Table of Content

20 January 2024, Volume 59 Issue 2

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Research Paper

Intervention study of lung cancer patients undergoing postoperative chemotherapy based on sentinel symptoms

MA Jingshuang, WANG Aiping, WANG Yanjie, LI Wei, LIU Yanxia

2024, 59(2):  133-141.  DOI: 10.3761/j.issn.0254-1769.2024.02.001

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Objective Based on sentinel symptoms，a nursing intervention program for gastrointestinal symptom group of postoperative chemotherapy for lung cancer was constructed and its application effect was evaluated. Methods The nursing intervention program of gastrointestinal symptom group was constructed on the basis of reference guidelines，qualitative interview and expert consultation. From January 2021 to January 2022，a total of 330 patients with postoperative chemotherapy for lung cancer in a tertiary hospital in Shenyang were selected as research subjects. The experimental group received the gastrointestinal symptoms group nursing intervention program on the basis of routine nursing，and the control group received routine care. Patients were investigated with the M.D. Anderson Symptom Inventory and the MOS 36-Item Short-Form Health Survey before 1st chemotherapy（T1），3rd chemotherapy（T2） and 5th chemotherapy（T3）. Results After the intervention，the total scores of the 2 groups and the total scores of each symptom in T2 and T3 were statistically significant（P<0.05），and the score of the experimental group was lower than that of the control group. For the scores of 6 dimensions of physiological function，physical pain，overall health，vitality，emotional function，mental health in 2 groups between different time points，the differences are statistically significant（P<0.05）. Conclusion The nursing intervention program of the gastrointestinal symptom group based on sentinel symptoms is beneficial to reduce the severity of the gastrointestinal symptom group and improve the quality of life for postoperative chemotherapy for lung cancer patients.

The effect of a mobile health intervention model based on self-determination theory on subthreshold depression in breast cancer patients

WU Guofeng, LI Xinrui, ZHONG Meirong, YANG Lin, CHENG Shujin, CHEN Yan, ZHONG Jingjing, SUN Rui

2024, 59(2):  142-148.  DOI: 10.3761/j.issn.0254-1769.2024.02.002

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Objective To explore the effect of a mobile health intervention model based on self-determination theory on subthreshold depression in breast cancer patients. Methods By convenience sampling method，74 patients with breast cancer subthreshold depression who received chemotherapy in the breast department of a tertiary hospital in Guangxi from July 2021 to August 2022 were selected as the research subjects. According to the order of admission time，the patients admitted from February 2022 to August 2022 were taken as an experimental group，and the patients admitted from July 2021 to January 2022 were taken as a control group，with 37 cases in each group. On the basis of routine nursing，the experimental group implemented a mobile health intervention model based on self-determination theory. The control group received routine nursing，with every 21 days for 1 cycle and a total of 4 cycles of intervention. Before and after the intervention，the Centre for Epidemiological Studies Depression Scale（CES-D），Hamilton Rating Scale for Depression（HAMD-17），Basic Psychological Needs Satisfaction Scale（BPNS） and Functional Assessment of Cancer Therapy-Breast（FACT-B） were used to evaluate the intervention effect. Results 34 patients in the experimental group and 36 patients in the control group completed the study. After intervention，the CES-D score and HAMD-17 score of the 2 groups were lower than those before intervention（P<0.05）；the CES-D score and HAMD-17 score of the experimental group were lower than those of the control group，and the difference was statistically significant（t=7.748，P<0.001；t=8.150，P<0.001）. The BPNS scores of the 2 groups were higher than those before the intervention，and the BPNS score of the experimental group was significantly higher than that of the control group（t=-6.534，P<0.001）. The scores of FACT-B in the 2 groups were higher than those before the intervention，and the scores of FACT-B in the experimental group were significantly higher than those in the control group（t=-4.579，P<0.001）. Conclusion The mobile health intervention model based on self-determination theory can improve the subthreshold depression，self-determination and quality of life of breast cancer patients.

