Table of Content

15 September 2019, Volume 54 Issue 9

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Research Paper

Construction of the evaluation system for the effects of standardized training of new nurses

JIAO Jing, XU Kepei, YING Qiaoyan, LI Zhenghong, WANG Wei, WU Xinjuan

2019, 54(9):  1285-1290.  DOI: 10.3761/j.issn.0254-1769.2019.09.001

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Objective To construct the evaluation system for standardized training effects of new nurses based on Koch’s four-level evaluation model.Methods Through literature review,expert interviews,the index items and evaluation time points and methods of each dimension of the evaluation system were preliminarily established. Two rounds of consultation were conducted among 18 experts in nursing management,clinical nursing teaching management and college nursing education by Delphi method.Results In this study,the evaluation system included four first-level indicators：response level,learning level,behavior level and result level. There were 16 second-level indicators and 48 third-level indicators.Conclusion The degree of coordination and consensus of experts was high. The evaluation system of standardized training effect for new nurses is scientific and reliable. It can provide scientific basis for hospital nursing managers to evaluate the training effect of new nurses and improve the training program.

Establishment of evaluation index system for quality of parenteral nutrition nursing for hospitalized patients

ZHAN Yuxin, LI Suyun, YANG Zhongshan, YU Jiaohua, YUE Gefen, OUYANG Yan, SHI Wenjia, MI Yuanyuan

2019, 54(9):  1291-1296.  DOI: 10.3761/j.issn.0254-1769.2019.09.002

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Objective To establish an evaluation index system for quality of parenteral nutrition nursing for hospitalized patients,to ensure the safe implementation of parenteral nutrition and promote health of patients.Methods Databases were systematically searched including Chinese Guideline Network,Up To Date,ASPEN,ESPEN,JBI,etc. All studies were screened and evaluated strictly. The initial questionnaire was developed combining the best evidence,and clinical data analysis of our hospital in the past two years. Two rounds of Delphi survey were conducted among 30 experts to determine the content and importance of each indicator. Analytic hierarchy process was used to determine the weight of each indicator.Results Nine studies were included,including 2 clinical decisions,1 evidence summary,2 guidelines and 4 expert consensuses. After two rounds of expert consultation,rates of parenteral nutrition criteria implementation focusing on process quality were determined：4 first-level indicators including rate of nutritional risk nursing assessment implementation,rate of parenteral nutrition assessment implementation,rate of parenteral nutrition solution preparation criterion implementation,and rate of parenteral nutrition infusion nursing criterion implementation,and 17 second-level indicators.Conclusion The evaluation index system of patient on parenteral nutrition is scientific,practical and operational,and can effectively guide nurses’ correct behavior and evaluate quality of parenteral nutrition nursing.

Correlation between blood glucose instability index and postoperative complications in patients with stress hyperglycemia after coronary artery bypass grafting

LING Qing, CHEN Yuhong

2019, 54(9):  1297-1301.  DOI: 10.3761/j.issn.0254-1769.2019.09.003

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Objective To select better glucose fluctuation parameters to evaluate the fluctuation of blood glucose in patients with stress hyperglycemia after coronary artery bypass graft（CABG）,in order to detect and intervene early and improve nursing quality.Methods The clinical data of 200 patients with stress hyperglycemia who underwent CABG in a tertiary hospital from January 2017 to October 2018 were collected. Peripheral blood glucose was measured within 72 hours after surgery,once every 4 hours. Differences in complication rates under different baseline characteristics were compared,the correlation between different blood glucose fluctuation parameters and postoperative complications was compared,and glycemic instability index（GLI） for predictive value of the risk of complications after coronary artery bypass grafting was determined using the receiver operating characteristic curve.Results GLI₁,GLI₂ and GLI_3d in patients with stress hyperglycemia after CABG were significantly associated with postoperative single complications and risk of complications（P<0.05）. GLI₁,GLI₂ and GLI_3d all predicted postoperative complications,and GLI₁ had the best predictive effect.Conclusion GLI₁,GLI₂ and GLI_3d are better evaluation parameters of blood glucose fluctuation in patients with stress hyperglycemia after CABG,which can predict the risk of postoperative complications to some extent. In particular,GLI₁ can prompt early intervention in blood glucose fluctuation,to reduce the occurrence of complications.

