Table of Content

20 March 2024, Volume 59 Issue 6

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Research Paper

Evidence-based practice for the prevention and management of gastrointestinal dysfunction in patients with liver cancer after surgery

GUO Xue’e, BIAN Lifang, LI He, LI Chunyan, SHI Xiaolan, LI Yan, CHEN Jiaping, LU Fangyan, ZHANG Huafang

2024, 59(6):  645-653.  DOI: 10.3761/j.issn.0254-1769.2024.06.001

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Objective To develop an evidence-based practice program for the prevention and management of postoperative gastrointestinal dysfunction in patients with hepatocellular carcinoma，based on the best available evidence，and to evaluate the effectiveness of its application. Methods An evidence-based nursing approach was conducted for systematical search，appraisal and summary of the best evidence for the prevention and management of postoperative gastrointestinal dysfunction in postoperative hepatectomy patients. From September 2022 to October 2022，under the guidance of Knowledge to Action Framework，and in combination with clinical scenarios，the best evidence was screened and adjusted，and an evidence-based practice plan was formulated. From November 2022 to March 2023，the plan was implemented in the Department of Hepatobiliary and Pancreatic Surgery of a tertiary A hospital in Hangzhou City，Zhejiang Province，China. We compared the rate of implementation of the measures by healthcare personnel before and after the application of the evidence，the qualified rate of knowledge of perioperative management of gastrointestinal dysfunction，and the incidence of postoperative gastrointestinal dysfunction in postoperative hepatectomy patients，the first time to flatus and bowel，the length of hospital postoperative stays，the BMI and serum albumin level on discharge. Results After evidence-based practice，the implementation of 11 review indicators and knowledge pass rate increased，and the difference was statistically significant（P<0.05）.The incidence of postoperative gastrointestinal dysfunction in patients decreased from 11.9% to 4.0%（P=0.037）. First time to gas and bowel，and the length of hospital postoperative stays were shortened，and the differences were statistically significant（P<0.05）. Conclusion The implementation of clinical evidence-based practice for the prevention and management of postoperative gastrointestinal dysfunction in postoperative hepatectomy patients provided support for clinical decision-making，improved healthcare professional awareness and implementation of review entries. It effectively reduced the incidence of gastrointestinal dysfunction in postoperative hepatectomy patients and accelerated the recovery process.

Construction and preliminary application of a lifestyle decision support system for population with high-normal blood pressure

MU Tingyu, XU Rixiang, ZHU Qianyin, CHEN Lingshan, HUANG Junping, LI Zhimin, SHEN Cuizhen

2024, 59(6):  654-661.  DOI: 10.3761/j.issn.0254-1769.2024.06.002

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Objective To construct a lifestyle decision support system for people with high normal blood pressure，and assess its effectiveness and usability in lifestyle management for people with high normal blood pressure. Methods A system development team was established to build an evidence-based lifestyle decision support system for people with high normal blood pressure. The system consists of a mobile application and a desktop management system. The mobile application includes the health assessment，decision results（including data overview/traditional Chinese medicine health care/nutritional recipes/energizing exercises/spiritual space），and data recording. The desktop management system includes user management and data supplementation，decision management，and data analysis. 20 patients with high normal blood pressure were recruited from September 19， 2022 to November 14，2022 at the Hangzhou Community Health Service Center for the initial application of the system. Results After using lifestyle decision support system，the population with high-normal blood pressure revealed statistically significant differences（P<0.05） in systolic blood pressure，moderate physical activity time per week，stress，anxiety，depression，self-management ability，and halophilic behavior. The majority of the high-normal blood pressure population（14 cases） and community healthcare workers（5 cases） rated the usability of lifestyle decision support system as Good. Conclusion The lifestyle decision support system constructed in this study is scientific and feasible，and can provide professional lifestyle guidance for individuals with high-normal blood pressure. The lifestyle decision support system plays a positive role in improving the unhealthy lifestyle of people with high-normal blood pressure，and provides an auxiliary decision-making system for people with high-normal blood pressure and community healthcare workers.