Special Planning—Dialysis Care

Construction of a retraining model for peritoneal dialysis patients based on ADDIE model

HE Peipei, CHEN Li, SUN Miaojuan, HU Lijun, YIN Xiaohong

2024, 59(2):  149-155.  DOI: 10.3761/j.issn.0254-1769.2024.02.003

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Objective To improve the survival rate and life quality of peritoneal dialysis（PD） patients，we established a retraining model based on ADDIE model，including optimizing the content，form and frequency. Methods From January 1，2022 to May 3，2023，based on the 5 stages of ADDIE model，we investigated the needs of patients，invited 55 experts in the peritoneal dialysis field to design the final draft of the retraining model through 2 rounds of Delphi expert consultations，and 23 peritoneal dialysis patients were preexperimented to evaluate and revise the retraining model. Results The questionnaire recovery rates of the 2 rounds of expert consultation were 100% and 96.36%，respectively. The coordination coefficients of the first-level catalog were 0.379 and 0.384，and the coordination coefficients of the second-level catalog were 0.446 and 0.427，respectively. The Chi-square test showed that P<0.05，indicating statistical significance. The content of the retraining model included 4 sections，33 subdirectories and 9 training forms，which were combined online and offline. The training frequency was different due to the different contents，and the single content of a single training form was mainly 15 min. Conclusion The PD patient retraining model constructed in this study is scientific，reliable and innovative. Its content is easy to understand and diverse in forms. The training duration and frequency are in line with the memory rule，and the evaluation takes into account both process and result.

Analysis of influencing factors and pathway of self-regulatory fatigue in maintenance hemodialysis patients

ZENG Haojie, ZHAO Li, ZHANG Chen, FAN Yixi, LUO Wenyu, ZHOU Jinfeng

2024, 59(2):  156-163.  DOI: 10.3761/j.issn.0254-1769.2024.02.004

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Objective Based on the process theory of stress effect，the structural equation model of the influencing factors of self-regulatory fatigue in maintenance hemodialysis patients is constructed，which provides theoretical bases and references for the formulation of intervention programs to relieve self-regulatory fatigue in patients. Method A total of 420 maintenance hemodialysis patients were surveyed using General Information Questionnaire，Self-Regulatory Fatigue Scale，Dialysis Symptom Index，Life Orientation Test-Revised，Perceived Social Support Scale，Brief Illness Perception Questionnaire and Medical Coping Styles Questionnaire. Results Total score of self-regulatory fatigue in maintenance hemodialysis patients was（49.52±10.93），and self-regulatory fatigue showed significant positive correlation with symptom distress，the illness perception，avoidance coping style，yieldly coping（r=0.476，0.428，0.303，0.611，all P<0.01）；self-regulatory fatigue showed significant negative correlation with perceived social support and dispositional optimism（r=-0.410，-0.652，all P<0.01）；it showed no significant correlation with facing coping（r=-0.032，P>0.05）. The Bootstrap analysis revealed that the mediation effect of yielding coping，dispositional optimism，perceived social support，and illness perception between symptom distress and self-regulatory fatigue was significant（95%CI：0.027~0.203）. The overall effect of symptom distress on self-regulatory fatigue was （P<0.001，95%CI：0.576~0.751）；the direct effect was（P<0.001，95%CI：0.170~0.357）；the indirect effect was（P<0.001，95%CI：0.332~0.485）；the mediation effect accounted for 61.1% of the total effect value. Conclusion Maintenance hemodialysis patients have a high degree of self-regulatory fatigue，which needs to be further improved. Medical staff should timely identify and evaluate the symptom distress of patients，focus on guiding patients to adjust optimistic disease，provide patients with psychological guidance and stress coping strategies，reduce the negative coping behavior tendency，guide the patients correctly perceive support and care in social relations，help patients set up the correct disease cognition，thus reducing the patient’s self-regulatory fatigue.

Benefit finding experience in maintenance hemodialysis patients：a qualitative research

GONG Yanlin, GAO Xinyue, CHEN Jing, LIU Lingling, WU Jing, LI Yongqi, CHU Jing

2024, 59(2):  164-169.  DOI: 10.3761/j.issn.0254-1769.2024.02.005

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Objective To illuminate the benefit finding experience of maintenance hemodialysis patients，and to provide a reference for promoting their mental health. Methods From March to May 2023，the purposive sampling was used to select 13 maintenance hemodialysis patients in a tertiary hospital in Shanghai for semi-structured interviews. The data were organized with the help of Nvivo software，and the Colaizzi’s seven-step method was used to analyze the data. Results 3 themes were extracted：①the search of meaning，including approved hemodialysis，the desire to live；②gaining a sense of mastery，including adjusting self-psychology，developing healthy living habits，and learning hemodialysis related behavior management；③self-enhancement，including excavating external resources and affirming self-worth. Conclusion Maintenance hemodialysis patients have benefit finding experience in many aspects. Medical staff can guide patients to carry out positive psychological construction by strengthening disease knowledge education，building a psychological mutual assistance platform，forming a multidisciplinary nursing team，excavate and provide effective social support resources，and cultivate patients’ self-health management，so as to improve the level and ability of benefit finding of patients，experience positive incentives，promote physical and mental health，and improve the quality of life of hemodialysis patients.

