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    10 August 2024, Volume 59 Issue 15
    Special Planning—The Action Plan for Improving Nursing Services
    Study on the effect of differentiated management in a multi-campus hospital for improving patient experience
    WANG Tingting, LAN Meijuan, ZHANG Yuping, YAO Meiqi, ZHU Chenling, SONG Jianping, YANG Yan, FENG Xiuqin
    2024, 59(15):  1797-1803.  DOI: 10.3761/j.issn.0254-1769.2024.15.001
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    Objective To explore and implement a differentiated management strategy for multi-campus hospitals to improve patient experience and satisfaction,and achieve the goal of homogenized management. Methods In December 2021,the Picker Patient Experience Questionnaire was used to survey the patient experience at 3 campuses of a tertiary A hospital in Hangzhou,and the reasons for the differences were analyzed. Based on policy document reviews,special group discussions,and expert meetings,differentiated management strategy for multi-campus hospitals was formulated. The patient experience and satisfaction before(December 2021) and after(December 2023) the implementation were compared. Results After the application of the one-hospital multi-campus difference management strategy,the overall medical experience score of the patients in the 3 campus was(58.54±2.36) points,which was higher than(58.13±3.24) points before the application(t=-3.223,P=0.001),and there was no statistically significant differences among the patients in the 3 campuses(F=0.781,P=0.458). After the application of the management strategy,the overall satisfaction score of the patients in the 3 campus was(98.44±6.22) points,which was higher than (97.98±6.87) points before the application of the management strategy(t=-2.490,P=0.013),and there was no statistical significance among the patients in the 3 campus(F=1.128,P=0.324). The number of banners and letters of commendation received by the 3 campuses increased from 1 661 before the application to 2 190 after the application,with a growth rate of 31.85%. Conclusion Differentiated management in a multi-campus hospital,aiming at homogenized quality through differentiated strategies,is practicable and can significantly improve the patient experience and satisfaction across different campuses.

    Development of a working model of evidence-based nursing practice in deep vein thrombosis prophylaxis
    WANY Yu, HAO Yufang, MA Yufen, XU Yuan, AN Ranxun, DENG Haibo, WANG Lei, WANG Xiaojie, SUN Jianhua, LIU Jia, ZHU Liyun, WU Xinjuan
    2024, 59(15):  1804-1811.  DOI: 10.3761/j.issn.0254-1769.2024.15.002
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    Objective To construct an evidence-based practice model for nurses in preventing deep vein thrombosis(DVT) and provide a scientific and targeted theoretical basis for nurses to carry out evidence-based nursing practice in DVT prevention. Methods Based on the previous evidence-based nursing practice project on DVT prevention after hip and knee arthroplasty,the research team used theoretical analysis and brainstorming to develop a draft of the work model. Expert meetings were organized to validate the content of the draft using the Delphi method,leading to the finalization of the evidence-based practice model for nurses in preventing DVT. Results The Knowledge-to-Action(KTA) framework was selected as the basic framework for constructing the evidence-based nursing practice model for preventing DVT. Theoretical Domain Framework,Theory of Planned Behavior,and Social Cognitive Theory were chosen to explore the influencing factors of nurses’ behavior change in preventing DVT through evidence-based practice. The authority coefficient of the participating experts was 0.904,indicating high reliability. The final model consisted of 6 key components:knowledge generation,problem identification,localization and adaptation,knowledge application,sustained knowledge use,and conceptual framework for behavior change through evidence-based practice. Conclusion Based on theoretical analysis and clinical practice,this study developed an evidence-based practice model for nurses in preventing DVT using the expert meeting. The research methodology was scientific,and the content was reliable,providing a theoretical basis for nurses to engage in evidence-based nursing practice for DVT prevention.