Special Planning-Gestational Diabetes Mellitus Nursing

The development of a patient guideline on non-pharmacological management of gestational diabetes mellitus

Center for Evidence-based Nursing, Fudan University, （Writing Committee：XING Nianlu, ZHOU Yingfeng, CHEN Shuyu, FANG Yuan, LI Li, GU Yanhong, ZHAO Minhui, PAN Xiuhong）

2024, 59(6):  662-668.  DOI: 10.3761/j.issn.0254-1769.2024.06.003

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Objective To construct a patient guideline for the non-pharmacological management of gestational diabetes mellitus（GDM） to provide decision support for the self-management of patients with GDM. Methods Utilizing evidence-based methods，health problems were identified through literature analysis，personal interviews，and on-site investigations. Systematic search was conducted on domestic and international guideline websites，professional association websites，and comprehensive databases. The quality of evidence was graded according to the GRADE system. The Evidence-to-Decision（EtD） framework was employed to summarize the evidence，leading to the initial formulation of recommendations. These recommendations were then refined，and the consensus was achieved through a round of expert consensus meetings and 2 rounds of Delphi method for expert correspondence，resulting in the final draft of the patient guideline. Results The core content of the patient guideline encompasses 5 aspects：screening and diagnosis of GDM，prenatal management，labor and delivery management，neonatal hypoglycemia management，and postpartum management. Conclusion This patient guideline，developed through a rigorous process，takes into account patients’ preferences，and it is scientifically sound，acceptable，operable，and readable. It can provide a foundation for decision-making in the self-management of patients with GDM.

Longitudinal relationship between family support and glucose management decision-making behaviours in patients with gestational diabetes mellitus

ZHANG Xin, YIN Wei, LIU Qiaoyan, JIN Huayi, ZU Houjuan

2024, 59(6):  669-676.  DOI: 10.3761/j.issn.0254-1769.2024.06.004

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Objective To explore the developmental trajectory of family support and glucose management decision-making behaviours of gestational diabetes mellitus patients and the mutual predictive relationship between them，in order to provide a basis for improving the glucose management decision-making behaviours of gestational diabetes mellitus patients. Methods From April to September 2022，216 patients with gestational diabetes mellitus in a tertiary hospital in Jiangsu Province were selected by convenience sampling method，and follow-up surveys were conducted during the diagnosis period，the expectant period，and the postpartum follow-up period，and data were analysed using latent variable growth model and cross-lagged model. Results 211 patients completed the follow-up survey. The latent variable growth model showed that family support（S=-0.222，P<0.001） and glucose management decision-making behaviours（S=-4.520，P<0.001） in patients with gestational diabetes mellitus showed a decreasing trend from the diagnostic period to the postnatal follow-up period，and that the initial level of family support positively predicted the initial level of glucose management decision-making behaviours（β=0.380，P=0.018） and developmental speed（β=0.747，P<0.001），and the developmental speed of family support can positively predict the developmental speed of blood glucose management decision-making behaviour（β=0.601，P<0.001）. The cross-lagged model showed that the family support of the previous period among the 3 periods can positively predict the blood glucose management decision-making behaviour in the next period（β=0.751，P=0.027），（β=0.590，P=0.049） and vice versa. Conclusion This study confirms that family support and glucose management decision-making behaviours of gestational diabetes mellitus patients gradually weakened from the diagnosis period to the postpartum follow-up period，revealing that family support is an important protective factor in the development of glucose management decision-making behaviours. Healthcare professionals should guide family members to participate in the management of glucose at an early stage，continue to pay attention to the developmental trajectory in different periods and develop personalized intervention strategies to assist patients in making the best decisions.

