm. Taking（$\bar{x}$-s），（$\bar{x}$-0.5s），（$\bar{x}$+0.5s），（$\bar{x}$+s）as the cut-off points，the demarcation norm of the Sub-Health Measurement Scale and sub-scales was established，which was divided into 5 categories，including disease，severe sub-health，moderate sub-health，mild sub-health and healthy states. Conclusion This study established the Sub-Health Measurement Scale norm of nurses，which provided a basis for effectively evaluating and identifying the sub-health status of nurses.

Case study

A nursing case report of a patient undergoing laryngeal transplantation

PANG Fang, ZHOU Chuanru, LIU Huan, ZHANG Yaodan, DU Aiping

2023, 58(21):  2645-2649.  DOI: 10.3761/j.issn.0254-1769.2023.21.012

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To summarize the nursing experience of a patient undergoing laryngeal transplantation due to laryngeal cancer. The case involved the development of a critical care management plan by a multidisciplinary team. By implementing nursing measures such as refined airway care，professional neck wound complication management，precise administration of immunosuppressants，ultrasound monitoring for nutritional management assurance，individualized psychological care，early rehabilitation of swallowing，speech and body function，thyroid function and hyperglycemia monitoring and other measures，the patient stayed in ICU for 23 days post-surgery and discharged after 40 days from admission.

Emergency care for a patient with extra and severe burn with inhalation injury when establishing advanced airway

YAN Danping, WANG Yuwei, WANG Sa

2023, 58(21):  2650-2652.  DOI: 10.3761/j.issn.0254-1769.2023.21.013

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To summarize the emergency nursing experience of a patient with extremely severe burns and inhalation injury who developed laryngospasm when establishing an artificial airway. Nursing points include：identification and treatment of complications during artificial airway establishment for high-risk airway patients，and elimination of the risk factors of airway spasm in patients. Conduction of early sedation and awakening，the use of simple communicatio. Methods，and the conduction of off-line respiratory assessment and training. The use of active warming measures，and paying attention to fluid resuscitation and body temperature management of burn patients. Trauma team manages the whole process to shorten the emergency stay time of extremely severe burn patients. After 44 days of active treatment and meticulous nursing care，the patient was successfully treated and discharged from the hospital.

Evidence Synthesis Research

Evidence summary for targeted temperature management in brain injury patients with ICU

GAI Tiantian, LI Zimeng, CUI Yu, HOU Ruonan, XU Ludan, HE Yin

2023, 58(21):  2653-2661.  DOI: 10.3761/j.issn.0254-1769.2023.21.014

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Objective To evaluate and summarize the evidence related to targeted temperature management in brain injury patients with ICU for health care workers and decision makers. Methods We systematically searched from the guideline websites，domestic and foreign databases and association official websites to collect the literature including guidelines，expert consensuses，clinic decision-making，evidence summaries and systematic reviews，according to the 6s evidence model. The search time limit was from January 2012 to April，2023. Evidence was extracted after the quality evaluation of the literature was conducted by evidence-based researchers. Results A total of 19 articles were incorporated，including 6 guidelines，3 clinic decision-making，5 expert consensuses，4 systematic reviews and 1 evidence summary. Finally，25 pieces of best evidence were formed from 10 aspects，temperature range，starting time，body temperature monitoring，pipeline management，analgesia and sedation management，mechanical ventilation and oxygenation management，hemodynamic support，nutrition management，condition monitoring and prognosis evaluation. Conclusion The best evidence for management of targeted temperature in brain injury patients with ICU in this study is scientific and comprehensive，providing the evidence-based basis for medical staff to standardized management of targeted temperature in critically ill patients in clinical practice.