    Construction and application of an intelligent interactive discharge follow-up platform
    MAO Wenping, LUO Jinkai, WANG Lihua, ZHANG Jie, REN Haiyan
    2024, 59(15):  1812-1817.  DOI: 10.3761/j.issn.0254-1769.2024.15.003
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    Objective To build an intelligent interactive discharge follow-up platform,and to explore its application effect in the management of discharge follow-up. Methods A research team was established to construct the intelligent interactive discharge follow-up platform,which includes 3 modules,namely follow-up plan customization module,follow-up execution module,and information backup and statistical analysis module. The discharge follow-up data of branch A and B of a tertiary hospital in Beijing from January to December 2022 were selected. Patients in branch A were given manual telephone follow-up by nurses,and patients in branch B were applied by the intelligent interactive discharge follow-up platform,and the follow-up efficiency of the 2 branches was compared. 100 cases of discharged patients in each of 2 hospital branches were randomly selected as research subjects,and the follow-up time and nursing manpower of 2 groups were compared. Results The follow-up rate and effective follow-up rate of branch A were 99.96% and 95.10%,while those of branch B were 99.84% and 99.66%,respectively,and the difference was statistically significant(χ2=19.028,2 081.008,P<0.001). The opinion collection rate of branch A was 0.47%,which was higher than that of the branch B(0.01%)(χ2=249.365,P<0.001). The time and nursing manpower spent on follow-up was even less. Conclusion The intelligent interaction discharge follow-up platform realizes human-robot multi-party intelligent interaction,which can release nursing manpower and time,improve the follow-up rate of discharged patients.

    Construction of an “Internet+ Traditional Chinese Medicine nursing” service capability evaluation index system based on the three-dimensional quality structure model
    HU Yanjiao, LI Yan, LUO Shimiao, ZOU Tao, DING Meizhu
    2024, 59(15):  1818-1823.  DOI: 10.3761/j.issn.0254-1769.2024.15.004
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    Objective To construct an evaluation index system of “Internet+ Traditional Chinese Medicine nursing” service capability,in order to provide references for the standardized and effective evaluation of “Internet+ Traditional Chinese Medicine nursing” service capability. Methods Literature analysis and semi-structured interview method were adopted,and three-dimensional quality structure model was used as the theoretical framework to initially construct the “Internet+ Traditional Chinese Medicine nursing” service capability evaluation index item pool. From July to October 2022,the Delphi method was used to conduct 2 rounds of consultation with 16 experts from Guangdong Province,to evaluate the enthusiasm,authority,degree of opinion concentration and degree of opinion coordination of the experts in the correspondence consultation,and the weight of the index system was determined with the combination of chromatography analysis. Results 2 rounds of expert letter consultation were conducted. The questionnaire recovery rates were 100%,and the authority coefficients were 0.844 and 0.834,respectively. Kendall coordination coefficients were 0.161 and 0.110,respectively(P<0.001). The first level indexes of the index system are structure evaluation,process evaluation and outcome evaluation. There were 3 first-level evaluation indicators,14 second-level evaluation indicators and 57 third-level evaluation indicators. Conclusion The evaluation index is scientific and practical,and it is carried out around the Internet+ Traditional Chinese Medicine nursing capability,which provides a certain reference for the effective evaluation of the service capability of “Internet+ Traditional Chinese Medicine nursing”.

    An applied study on a care ability intervention scheme for family caregivers of advanced lung cancer patients
    WAN Yinchen, WANG Zhaodi, WU Kun, ZHOU Chunxia, CHENG Lijuan, AN Xiangli
    2024, 59(15):  1824-1831.  DOI: 10.3761/j.issn.0254-1769.2024.15.005
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    Objective To analyze the effect of Meleis transition theory in the intervention of family caregivers of advanced lung cancer patients. Methods From January 2022 to June 2023,94 patients with advanced lung cancer and their family caregivers treated in 4 hospitals of a tertiary A hospital in Zhejiang Province were selected by convenience sampling method,and they were divided into a control group(n=47) and an experimental group(n=47) according to random number table method. The family caregivers of the experimental group received a four-week intervention based on the Meleis transition theory on the basis of routine nursing education,including role recognition,disease knowledge,life care,psychological support,and social resource connection. Family caregivers in the control group received routine nursing education,caregiving education and guidance. The differences in the readiness,caring ability,psychological burden and patients’ quality of life were compared between the 2 groups. Results There was no lost follow-up cases in the control group and experimental group. After intervention,the preparation,ability,and quality of life of family caregivers in the experimental group were better than those in the control group,and the psychological burden of caregivers was significantly lower than that in the control group(P<0.05). Conclusion The intervention of caregiving ability of family caregivers based on Meleis transition theory can effectively improve the caregiving ability of caregivers,reduce the psychological burden of caregivers,improve the quality of care,and improve the quality of life of patients.