Development and reliability and validity test of a risk perception scale for pregnant women with gestational diabetes mellitus

CHEN Yumei, ZHAO Huifen, ZHAO Xiaoshan, ZHAO Meijing, PENG Yumei, SHEN Liqin

2024, 59(6):  677-684.  DOI: 10.3761/j.issn.0254-1769.2024.06.005

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Objective To develop and test the reliability and validity of a risk perception scale for pregnant women with gestational diabetes mellitus（GDM），and to make a preliminary application. Methods Using the Health Belief Model as a theoretical framework，a first draft of the scale was developed through literature analysis，semi-structured interviews，expert correspondence and a pre-survey. From September to October 2022，276 pregnant women with GDM were recruited from 4 hospitals in Quanzhou City by convenience sampling method to screen entries and test the reliability of the scale. The validation and initial application of the scale structure was completed by recruiting 335 pregnant women with GDM in 3 other hospitals in Quanzhou City from November to December 2022. Results The risk perception scale for pregnant women with GDM contained 4 dimensions and 29 items. Exploratory factor analysis extracted 4 factors with a cumulative variance contribution of 79.93%. The Cronbach’s α coefficient was 0.932；the fold-half reliability was 0.949；the test-retest reliability was 0.757；the content validity was 0.900. The results of the validation factor analysis showed that the scale factor structure was stable. The mean total risk perception score of pregnant women with GDM was 116.53±15.82. Literacy，frequency of internet searches for ways to control blood glucose，and per capita monthly household income were factors that influenced the risk perception of pregnant women with GDM（P<0.05）. Conclusion The risk perception scale for pregnant women with GDM has good reliability and validity，and it can be used as a tool for health care professionals to measure the perceived risk of pregnant women with GDM. The perceived risk of pregnant women with GDM is at a moderate level，and caregivers should pay more attention in the future to pregnant women with GDM who have low literacy，low income and low frequency of participation in GDM-related learning.

Analysis on the current situation and influencing factors of social network among pregnant women with gestational diabetes mellitus

TANG Yalin, WEI Lili, LI Qianqian, KUANG Guofang, YUE Chongyu, ZHANG Xinwei, ZHANG Yan, GU Ruting, LÜ Bohan, ZHAO Yafei

2024, 59(6):  685-690.  DOI: 10.3761/j.issn.0254-1769.2024.06.006

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Objective To investigate the current social network status of pregnant women with gestational diabetes mellitus（GDM） and analyze the influencing factors to provide a reference for improving the health status of pregnant women with GDM. Methods The convenience sampling method was used. 315 pregnant women with GDM from 4 tertiary hospitals in Qingdao City were selected as study respondents from June to October 2022. The General Condition Questionnaire，Name Generator Questionnaire，and Self-Management Ability Questionnaire for Patients with Gestational Diabetes Mellitus were used to conduct the survey. Univariate analysis and multiple linear regression were used to analyze the influencing factors of the social network of GDM pregnant women. Results 306 valid questionnaires were collected. The size of the structural network of the social network of pregnant women with GDM was（8.24±1.81） persons，and the size of the functional network was（11.90±2.39） persons. The results of multiple linear regression analysis showed that in the structural network of the pregnant women with GDM，the score of self-management level，age，economic activity，and education level were the influencing factors（P<0.05）. In the functional network，the place of residence，age，and public welfare activities were the influencing factors（P<0.05）. Conclusion The overall social network level of pregnant women with GDM is intermediate. Nursing clinical work should focus on the blood glucose management of young pregnant women who have low education，live in rural areas，have insufficient self-management levels，and have low participation in social activities，and at the same time，help this kind of pregnant women to improve the ability of acquiring and utilizing the social network and social support.

Evidence summary for maternal postpartum management of gestational diabetes mellitus

WANG Qiaosong, ZHANG Kun, ZHENG Qirong, LIN Jingjing, ZHANG Xueling, FANG Yan, YANG Jingping, LIN Rong, LIN Rongjin

2024, 59(6):  691-698.  DOI: 10.3761/j.issn.0254-1769.2024.06.007

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Objective To provide solid evidence for clinical development and implementation of maternal postpartum management of gestational diabetes mellitus，we systematically retrieve，extract，summarize，and analyze the latest and the best evidence of maternal postpartum management of gestational diabetes mellitus. Methods According to the top-down principle of the evidence-based resource 6S model，a systematic search of domestic and foreign computer decision support systems，guideline websites，databases，and relevant social websites was conducted for evidence on maternal postpartum management of gestational diabetes mellitus，including clinical practice guidelines，best clinical practice information manuals，evidence summaries，expert consensuses，systematic reviews，and standards. The search time limit was from the establishment of the databases to April 2023. 2 trained researchers in systematic evidence-based knowledge evaluated the quality of the literature，combined with professional judgment，selected the literature that met the inclusion and exclusion criteria，and extracted the evidence. Results A total of 16 articles were included，including 9 guidelines，5 systematic reviews，and 2 expert consensus articles. The best evidence includes 32 recommendations in 6 aspects：breastfeeding，postpartum medication precautions，lifestyle，postpartum follow-up and screening，contraception，and repeat pregnancy. Conclusion The study summarizes the best evidence for postpartum management of women with gestational diabetes，and provides an evidence-based basis for targeted application of evidence by clinical healthcare providers.