Nursing care of a case of intimal hyperplasia at buttonhole puncture site of arteriovenous fistula

LI Mingyan, LU Yao, ZHANG Meibin, LI Siyi

2024, 59(2):  170-173.  DOI: 10.3761/j.issn.0254-1769.2024.02.006

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The nursing experience of intimal hyperplasia at buttonhole puncture site in a patient with autogenous arteriovenous fistula was reported. The key points of nursing：to formulate a scientific and reasonable internal fistula puncture plan，to establish and maintain the buttonhole tunnel，to regularly monitor the use of arteriovenous fistula，to replace the traditional internal fistula steel needle（hereinafter referred to as the steel needle） with the hemodialysis trocar needle （hereinafter referred to as the trocar needle） for buttonhole puncture，to treat with far infrared ray during each dialysis，and to guide the patient to apply hirudoid cream on the arm of the fistula side. After careful nursing，the intimal hyperplasia at the buttonhole puncture site disappeared，and there was no recurrence after 6 months of follow-up.

Systematic review of risk prediction models for intradialytic hypotension in patients with maintenance hemodialysis

ZHU Dongge, WANG Juzi, ZHAO Qian, HE Yapeng, ZHANG Zhuanzhuan, YANG Yutong

2024, 59(2):  174-183.  DOI: 10.3761/j.issn.0254-1769.2024.02.007

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Objective To systematically review the risk prediction models for intradialytic hypotension in maintenance hemodialysis patients，with a view to provide references for clinical practice. Methods PubMed，Embase，Web of Science，Cochrane Library，CINAHL，CNKI，VIP，Wanfang and CBM were searched from inception to May 29，2023. 2 reviewers independently screened the literature，extracted information and assessed methodological quality using the Prediction Model Risk of Bias Assessment Tool. Results A total of 20 studies and 25 models were included with the sample size of 68~9 292 cases and the incidence of outcome events of 2.1~51%. Baseline systolic blood pressure，age，ultrafiltration rate，diabetes and dialysis duration were the top 5 predictors of repeated reporting of the models. 20 models reported the area under the curve of ranging from 0.649 to 0.969，and 5 models reported calibration metrics. There were 9 internal validations and 4 combined internal and external validation models. The overall applicability of the 20 studies was good，but all had a high risk of bias，mainly in data analysis. Conclusion Research on risk prediction models for intradialytic hypotension in maintenance hemodialysis patients is still in the developmental stage. Future studies should improve the research design and reporting process，and validation studies of existing models should be carried out to further evaluate the effectiveness and feasibility in clinical practice.

Specialist Practice and Research

Construction and application of prenatal health education curriculum based on virtual simulation technology

YU Xiaojing, XU Xuefen, XU Lili, TIAN Yanping, FAN Danfeng, FENG Suwen

2024, 59(2):  184-190.  DOI: 10.3761/j.issn.0254-1769.2024.02.008

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Objective To construct，implement and evaluate the effectiveness of the virtual simulation technology-based prenatal health education course. Methods The curriculum included 4 parts：“warm delivery room and easy delivery”，“medicated analgesic delivery”，“non-medicated analgesic delivery” and “early maternal and infant health care”. From May to September 2022，100 primiparas in an obstetrics and gynecology hospital in Zhejiang Province were investigated by convenient sampling method. Random number table method was used to divide the participants into an experimental group and a control group，with 50 participants per group. The control group received conventional health education，while the experimental group received an augmented virtual reality technology-based prenatal health education course during the late stages of pregnancy on this basis. We conducted a post-intervention comparative analysis of antenatal anxiety levels，fear of childbirth，and birth outcomes between the 2 groups. Furthermore，a post-intervention satisfaction survey was administered to the experimental group. Results After intervention，the antenatal anxiety of the experimental group was lower than that of the control group（χ²=4.943，P=0.026），and the decrease in fear of childbirth scores was higher than that of the control group（t=3.200，P=0.002）. The experimental group was highly satisfied with all of the 4 dimensions of the course，and the overall evaluation was（31.8±3.23） points. However，there were no significant differences in vaginal delivery rate，postpartum bleeding volume，postpartum hemorrhage incidence，perineal injury degree and duration of each labor stage between the 2 groups（P>0.05）. Conclusion The virtual reality technology-based prenatal health education course was effective in improving the antenatal anxiety and fear of childbirth of primipara，and the use satisfaction is high.