    Specialist Nursing Practice and Research
    The application of a psychological nursing programme based on acceptance and commitment therapy in end-stage cancer patients
    XUE Rong, WANG Xuejing, YANG Runping, DU Qiaohong, ZHANG Jing, HE Haiyan
    2024, 59(15):  1832-1839.  DOI: 10.3761/j.issn.0254-1769.2024.15.006
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    Objective To explore the effects of a psychological nursing programme based on acceptance and commitment therapy on patients with end-stage cancer. Methods The convenience sampling method was adopted to select 120 patients with end-stage cancer who were hospitalized in the radiotherapy department of a tertiary A maternity and general hospital in Yuncheng from June 2021 to December 2022 as the research subjects. The Research Randomizer was used to divide them into an experimental group and a control group,with 60 cases in each group. The experimental group adopted the psychological nursing programme based on acceptance and commitment therapy,and the control group received the routine psychological nursing. The differences of psychological resilience,psychological pain,experiential avoidance level and quality of life before and after intervention were compared between the 2 groups. Results 57 cases in the experimental group and 58 cases in the control group completed the study. The scores of the 10-item Connor-Davidson Resilience Scale were(35.14±4.76) points in the experimental group and(33.17±2.97) points in the control group,and the difference between the 2 groups was statistically significant(t=2.664,P=0.009). After intervention,the scores of the Distress Thermometer in experimental group and control group were(4.14±1.88) points and(5.69±2.13) points,and the difference between the 2 groups was statistically significant(t=-4.138,P<0.001). The scores of the Acceptance and Action Questionnaire-Ⅱ were(16.19±3.80) points in the experimental group and(23.93±2.46) points in the control group,and the difference between the 2 groups was statistically significant(t=-13.002,P<0.001). The EORTC QLQ-C30 score in the experimental group was(117.00±8.50) points,and that in the control group was(101.45±11.88) points,and the difference between the 2 groups was statistically significant(t=8.066,P<0.001). Conclusion The psychological nursing programme based on acceptance and commitment therapy can effectively reduce the level of psychological pain and experiential avoidance,improve psychological resilience and improve the quality of life of patients.

    Latent profile analysis of exercise perception among end-stage renal disease patients and its relationship with change in physical activities
    HAO Yonghui, HUA Huijuan, HE Lijun
    2024, 59(15):  1840-1846.  DOI: 10.3761/j.issn.0254-1769.2024.15.007
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    Objective To investigate the potential categories of exercise perception in patients with end-stage renal disease(ESRD),and analyze the relationship between different latent categories and change in physical activity,so as to provide references for targeted intervention. The latent profile analysis was used to extract potential categories of exercise perception,and multiple linear regression analysis was conducted with potential categories as independent variables and change in physical activity as dependent variables. Methods A total of 265 ESRD patients from a tertiary hospital were selected from June 2022 to May 2023 by convenience sampling method. The general data questionnaire,the Dialysis Patient-perceived Exercise Benefits and Barriers Scale(DPEBBS) and the Measuring Change in Physical Activity Questionnaire(MCPAQ) were used for investigation. Results A total of 241 ESRD patients completed the survey. The results of multiple linear regression analysis showed that education level,family per capita monthly income and potential categories of exercise perception were the influencing factors of change in physical activity in ESRD patients(P<0.05). Conclusion There was group heterogeneity in the exercise perception in patients with ESRD. Clinical workers should give targeted intervention according to the potential categories of patients’ exercise perception,so as to promote the initiation and long-term maintenance of the change in physical activity.