Specialist Practice and Research

Development of health science popularization works for the prevention of deep vein thrombosis in patients after joint replacement

WANG Yu, XU Yuan, DENG Haibo, WANG Lei, WANG Xiaojie, HAO Yufang, ZHU Liyun, LIU Jia, SUN Jianhua, AN Ranxun, MA Yufen, WU Xinjuan

2024, 59(6):  699-705.  DOI: 10.3761/j.issn.0254-1769.2024.06.008

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Objective To develop evidence-based health science popularization works for the prevention of deep vein thrombosis（DVT） in patients after joint replacement. Methods In this study，guided by the Guideline International Network patient guideline formulation manual and Patient Education Materials Assessment Tool，we conducted semi-structured interviews to clarify the health science themes. These themes were matched with relevant evidence，and the relevant evidence recommendation items for each theme were refined. It is translated into easily understandable language and other forms. 12 representatives（doctor，nurse，patient，science popularization expert and evidence-based methodology expert） conducted an external review of the quality of these science popularization works. Results Prevention of post-operative DVT，patients’ main concerns and the most urgent need for action were extracted from a total of 6 scientific topics. After the matching with 22 pieces of evidence，a health education content system for the prevention of DVT after total joint arthroplasty was created. According to the system framework and evidence，as well as the preferences and needs of patients，a popular science manual and popular science video were created，with the final external review rate of 94%~100% and the coefficient of variation of 0~0.101. The revised health science works for the prevention of DVT after joint replacement included popular science manuals-trifolds and popular science videos. The copyright of both popular science manuals（copyright number：Guozuo Dengzi-2022-L-10159159） and popular science videos（copyright number：Guozuo Dengzi-2022-I-10162339） have been registered. Conclusion The method of developing science popularization works on the prevention of DVT in patients after joint replacement is scientific. It can provide a methodological reference for the development of other science popularization works.

The process of mental resource depletion and recovery in patients with heart failure：a qualitative research

SUN Shuyi, SUN Guozhen, GAO Min, WANG Jie, YU Tianxi, LIU Shenxinyu, TANG Zhijie, WEN Gaoqin

2024, 59(6):  706-712.  DOI: 10.3761/j.issn.0254-1769.2024.06.009

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Objective To explore the process of mental resource depletion and recovery in patients with heart failure. Methods Based on the ego-depletion theory，using descriptive phenomenology research method，a semi-structured in-depth interview was conducted on 16 patients with heart failure in the cardiovascular ward of a tertiary A general hospital in Nanjing from September to November 2022，and the data were analyzed and refined by the Colaizzi seven-step method. Results 4 themes were extracted：acute ego-depletion sources（including psychological stress caused by role transition，and mental resource crisis caused by physical pain），chronic ego-depletion sources （including physical symptoms leading to changes in old habits，patients suffering from persistent discomfort symptoms，patients mired in rumination due to uncertainty，and the cost of treatment increasing the economic burden），ego-depletion（including negative thinking patterns and shallow cognitive processing，complex mixed adverse emotions，and weak performance of behavior），mental resource recovery（including seeking self-healing and providing a healing environment）. Conclusion There are acute and chronic ego-depletion sources in the course of heart failure patients，which can lead to a variety of ego-depletion manifestations，depletion and recovery coexist，and change dynamically. Medical staff should pay attention to the impact of ego-depletion sources on patients，evaluate the performance and severity of ego-depletion，and take timely recovery measures to maintain the balance of patients’ mental resource and improve the ability of self-regulation.