Best evidence summary for prevention and management of lifestyle-related dry eye

YANG Juan, LI Muling, ZHU Peiyan, LI Chunmei, HUANG Qinghui, XIE Ling, ZHOU Hongzhen

2023, 58(21):  2662-2669.  DOI: 10.3761/j.issn.0254-1769.2023.21.015

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Objective To retrieve，evaluate and integrate evidence related to prevention and management of lifestyle-related dry eye patients. Methods The clinical decisions，recommended practices，evidence summaries，technical reports，guidelines，expert consensuses and systematic evaluations on the prevention and management of lifestyle-related dry eye patients in domestic and foreign databases were retrieved by the 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 databases to September 2022. Results According to the inclusion criteria，13 pieces of the literature were screened，including 1 guideline，5 systematic reviews，3 expert consensuses，2 technical reports and 2 evidence summaries. Through literature reading，evidence extraction and classification，a total of 25 pieces of evidence were summarized，including assessment，symptom identification，identification of risk factors，artificial tear management，eye care，diet management，health guidance，follow-up education. Conclusion This study summarized the best evidence of prevention and management of lifestyle-related dry eye patients，so as to provide references for nurses to carry out clinical practice. In the process of evidence transformation，the actual situation should be combined to improve the quality of nursing.

A systematic review of health literacy assessment tools for diabetic patients based on COSMIN guidelines

LIU Suxiang, BIAN Li, ZHANG Yequn, QI Miaomiao

2023, 58(21):  2670-2676.  DOI: 10.3761/j.issn.0254-1769.2023.21.016

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Objective To evaluate the methodological quality and measurement characteristics of health literacy assessment tools for diabetic patients and to provide references for medical staff to select the best assessment tools. Methods The PubMed，Embase，CINAHL，Web of Science，CNKI，VIP database，Wanfang Data，and Chinese Biomedical Database were searched from inception to December 31，2022. Data were screened and extracted independently by 2 researchers. The consensus-based standards for the selection of health measurement instruments （COSMIN） system evaluation guidelines were spontaneously used to evaluate the included assessment tools. Finally，recommendations were made. Results A total of 15 studies were included，involving 12 health literacy assessment tools for diabetic patients. Among them，KHLS-DM and DNT-15 have satisfactory content validity and internal consistency and are recommended as Grade A. HLSQ-3 has high-quality evidence to suggest that its internal consistency is "inadequate" and recommended as Grade C，while the other 9 scales are recommended as Grade B for content validity or internal consistency of uncertain/inadequate evidence at or above the intermediate level. Conclusion KHLS-DM can evaluate written literacy，numeracy，and critical literacy of patients，and each measurement characteristic has been comprehensively evaluated with high reliability and validity，so it is recommended to be applied first. DNT-15 focuses on evaluating the numeracy of patients，which can be used in combination with other scales to evaluate health literacy of patients more comprehensively.

Review

Research progress of Episodic Future Thinking in health behavior decision-making of chronic disease patients

RU Yifan, DING Shanni, GAO Yang, WANG Meijuan, XU Yihong, HONG Sisi, PAN Hongying

2023, 58(21):  2677-2682.  DOI: 10.3761/j.issn.0254-1769.2023.21.017

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Health behavior decision-making often involves the balance of gains and losses at different time points，which affects the choice and maintenance of health behaviors. As a cognitive processing method of “pre-experiencing” future events，Episodic Future Thinking（EFT） can promote the formation of health intentions and health behavior change by increasing the value of future health outcomes. This paper reviews the concept，intervention model and action effect of EFT in health behaviors，in order to provide references for nurses to innovate health education and behavior management from the perspective of behavioral economics.

Recent developments of acute alcohol impairment assessment tools

GUO Yunfei, DU Lixia, ZHANG Qi, QIU Hui, ZANG Shuting, REN Ying

2023, 58(21):  2683-2688.  DOI: 10.3761/j.issn.0254-1769.2023.21.018

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The evaluation of acute alcohol impairment is an important basis for evaluating the physiological and psychological status of patients and judging their treatment and nursing measures. There is a large number of research on acute alcohol impairment by foreign researchers，but there are few relevant research reports in China. This article reviews the origin，development and the evaluation tools of acute alcohol impairment in the context of emergency treatment，and summarizing its advantages and disadvantages by comparing the content，evaluatio. Methods，applicable population，reliability and validity of each evaluation tool，in order to provide scientific references for the evaluation，treatment and nursing care of acute alcohol impairment for emergency departments in China.