    Health behavior decision-making experience and needs of patients after percutaneous coronary intervention:a qualitative research
    ZHANG Lan, GAO Xueqin, LIN Ping, ZHAO Zhenjuan, LIU Guojie
    2024, 59(15):  1847-1851.  DOI: 10.3761/j.issn.0254-1769.2024.15.008
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    Objective To explore the experiences and needs of patients making health behavior decisions after percutaneous coronary intervention(PCI),and to provide evidence for formulating targeted decision support strategies. Methods Based on the Ottawa decision support framework and descriptive qualitative study,16 patients with unhealthy behaviors 1 year after PCI were selected as research subjects in a tertiary A general hospital in Harbin from July to December 2022 by purpose sampling method,and their decisional experience and needs were deeply interviewed by semi-structured interview method. The data were sorted out and analyzed by content analysis method. Results After the analysis of the interview data,the 2 themes and 6 sub-themes were extracted,including the experience of health behavior decision(uncertainty about the benefits of health behavior,low recognition of health behavior,and worry about the negative impact of behavior change);health behavior decision-making needs (health behavior knowledge needs,medical resources needs,emotional support needs). Conclusion PCI patients have a variety of conflicting experiences and multi-dimensional health behavior decision-making needs. Clinical nurses should start from the experience and needs of patients,pay attention to and identify the conflict experience of patients early,meet the individual needs of patients from the aspects of knowledge,medical resources,emotional support,etc.,and promote the transformation and long-term maintenance of PCI patients’ health behaviors.

    Development and reliability and validity test of the Intrinsic Capacity Assessment Scale for the Older People
    YAN Zhili, YANG Zhilan, ZHAO Huimin, ZHAI Yanping, JIA Yueyue, JIN Yuanyuan, TIAN Ziwei, LIU Xingyu
    2024, 59(15):  1852-1859.  DOI: 10.3761/j.issn.0254-1769.2024.15.009
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    Objective To develop and test the reliability and validity of the Intrinsic Capacity Assessment Scale for the Older People,so as to provide an effective tool for the assessment of the intrinsic capacity of the aged. Methods Based on the International Classification of Functioning,Disability and Health(ICF) as the theoretical framework,the initial version of The Intrinsic Capacity Assessment Scale for the Older People was developed through literature analysis,Delphi expert consultation and pre-survey. From July to September 2023,650 old people were selected by convenience sampling method to conduct a survey,and 20 old people were surveyed after 2 weeks again to test the reliability and validity of the scale. Results The effective questionnaire recovery rates of the 2 rounds of expert correspondence were 92.3% and 91.7%;the expert authority coefficients were 0.83 and 0.86;the mean importance scores of items were 2.04-3.79 and 3.50-3.82,and the full score ratios were 4.2%-83.3% and 54.6%-86.4%,respectively. The coefficients of variation were 0.11-0.42 and 0.11-0.23,respectively. A total of 5 common factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 68.327%. The results of confirmatory factor analysis showed that the fit indexes were χ2/df=1.908,RMSEA=0.054,CFI=0.931,IFI=0.932,TLI=0.922,indicating a good fit. The Cronbach’s α coefficient of the scale was 0.944;the split half reliability was 0.806;the retest reliability was 0.933. The content validity index of item level was 0.82-1.00,and the content validity index of scale level was 0.91. The Intrinsic Capacity Assessment Scale for the Older People included 35 items in 5 dimensions:movement,vitality,sensation,cognition and psychology. Conclusion The Intrinsic Capacity Assessment Scale for the Older People has good reliability and validity,and it can be used as a reliable tool to evaluate the intrinsic capacity level of the aged.

    Human Resource Management and Career Development
    Construction of an indicator system for performance appraisal in operating room nurses of cancer hospitals
    WEI Yongting, XI Zuyang, TIAN Shumei, ZHENG Yining, XIE Dan
    2024, 59(15):  1860-1868.  DOI: 10.3761/j.issn.0254-1769.2024.15.010
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    Objective To explore and construct an indicator system for performance appraisal in operating room nurses of cancer hospitals,in order to provide references for performance management. Methods From May to December 2022,the four-dimensional model of individual performance was used as the theoretical framework,and the research was carried out by literature research method,focus group interview method,Delphi expert consultation method and analytic hierarchy process,to establish the content of the performance appraisal index system of operating room nurses in cancer hospitals and the weight of each index. Results After 2 rounds of expert correspondence,29 questionnaires were sent out and 27 returned in the first round,with an expert positive coefficient of 93.10%;27 questionnaires were sent out and 27 returned in the second round,with an expert positive coefficient of 100%;expert authority coefficient of the first round was 0.941 and the second round was 0.937. In the first round,the variation coefficient of each index was 0-0.249,and the coordination coefficient was 0.201-0.352;in the second round,the variation coefficient of each index was 0-0.204,and the coordination coefficient was 0.275-0.407. Finally,a performance appraisal index system of operating room nurses in cancer hospitals was formed,which consisted of 4 first-level indicators,including task performance,interpersonal performance,adaptive performance and effort performance,11 second-level indicators and 54 third-level indicators. Conclusion The indicator system for performance appraisal in operating room nurses of cancer hospitals constructed in this study is reliable and scientific,specialized and applicable,and it can provide references for performance management.