The sinicization of the Leading a Culture of Quality for Infection Prevention Scale and the test of its reliability and validity

LI Shuhua, SHANG Linping, YUAN Lirong, YIN Wenhui, WEN Jinqi

2024, 59(6):  713-718.  DOI: 10.3761/j.issn.0254-1769.2024.06.010

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Objective To translate the Leading a Culture of Quality for Infection Prevention （LCQ-IP） Scale into Chinese，and to test its reliability and validity. Methods The English version of LCQ-IP scale was translated into Chinese and back translated according to the Brislin model. The Chinese version of the scale was determined after cross-cultural adaptation and pre-experiment. A convenient sampling method was used to investigate 430 nurses from 5 tertiary A hospitals in Taiyuan City from May to July 2022 to analyze the reliability and validity of the scale. Results The Chinese version of LCQ-IP scale included psychological safety，quality priority，supportive environment and improvement orientation，with a total of 15 items. The content validity and the content validity index of the item level of the scale was 0.836-1.000 and 0.917. Totally 4 common factors were extracted by exploratory factor analysis，and the cumulative variance contribution rate was 76.088%. By confirmatory factor analysis，the chi-square/DOF ratio is 2.779，and the mean square and square root of progressive residuals are 0.063. The Cronbach’s α coefficient of this scale was 0.931，and the retest reliability was 0.925. Conclusion The Chinese version of LCQ-IP scale has good reliability and validity，and it can be used as an evaluation tool for a culture of quality for infection prevention.

Intractable Disease Care

Nursing care of a patient with pulmonary arteriovenous fistula and postoperative acute ischemic stroke

XIE Xuping, YU Limei, CHEN Mingxiang, LI Fuping, LI Zhiping

2024, 59(6):  719-722.  DOI: 10.3761/j.issn.0254-1769.2024.06.011

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To summarize the nursing experience of a patient with pulmonary arteriovenous fistula and secondary acute ischemic stroke after surgery. Nursing points include：implementing predictive care to ensure smooth emergency access；accurate evaluation and early identification to seize golden rescue time；strengthening postoperative management and promoting the recovery of important organs；dynamically adjusting anticoagulation strategies to ensure maximum benefit for patients；actively correcting perioperative anemia and preventing complications；implementing continuous care through an intelligent follow-up system to promote physical and mental recovery. The patient was discharged from hospital after multidisciplinary teamwork and careful nursing.

Nursing care of a patient with renal amyloidosis complicated with severe erythroderma

REN Hongmei, ZENG Li, HUANG Jing

2024, 59(6):  723-726.  DOI: 10.3761/j.issn.0254-1769.2024.06.012

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To summarize the nursing experience of a patient with renal amyloidosis complicated with severe erythroderma. Nursing points：to set up an exclusive nursing team to implement fine nursing management；to reduce edema exudation，promote renal function recovery；to focus on skin care，reduce local symptoms of skin mucosa；the combined application of wound nursing techniques to prevent infection aggravation；to use a variety of stress relief measures to reduce the risk of pressure sores；to strengthen nutritional support treatment to improve nutritional status；to carry out characteristic continuous nursing to improve patients’ ability of disease management. After 29 days of careful treatment and nursing，the renal function of the patient returned to normal；the symptoms of severe erythroderma improved significantly；the patient’s condition was stable after 1.5 months of follow-up.

Evidence Synthesis Research

Summary of best evidence for prevention and control of multidrug-resistant organism infection in adult ICU