General well-being and its influencing factors in peer educators of breast cancer

WANG Yue, LIU Fei, ZHU Dan, WANG Yingxin, GU Hongtao, WAN Qiaoqin

2024, 59(2):  191-196.  DOI: 10.3761/j.issn.0254-1769.2024.02.009

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Objective To investigate the general well-being of breast cancer peer educators and to analyze its influencing factors. Methods Convenience sampling method was used to select 210 breast cancer peer educators from 8 tertiary hospitals in China from January to February 2023. General information questionnaires，General Well-Being Scale，Cornor-Davidson Resilience Scale，and Social Support Rating Scale were used for investigation. Multiple linear regression analysis was used to explore the influencing factors of the general well-being in peer educators of breast cancer. Results A total of 206 breast cancer peer educators were investigated. The general well-being score was（86.70±14.08）. The results of multiple linear regression analysis showed that psychological resilience，the utilization of social support and the current self-funded treatment of less than 1，000 yuan per month were the influencing factors of general well-being（P<0.001）. Conclusion The general well-being of breast cancer peer educators is at a high level. Improving the social support system for breast cancer patients，selecting peer educators with strong psychological resilience，high utilization of social support and low self-funded treatment，and paying attention to the psychologic status of peer educators，providing timely and positive psychological interventions will help to raise the general well-being of breast cancer peer educators and ensure the quality and continuity of peer education.

Community Care

A qualitative study on the work experience of nurses in community family medical team

LIU Xuebing, XU Yahong, YAN Yuran

2024, 59(2):  197-202.  DOI: 10.3761/j.issn.0254-1769.2024.02.010

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Objective To understand the feelings and experiences of nurses in family medical team in the process of implementing contracted services，in order to provide a reference for effectively exerting the function of nursing in contracted services，and promoting and optimizing the contracted services in China. Methods Using phenomenological research methods，14 team nurses from 3 community health service centers in Beijing were interviewed with semi-structured interviews. The content analysis method was used to analyze the data. Results 3 themes were extracted in the nurses’ experiences and feelings during the implementation of the contracted services，personal growth and benefit，and the need to optimize the work. 3 sub-themes were extracted in work experiences and feelings，namely sense of optimization of nursing philosophy，sense of changing focus of nursing，improvement of nurse and patient bond. 4 sub-themes were extracted in personal growth and benefits，namely increasing job responsibility and accomplishment，forming a sense of teamwork，greater understanding and respecting for patients. 5 sub-themes were extracted in the optimization of contracted service needs，namely clarifying the position of team nurses，improving the bidirectional referrals，improving the contracted team management and assessment mechanisms，strengthening the support of the policy on home care，and providing opportunities for continuing education and training. Conclusion In practicing contracted services，team nurses have gained recognition of their profession and continuous self-growth. The government should continue to improve the support of contracting-related policies to meet the needs of team nurses’ career development，optimize contracted services，and attract more nurses into the practice of contracted services.

Self-neglect in elderly diabetic patients in the community：an interpretive phenomenological study

LUO Yaping, YU Shujuan, ZHU Miaomiao, PAN Hongying

2024, 59(2):  203-209.  DOI: 10.3761/j.issn.0254-1769.2024.02.011

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Objective To explore the experience and causes of self-neglect of elderly diabetic patients in community，so as to provide references for community nursing workers to identify and intervene the self-neglect behavior of elderly diabetic patients. Methods An interpretative phenomenological method was used to collect data from elderly diabetic patients registered in 3 community health service centers in Hangzhou，Zhejiang Province through semi-structured interviews. Van Manen’s method was used to analyze qualitative data. Results The experience and reasons of self-neglect of elderly diabetic patients in community were summarized into 4 themes and 10 sub-themes，including neglecting personal health（low sense of self-worth，high level of self-esteem，being afraid of compromising the family），neglecting blood glucose management（weak health awareness，difficulty in blood glucose management），inadequate self-care capacity（poor financial situation，insufficient personal time，diminished mobility） and inadequate perceived support（low social support，insufficient emotional support）. Conclusion The experience and reasons of self-neglect of elderly diabetic patients in community are diversified. Community health services and nursing workers should pay attention to the performance of self-neglect behavior of elderly diabetic patients and actively explore effective prevention and intervention measures.