    Current status and latent profile analysis of nurses’ health promotion lifestyle in tertiary comprehensive hospitals
    LI Weijuan, ZHAO Yue, JIANG Jing, LIU Mengyuan, LUO Hui, FENG Xinyu, LI Yinglan
    2024, 59(15):  1869-1876.  DOI: 10.3761/j.issn.0254-1769.2024.15.011
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    Objective To understand the current status of nurses’ health promotion lifestyle in tertiary comprehensive hospitals,explore the category characteristics of nurses’ health promotion lifestyle,and analyze the influencing factors under different categories. Methods From March to April 2023,a multi-stage sampling method was used to select 1326 nurses from 10 tertiary comprehensive hospitals in Hunan Province as the research subjects. A cross-sectional survey was conducted by General Information Questionnaire,Health Promotion Lifestyle Profile Scale,Self-Rated Abilities for Health Practices Scale,Health Behavior Self-Efficacy Assessment Scale,and Nursing Work Environment Scale. Latent profile analysis(LPA) of nurses’ health promotion lifestyle was conducted,and the influencing factors of different profiles were explored through univariate analysis and logistic regression analysis. Results A total of 1220 nurses were included,and the score of Health Promotion Lifestyle Profile Scale was(62.61±18.67) points. Nurses’ health promotion lifestyle in tertiary comprehensive hospitals can be divided into 3 profiles,namely survival type(25.41%),vitality type(21.97%) and normal type (52.62%). The results of logistic regression analysis showed that coping strategies for stress,non-occupational physical activity,perceived health status,health behavior self-efficacy,and nursing work environment are the influencing factors of nurses’ health promotion lifestyle in tertiary comprehensive hospitals(P<0.05). Conclusion Nurses’ health promotion lifestyle in tertiary comprehensive hospitals exhibit significant heterogeneity. It is recommended that nursing managers carry out individualized interventions based on the characteristics of nurses in different categories. Health behavior self-efficacy can be used as the core of intervention to improve nurses’ health promotion lifestyles.

    Enteral and Parenteral Nutrition
    Development and validation of a prediction model for enteral feeding intolerance in critically ill patients
    BU Lijing, CHENG Feier, ZHANG Aiqin, ZHAO Minyan, ZHANG Yidan
    2024, 59(15):  1877-1883.  DOI: 10.3761/j.issn.0254-1769.2024.15.012
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    Objective To explore the factors influencing enteral nutrition intolerance in critically ill patients and to develop a risk prediction model to provide medical staff with a tool for early identification of patient intolerance. Methods Domestic and international databases such as CNKI,PubMed and Web of Science were searched and supplemented by searching references and grey literature. The search period was from inception to November 2022. Data were independently screened and extracted by 2 systematically trained researchers,and the quality of the literature was evaluated. Meta-analysis was performed using Review Manager 5.4 software. The OR value of the comprehensive effect of the factors was taken as the coefficient of each factor in the formula,and the natural logarithm of the ratio of intolerance incidence and non-incidence was the constant term of the formula. From December 2022 to June 2023,360 patients who met the inclusion and exclusion criteria in the ICU of a tertiary hospital were collected as a model verification group by convenient sampling method,and the collected clinical data were substituted into the formula to evaluate the discrimination and calibration of the model. Results A total of 13 articles were included. 7 influencing factors with more than 3 times of reports and statistically significant results were obtained. For age[OR=0.97,95%CI(0.94,0.99),P=0.010],Acute Physiology and Chronic Health Evaluation score Ⅱ[OR=1.17,95%CI(1.01,1.36),P=0.040],comorbidity with diabetes[OR=1.21,95%CI(1.05,1.40),P=0.008],comor-bidity with neurological diseases[OR=0.85,95%CI(0.74,0.98),P=0.020],mechanical ventilation[OR=3.21,95%CI(1.82,5.66),P<0.001],using sedative analgesics[OR=2.27,95%CI(1.66,3.10),P<0.001],using gastric motility drugs[OR=0.23,95%CI(0.15,0.36),P<0.001]. The incidence of enteral nutrition intolerance was 35.00%. The risk prediction model for enteral nutrition intolerance in critically ill patients was logit(P)=-0.619-0.031×age+0.157×APACHE Ⅱ+0.191×comorbidity with diabetes-0.163×comorbidity with neurosurgery+0.820×using sedatives and analgesics+1.166×mechanical ventilation-1.470×using gastric dynamic drugs. The area under the receiver operating characteristic curve of the model was 0.864. The maximum Youden index was 0.589. The sensitivity was 0.922. The specificity was 0.667. The corresponding clinical diagnostic threshold was 0.536. Hosmer-Leme-show test χ2=13.410,P=0.098. Brier score was 0.195. Conclusion The risk prediction model of enteral nutrition intolerance in critically ill patients based on large sample evidence-based medicine is universal,scientific and practical. It provides a tool for medical staff to identify patients with enteral nutrition feeding intolerance in ICU.