SHI Xiaoliu, SHI Jinmei, SHEN Hongwu, ZHANG Qian, ZHANG Yan

2024, 59(6):  727-735.  DOI: 10.3761/j.issn.0254-1769.2024.06.013

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Objective To search and summarize the best evidence for the prevention and control of multidrug-resistant organism infection in adult ICUs，and to provide evidence-based basis for clinical standard control. Methods We systematically searched relevant guideline websites and professional association websites，UpToDate，BMJ best practice，National Institute for Health and Care Excellence，National Guidelines Clearinghouse，Registered Nurses’ Association of Ontario，Yimaitong，the Cochrane Library，Embase，PubMed，Web of Science，CNKI，Wanfang，VIP and SinoMed to collect all the clinical guidelines，system reviews，expert consensuses，evidence summaries and original research related to prevention and control of multidrug-resistant organism infection in adult intensive care units. The search period was from the establishment of the database to April 30，2023. 2 researchers independently conducted the literature quality evaluation and data extraction. Results A total of 19 articles were included，including 1 guideline，8 expert consensuses，1 expert opinion，2 systematic evaluations，and 7 original studies. Ultimately，10 evidence themes and 41 pieces of best evidence were formed，including risk factors，hand hygiene，decolonization，active monitoring，equipment related strategies，contact protection，patient isolation，environmental cleaning，personnel training management supervision，and multidisciplinary collaborative management. Conclusion This study summarizes 41 pieces of best evidence for the prevention and control of multidrug-resistant organism infections in adult ICUs，which can provide resource preparation for clinical transformation and clinical decision-making basis for nursing staff to conduct scientific and effective nursing practices. Specialized nursing staff should reasonably select the best evidence for localized application，continuously update the best evidence，standardize nursing practices，and improve nursing quality.

The cardiac rehabilitation adherence assessment tools：a systematic review of psychometric properties

WANG Xuan, WEN Xianxiu, GOU Li, ZHOU Lijuan, CHEN Fuli, WU Haiyan, WANG Liang

2024, 59(6):  736-743.  DOI: 10.3761/j.issn.0254-1769.2024.06.014

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Objective To evaluate the systematic review of the cardiac rehabilitation adherence assessment tools，so as to provide references for the selection of appropriate research tools. Methods We searched the American Association of Cardiovascular and Pulmonary Rehabilitation website，the National Institute for Health and Care Excellence website，PubMed，CINAHL，PsycINFO，Embase，Web of Science，CNKI，Wanfang database，VIP database and Chinese Biomedical Literature database for published studies on cardiac rehabilitation adherence assessment tools for patients with cardiovascular disease，and the search time limit is from the establishment of the databases to December 3，2022. 2 researchers independently screened the literature，extracted data，and evaluated the methodological quality and the psychometric properties of the included studies according to the consensus-based standards for the selection of health measurement instruments，and the modified grading of recommendations assessment，development of evaluation was used to classify the grade of evidence and recommendations of the tools. Results A total of 12 studies were included，involving 7 cardiac rehabilitation adherence assessment tools. None of the 7 assessment tools reported cross-cultural validity or measurement invariance，measurement error or respon-siveness；the Cardiac Rehabilitation Adherence Tool is Category C and not recommended due to high quality evidence of inadequate internal consistency. The remaining 6 assessment tools are of moderate or low quality of evidence due to uncertainty of content validity or inadequate internal consistency，and all are category B and recommended. Conclusion Compared with the other 6 assessment tools，the Cardiac Rehabilitation Barriers Scale was evaluated more comprehensively for its psychometric properties with good reliability and validity，and it can be provisionally recommended for use. However，more high-quality evidence is still needed to further explore assessment tools for cardiac rehabilitation adherence in patients with cardiovascular disease.

Evidence summary for prevention and rehabilitation of radiation-induced trismus in patients with nasopharyngeal carcinoma

WANG Ting, LU Yan, ZENG Mi, WU Jingjing, LIU Caijuan, ZENG Qingqing, ZENG Guqing, TAN Ying