Case Study

Nursing care of an infant with severe bronchopulmonary dysplasia during the transition period from hospitalization to family

QIAN Liqing, LU Xiaoyan, LI Liling, JIANG Siyuan, HU Xiaojing

2024, 59(2):  210-213.  DOI: 10.3761/j.issn.0254-1769.2024.02.012

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To summarize the nursing care of a very low birth weight premature infant with severe type Ⅱ bronchopulmonary dysplasia（BPD） during the transition period from hospitalization to home. The care of the infant was provided one-on-one by a BPD specialist nurse throughout the period. The key points of transitional care from hospitalization to home include：implementing tracheotomy and mechanical ventilation care to ensure stable blood oxygen saturation of the infant；providing nutritional support to improve the nutritional status of the infant；implementing step-by-step rehabilitation measures to improve the neuromotor development of the infant；implementing family integrated care to promote the primary caregivers of the infant to master nursing knowledge and skills；conducting personalized discharge follow-up with a multidisciplinary team to improve the quality of home care for this infant. After being hospitalized for 106 days，the infant was successfully discharged with a tracheotomy tube. At the age of 2 years and 6 months，a tracheotomy closure surgery was performed. After the surgery，the infant was able to breathe autonomously without symptoms of breathing difficulties and returned to normal family life.

5 patients with severe ARDS complicated with hypercapnia received in vitro carbon dioxide removal therapy

PAN Chenwei, WANG Wenchun, CHEN Guanjie, LI Xiaoqing

2024, 59(2):  214-218.  DOI: 10.3761/j.issn.0254-1769.2024.02.013

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To summarize the nursing experience of 5 patients with severe ARDS complicated with hypercapnia who underwent extracorporeal carbon dioxide removal（ECCO₂R）. Key points of nursing care included：establishing a rapid emergency response nursing team for ECCO₂R；PETCO₂ real-time monitoring to grasp the timing of the machine；ensuring continuity of treatment and improving the removal efficiency；respiratory-related monitoring；prevention of complications of blood coagulation and hypothermia；and weaning from extracorporeal carbon dioxide removal. After careful treatment and care，all the 5 patients were successfully removed from ECCO₂R treatment.

Evidence Synthesis Research

Experience of medical transition from adolescents with congenital heart disease to adults：a meta-synthesis of qualitative research

YU Wanhui, CUI Zhaomei, CHI Jiajing, JIN Ziheng, GOU Xiaoyu, LI Mengjie, LU Nan, YANG Lijuan

2024, 59(2):  219-227.  DOI: 10.3761/j.issn.0254-1769.2024.02.014

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Objective To systematically evaluate qualitative studies on the experience of transition from adolescent to adult medical care for patients with congenital heart disease（CHD），and to provide a reference for exploring CHD transition management options and developing intervention strategies. Methods A computerized search of PubMed，Embase，Web of Science，Cochrane Library，EBSCO，CINAHL，China Knowledge Network，Wanfang database，Vipshop database，and China Biomedical Literature Database for qualitative studies on the transition experience of CHD patients from adolescence to adult medical care was conducted for the period from the establishment of the database to April 2023. The quality of the literature was evaluated using the Joanna Briggs Institute（JBI） Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research（2016），and the results were integrated using meta-integration methods. Results A total of 9 studies were included，and 49 research results were extracted，and 11 categories were summarized. The final synthesis included 4 integrated results：①Complex attitudes towards healthcare transition，with both attachment and expectation：attachment to paediatric healthcare providers，expectation of transition to adult healthcare providers. ②Facing multiple healthcare transition challenges：lack of adequate preparation for healthcare transition，parents withdrawing from the role of disease manager，large differences in services between paediatric and adult healthcare providers. ③Expect to receive multiple supports：expect to receive comprehensive health education from healthcare personnel，expect healthcare institutions to set up healthcare transition counselling clinics and achieve handover of illness，expect to receive companionship and support from parents，expect to receive understanding and help from peers. ④Per-ceived benefits of medical transition：increased ability to manage illness，role change and personal growth. Conclusion Adolescents with CHD have a complex experience of transitioning to adult healthcare，and healthcare professionals should be attentive to their feelings，encourage them to deal with challenges positively，and provide adequate information and joint parental and peer support to facilitate a smooth transition to adult healthcare for adolescents.