Special Planning--Perioperative Nursing

Evidence-based practice of prevention and management of inadvertent perioperative hypothermia

XIAO Yao, YANG Hui, HU Juanjuan, YU Wenjing, GAO Xinglian

2019, 54(9):  1302-1307.  DOI: 10.3761/j.issn.0254-1769.2019.09.004

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Objective To apply the best evidence for prevention of inadvertent perioperative hypothermia（IPH）and to evaluate its clinical effects.Methods Following steps of practical application of clinical evidence system developed by Joanna Briggs Institute,based on best evidence obtained from previous studies,we constructed audit indicators and then performed clinical audits. We analyzed obstacles and facilitators and formulated strategies. Awareness of nurses towards prevention and management of IPH,incidence of IPH among patients,implementation of audit indicators among nurses were compared before and after application.Results Before and after application of the best evidence,operating room nurses’ score for knowledge on prevention and management of IPH was 10~100（40.03±13.55） and 65~100（85.23±8.25）,and the difference was statistically significant（P<0.01）. The incidence of IPH among patients were 47.83% and 16.67%,and the difference was statistically significant（P<0.01）. Before application,implementation rate of audit indicator No. 17 was 98.55%,No. 16 was 76.81%,and the rest were under 50%. After application,implementation rates of audit indicators No.1 to No.9,No.11 to No.15,and No.18 were significantly improved（P<0.01）.Conclusion Evidence-based practice of IPH prevention can regulate behaviors of nurses,improve nurses’ compliance,and reduce the incidence of IPH.

Establishment and validation of a risk prediction model for intraoperative hypothermia in patients undergoing laparoscopic surgery

PU Ying, ZHANG Ying, TANG Jiajun, BEN Yang, TONG Yueli, FANG Fang

2019, 54(9):  1308-1312.  DOI: 10.3761/j.issn.0254-1769.2019.09.005

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Objective To construct a predictive model to assess the risk of intraoperative hypothermia during laparoscopic surgery,and to provide technical support for screening patients with high risk of intraoperative hypothermia during laparoscopic surgery.Methods A total of 264 patients were enrolled from January 2016 to December 2017,and risk factors between hypothermia group（116 cases） and non-hypothermia group（148 cases） were compared using logistic regression for model construction. The goodness of fit of the model was verified by Hosmer-Lemeshow test. The predictive validity of the model was evaluated by the area under the ROC curve（AUC）. From January to December 2018,132 patients were recruited for application of the model.Results The incidence of hypothermia in this study was 43.93%（116/264）,and 41.66%（55/132）. The factors that ultimately entered the predictive model were basal body temperature（OR=0.296）,type of surgery（OR=1.457）,room temperature（OR=0.521）,and anesthesia time（OR=1.009）. H-L test P=0.123,the area under the ROC curve（AUC） was 0.791,while the Youden index was 0.867,with sensitivity as 0.60 and specificity as 0.867. The accuracy of the model was 79.54%,indicating the fit and predictive validity of the model were good.Conclusion The predictive model constructed in this study can predict the risk of intraoperative hypothermia in patients undergoing laparoscopic surgery,and thus can provide a reference for clinical screening of high-risk patients.

Formulation and application of recreational exercise program in perioperative period for lung cancer patients

MA Xiaoran, DONG Gaoyue, MENG Aifeng, WANG Meixiang, ZHI Xiaoxu, SHAO Yan, QIAN Donglan, CHEN Tao, LIU Lagen

2019, 54(9):  1313-1317.  DOI: 10.3761/j.issn.0254-1769.2019.09.006

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Objective In order to enable patients to participate in exercise actively and optimistically,promote the recovery of the patients.Methods A rehabilitation program integrating exercise and entertainment was designed and implemented in stages,including preoperative recreational exercise,early post-operative recreational exercise,and recreational exercise within 2 weeks after discharge.ResultsAmong 30 lung cancer patients in this group,no exercise related severe adverse event occurred. The rates of reaching recreational exercise standards before operation,after operation and after discharge were 93.3%（28 cases）,83.3%（25 cases） and 80.0%（23 cases）,respectively,and patients showed good adherence. The postoperative complication rate was 6.67%（2 cases） and the average length of hospital stay was 4~10（5.73±1.66） d.Conclusion Recreation exercise program is good to the recovery of the patients.