2024, 59(6):  744-752.  DOI: 10.3761/j.issn.0254-1769.2024.06.015

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Objective To conduct a systematic search and summary of the relevant evidence regarding the prevention and rehabilitation of radiation-induced trismus in patients with nasopharyngeal carcinoma，and offer recommendations towards the comprehensive prevention and control of trismus in clinical practice. Methods A standardized strategy was employed to search UpToDate，BMJ Best Practice，Cochrane Library，JBI EBP Datebase，GIN，NICE，SIGN，NGC，yimaitong，PubMed，Web of Science，EBSCO，CINAHL，Open Grey，China National Knowledge Infrastructure，Wanfang Medical Network，and VIP database for clinical decisions，guidelines，expert consensuses，systematic reviews，evidence summaries，best practices，and original research. The search time was from the establishment of the databases until March 2023. Results 18 articles were included in total，including 1 best practice，2 evidence summaries，2 clinical decisions，3 guidelines，1 expert consensuses，6 systematic reviews，and 3 original studies. A total of 24 pieces of evidence were summarized in 7 aspects，including multidisciplinary cooperation，identification and prevention of risk factors，standardized assessment，trismus management and functional exercise，nutritional support，health education and follow-up. Conclusion The evidence summarized in this study can provide an evidence-based basis for clinical professionals to develop plans related to the prevention and rehabilitation of trismus in patients with nasopharyngeal carcinoma. When applying the evidence，professionals need to maximize the preventive and rehabilitative effects according to the current status of management of trismus with nasopharyngeal carcinoma in their hospitals and the needs of patients.

Review

Application and progress of knowledge graphs in dietary management of patients with chronic diseases

YAN Yu, GONG Shu, DUAN Difei, MA Dengyan

2024, 59(6):  753-757.  DOI: 10.3761/j.issn.0254-1769.2024.06.016

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Diet is an important modifiable factor affecting the onset，progression and prognosis of chronic diseases. However，the complexity and long-term nature of diet management of chronic diseases usually brings great challenges to patients. Knowledge graph uses semantic technology to standardize the representation，extraction，fusion and reasoning of massive knowledge，so that it has the characteristics of knowledge visualization and reasoning support. It helps users to obtain relevant knowledge conveniently，quickly and accurately，and provides a new idea and method for diet management of patients with chronic diseases. This study aims to comprehensively review the relevant literature at home and abroad，elaborate on the concept，development and application of knowledge graph in diet management of patients with chronic diseases，and put forward prospects，in order to provide references for the diet management of patients with chronic diseases.

Decision aids for care decision making in dementia patients：a scoping review

DENG Yifan, WANG Jianning, PENG Mengting, HONG Du

2024, 59(6):  758-763.  DOI: 10.3761/j.issn.0254-1769.2024.06.017

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Objective To conduct a scoping review of the application of decision aid （DA） in the nursing decision making of patients with dementia，identify the elements and application status of DA intervention，and provide references for the practice of DA and related research. Methods Pubmed，CINAHL，Cochrane Library，Embase，PsycINFO，CNKI，Wanfang database，CBM and VIP database were searched. The time limit for the search was from the establishment of databases until July 31，2023. The included literature was summarized and analyzed. Results A total of 19 articles were included，and topics on DA included advance care planning，care models，feeding choices，daily living，and goal of care decisions. The content elements of DA include providing information related to the patient’s physical condition and decision-making topics，providing alternative decision options and describing advantages and disadvantages，clarifying values and treatment preferences，and interactive decision support communication with peers and professionals. The outcome measures include decision process indicators，decision quality indicators and feasibility evaluation. Conclusion DA can significantly reduce the level of decision conflict between patients and caregivers，improve the quality of decision-making，with good feasibility. More high-quality randomized controlled studies with homogeneous interventions are needed in the future，in order to improve the effect evaluation index，and explore the best intervention time of DA，strengthen the professional support in the decision-making process，and accelerate the development of local relevant DA according to the specific practice situation in China，so as to provide high-quality decision support for dementia patients and caregivers.

Overseas Knowledge

Introduction and enlightenment of dementia care managers in Macao，China

ZUO Shunli, WU Jianwei, GUO Jun, LIU Ning

2024, 59(6):  764-767.  DOI: 10.3761/j.issn.0254-1769.2024.06.018

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As a major public health problem，dementia has attracted worldwide attention. The rapid increase in the number of elderly patients with dementia in China poses challenges to prevention and treatment systems，health promotion，and social support. The development of dementia care managers in Macao，China，is early，and the system is mature with a good institutional guarantee，a clear job setting，an advanced training mode，and unified certification standards. They can formulate professional and comprehensive care plans for the elderly with dementia and their families through interdisciplinary cooperation and the integration of social resources. This paper introduces the origin and development status，access criteria and assessment，training mode，continuing education，and practice scope of dementia care managers in Macao，China，in order to provide references for dementia care in China.