    Management of home enteral tube feeding based on mobile health:a scoping review
    SHI Ming, LI Mengjie, FU Manyi, FANG Yuhui, TU Hangjia, ZHANG Shuyi, HE Guijuan
    2024, 59(15):  1884-1890.  DOI: 10.3761/j.issn.0254-1769.2024.15.013
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    Objective To conduct a scoping review of research on the application of mobile health(mHealth) in the management of home enteral tube feeding,so as to provide references for future research and clinical practice. Methods A literature search was performed in the PubMed,Cochrane Library,Embase,Web of Science,CINAHL,CNKI,Wanfang,and CMB databases to identify relevant studies. The search period spanned from the establishment of databases until February 18,2024. According to the scoping review framework,2 researchers independently screened the studies,extracted the data of the included studies,and collaborated on the final analysis. Results A total of 24 studies were included. 9 studies were conducted with interventions based on nursing models such as discharge planning model,“Hospital to Home” nutrition management model,guided care nursing model. The management forms included application,network communication software,and website. The content elements included education,assessment,consultation,referral,self-management,electronic health archive,appointment service,peer support. The outcome indicators included patients’ physical and mental health,self-management ability,caregiver competence,family burden and user assessment. Conclusion The mHealth has played a positive role in the management of home enteral tube feeding. In the future,it is recommended to establish a multidisciplinary team to conduct high-quality research and continuously improve the form and content of mHealth management.

    Intractable Intensive Care
    Nursing care of a patient with median arcuate ligament compression syndrome
    ZHU Huidi, ZHANG Meiyun, YAN Lili, JIANG Yuehong, XU Qiaoying
    2024, 59(15):  1891-1894.  DOI: 10.3761/j.issn.0254-1769.2024.15.014
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    To summarize the nursing experience of a patient with median arcuate ligament compression syndrome. Nursing points:to implement effective measures to relieve local compression and improve gastrointestinal symptoms;to establish a monitoring and evaluation plan focusing on abdominal pain to prevent serious adverse vascular events;to implement pre-rehabilitation care with psychological and nutritional support to reduce surgical risks;to actively provide postoperative gastroparesis care and discharge follow-up care. The patient was discharged from the hospital 22 days after surgery and was followed up for 6 months. His weight increased and his quality of life was high.

    Perioperative respiratory care in 27 severely obese patients with type A aortic dissection
    TAO Jian, LEI Liming, SONG Yamin
    2024, 59(15):  1895-1899.  DOI: 10.3761/j.issn.0254-1769.2024.15.015
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    To summarize the perioperative nursing of respiratory care in 27 severely obese patients with acute type A aortic dissection. The mainly nursing points are as follows:active intervention for obesity hypoventilation syndrome and obstructive sleep apnea syndrome were conducted preoperatively,and a transient increase in intrathoracic and abdominal pressure were avoided. Intraoperative emergency care coordination for difficult airway was enhanced,and intensive lung function protection measures were implemented. Postoperative postural management was optimized;lung diaphragm protective strategies were carried out;progressive invasive-non-invasive step-down therapy was conducted to enhance ventilator endurance;lung infection surveillance was strengthened;early rehabilitation and psychological counselling were implemented. After careful treatment and nursing care,26 cases were cured and discharged from the hospital,and a case with difficulty in extrication was transferred to the respiratory rehabilitation hospital under tracheotomy.