Effects of different non-pharmacological interventions on postpartum depression in pregnant women：a network Meta-analysis

JI Moufang, LI Ruobing, HU Tingjin, CHEN Jingyi

2024, 59(2):  228-235.  DOI: 10.3761/j.issn.0254-1769.2024.02.015

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Objective To evaluate the effects of different non-pharmacological interventions on postpartum depression，and to provide the evidence for the formulation of relevant intervention programs. Methods Databases，including China National Knowledge Infrastructure（CNKI），China Biomedical Literature Database，Wanfang Database，VIP database，PubMed，EMBase，the Cochrane Library，were systematically searched for randomized controlled trials （RCT） on the effects of non-pharmacological interventions on postpartum depression. The search time limit was from the establishment of the database to July 2022. Network meta-analysis was performed using Stata17.0 and Review Manager 5.3 software. Results A total of 43 studies were included，including 14 non-pharmaceutical interventions，involving 4451 parturients. The results of network meta-analysis showed that compared with the usual care group，exercise therapy[SMD=-5.41，95%CI（-6.94，-3.89），P<0.001]，cognitive behavioral therapy[SMD=-4.72， 95%CI（-6.13，-3.31），P<0.001]，acupuncture and moxibustion[SMD=-4.52，95%CI（-8.01，-1.03），P<0.001] and the comprehensive psychotherapy[SMD=-4.64，95%CI（-8.53，-0.75），P<0.001] had better improvement effects on postpartum depression. The results of the area under the cumulative rank probability map showed that exercise was the best non-pharmacological intervention to improve postpartum depression. Conclusion Exercise has the best effect on improving postpartum depression，and it is recommended that clinical nursing care should be prioritized. However，a large number of high-quality RCTs are still needed for verification.

Best evidence summary on prehabilitation interventions of patients undergoing elective gastrointestinal surgery

TAI Rui, FANG Fang, YANG Fu, YU Qian

2024, 59(2):  236-243.  DOI: 10.3761/j.issn.0254-1769.2024.02.016

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Objective To retrieve，evaluate and summarize the best evidence of prehabilitation interventions of patients undergoing elective gastrointestinal surgery，so as to provide references for clinical application. Methods All evidence on prehabilitation interventions of patients undergoing elective gastrointestinal surgery was retrieved from databases and websites including UpToDate，JBI Library，PubMed，CINAHL，Cochrane Library，CNKI，CBM，Wanfang and NGC，SIGN，NICE，NZGG，RNAO，ONS，ESPEN，CGC，CACA，CAMCSPEN. The retrieved evidence inclu-ded guidelines，clinical decisions，expert consensuses，evidence summaries，systematic reviews，randomized controlled trials，et al. The retrieval time limit was from the database construction to March，2022. Results Totally 21 articles were involved，including 6 guidelines，8 expert consensuses，2 meta-analyses and 5 systematic reviews. The overall quality of the included literature was high. Finally，22 pieces of best evidence about nutritional support，exercise training and psychological intervention were summarized. Conclusion The best evidence for prehabilitation intervention of patients undergoing elective gastrointestinal surgery summarized in this study is scientific and practical to a certain extent，which can provide bases for clinical workers to carry out prehabilitation clinical practice.

Review

Longitudinal mixed methods and its application progress in nursing

YUAN Xiaoyi, XING Weijie

2024, 59(2):  244-249.  DOI: 10.3761/j.issn.0254-1769.2024.02.017

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This review introduces the concept，design and implementation of longitudinal mixed methods research. It summarizes its common applications，including the in-depth exploration of potential causes and association among variables of the complex phenomenon over time，the comprehensive evaluation of intervention effectiveness，the identification of facilitators and challenges for implementation，as well as the exploration of changes in behavior and underlying mechanisms. Moreover，this review analyzes existing challenges and future insights of this method. In conclusion，this review aimed to strengthen the nursing researchers’ understanding of longitudinal mixed methods research and provide insights for future related studies.

Research progress of blockchain technology in clinical nursing

CHEN Li, YANG You

2024, 59(2):  250-256.  DOI: 10.3761/j.issn.0254-1769.2024.02.018

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Blockchain technology integrates a series of complex technologies such as distributed accounting，peer-to-peer transmission，cryptography，smart contracts，consensus algorithms，etc.，providing services for controlling，storing，sharing，and managing data. At present，clinical nursing data is growing exponentially，and blockchain technology can be well used to process a large amount of clinical nursing data，bringing many advantages to clinical nursing. This article provides an overview of the current research status of blockchain technology in clinical nursing，with a focus on application types，advantages，and difficulties and challenges in the application process. It also proposes suggestions for designing data models and formats that meet specifications and standards，providing decision support for the application and development of blockchain technology in clinical nursing in China，thereby improving the quality of nursing services.