    Evidence Synthesis Research
    The experience of medical staff participating in remote home palliative care:a qualitative Meta-synthesis
    XU Yanan, YUAN Ling, WU Ligui, LIU Yahui, KANG Yubiao
    2024, 59(15):  1900-1907.  DOI: 10.3761/j.issn.0254-1769.2024.15.016
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    Objective To systematically integrate the experience of medical staff participating in remote home palliative care,and to provide a reference for further promoting the development of remote home palliative care and improving the service quality in China. Methods PubMed,Web of Science,CINAHL,Cochrane Library,Embase,CNKI,Wanfang Database,VIP Database,and Chinese Biomedical Literature Database were searched to collect qualitative studies on the experience of medical staff participating in remote home palliative care,and the search time was from inception to November 2023. The quality of the included literature was evaluated according to the 2016 edition of the Qualitative Research Quality Evaluation Criteria of the Joanna Briggs Institute for Evidence-Based Health Care in Australia,and the results were summarized by meta-synthesis method. Results A total of 11 studies were included,and 40 research results were extracted,and 11 categories were formed,which were summarized into 3 integrated results. ①Medical staff perceived the benefits of participating in remote home palliative care:improving the efficiency of medical services,breaking through the limitations of time and space,enhancing job satisfaction,and improving the continuity of palliative care. ②Medical staff recognized the challenges of participating in remote home palliative care:poor stability of remote working environment,complex equipment operation,insufficient theoretical knowledge and professional skills,inability to meet the special care needs of patients,and difficulty in defining service time. ③Medical staff believe that remote home palliative care services need to be improved:pay attention to the importance of family participation,use remote palliative care as an auxiliary method,and pay attention to establishing a doctor-patient trust relationship. Conclusion There are many benefits and challenges for medical staff to participate in remote home palliative care,and hospital managers should provide multi-faceted support for medical staff,strengthen the construction of remote home palliative care team,establish an online and offline linkage mechanism,and continuously improve the quality of remote home palliative care in China.

    The effects of music therapy on patients with post-stroke aphasia:a Meta-analysis
    YANG Linghong, JIA Ruiying, WEI Hui, LIU Miaomiao, GAO Yangqin, YANG Hongyan
    2024, 59(15):  1908-1917.  DOI: 10.3761/j.issn.0254-1769.2024.15.017
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    Objective To investigate the effectiveness of music therapy on patients with post-stroke aphasia. Methods Randomized controlled trials of music therapy for patients with post-stroke aphasia were systematically searched from 9 databases,such as CNKI,WanFang,PubMed,etc. The search time was from the inception of databases to July 2023. The literature was screened and extracted by 2 researchers according to the inclusion criteria,and the quality of the literature was assessed using Cochrane Manual 5.1.0. Revman 5.3 software was used for meta-analysis. Results We selected 22 studies comprising 827 participants comparing with control conditions. The meta-analysis demonstrated that music therapy significantly improved spontaneous speech[SMD=0.60,95%CI(0.40~0.80),P<0.01],listening comprehension[SMD=0.49,95%CI(0.32~0.67),P<0.01],repetition[SMD=0.77,95%CI(0.60~0.94),P<0.01],naming[SMD=0.54,95%CI(0.29~0.78),P<0.01],communication ability[SMD=0.40,95%CI(0.02~0.78),P<0.01],depression[SMD=-0.75,95%CI(-1.10~-0.40),P<0.01],but had no significant effect on the severity of aphasia[SMD=0.82,95%CI(-0.26,1.90),P=0.14]. Conclusion Music therapy significantly improved language expres-sion and understanding ability,but there was no clear evidence for the improvement of aphasia severity.

    Review
    Research progress of risk communication in cardiovascular disease
    WANG Xuyang, GUO Zhiting, ZHANG Yuping, JIN Jingfen
    2024, 59(15):  1916-1920.  DOI: 10.3761/j.issn.0254-1769.2024.15.018
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