Application of nursing project management on reducing postoperative complications of stereotactic EEG surgery for epilepsy patients

ZHANG Wenjie, SHI Yanwei, WANG Huijuan, LI Jiping, ZHANG Guojun

2019, 54(9):  1318-1323.  DOI: 10.3761/j.issn.0254-1769.2019.09.007

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Objective To explore the application of nursing project management on reducing complications after stereotactic electroencephalographic surgery.Methods Since February 2017,our institute started to implement the nursing project management together with routine nursing,through analyzing nature and reasons of complications as well as providing improvement measures. A total of 100 epilepsy patients who underwent stereotactic electroencephalographic surgery in Beijing Institute of Functional Neurosurgery from January 2015 to January 2017 were assigned into the control group,and they were given routine nursing care; after the implementation of nursing project management,from February 2017 to January 2019,158 epilepsy patients who underwent stereotactic electroencephalographic surgery were assigned into the intervention group. The incidence of complications between two groups was compared.Results There was no significant difference in the incidence of surgery-related complications between two groups（P>0.05）,but the incidence of nursing-related complications in the intervention group was significantly reduced（P<0.05）.Conclusion Nursing project management can reduce the occurrence of nursing-related complications of stereotactic electroencephalographic surgery.

Standards

Expert consensus on venous catheter maintenance

Intravenous Therapy Committee of Chinese Nursing Association , Writing Committee：SUN Hong , CHEN Lifen, GUO Caixia, YANG Qiaofang, LI Xuying, ZHAO Gaiting, MEI Ganhong, CHEN Ying, XING Hong, FENG Bilong, WANG Lei

2019, 54(9):  1334-1342.  DOI: 10.3761/j.issn.0254-1769.2019.09.011

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Objective To standardize the maintenance of clinical venous catheter,so as to reduce the catheter related complications,prolong the service life of catheter and reduce medical cost.Methods The consensus was formed through literature searching,interview with key stakeholders,and repeated expert discussion meetings.Results The consensus summarized the latest evidence in six chapters covering all aspects of catheter maintenance,such as flushing and locking tube,dressing replacement and catheter maintenance,infusion joint,catheter removal,education and training,and infection control.Conclusion Items in this consensus are concise and easy to implement,and the new content can supplement and perfect the existing norms and standards to a certain extent,which is helpful to solve clinical problems and guide clinical practice.

Specialist Practice and Research

The intervention effects of fracture liaison service in elderly patients with hip fragility fractures

LIU Chunxiang, CHENG Chuanfang, ZHAO Chen, ZHAI Jieting, LIU Chunlan, DUAN Gongxiang

2019, 54(9):  1343-1348.  DOI: 10.3761/j.issn.0254-1769.2019.09.012

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Objective To explore the intervention effects of fracture liaison service in elderly patients with hip fragility fractures.Methods Totally 106 patients with hip fragility fractures were selected in a tertiary hospital from March to July 2018. The patients were numbered according to the admission order. The odd-numbered digital grasping method was used to determine that patients with the odd numbers were included in the experimental group（n=53）,and those with even numbers were included in the control group（n=53）. The experimental group was given fracture liaison service on the basis of routine nursing and the control group was given routine nursing. The degree of frailty（Elderly Frailty Assessment Scale）,osteoporosis diagnosis rate and secondary fracture incidence were compared between two groups.Results After 3 months of intervention,the scores of physiological and psychological frailty dimensions in the experimental group were lower than those in the control group. After 6 months of intervention,the scores of physiological,psychological,cognitive dimensions and frailty total score in the experimental group were lower than those in the control group,and the differences were statistically significant（P<0.05）. Repeated measurement analysis of variance results showed that the inter-group effect,time effect and interaction between the two groups of physiological,cognitive dimension score and frailty total score were statistically significant（P<0.05）. After 3 months and 6 months of intervention,the diagnosis rate of osteoporosis in the experimental group was higher than that in the control group,and the difference was statistically significant（P<0.05）. There was no significant difference in the incidence of secondary fracture between two groups during different intervention periods（P>0.05）.Conclusion Fracture liaison service can reduce the degree of frailty in elderly patients with hip fragility fractures,and improve the patients’ osteoporosis diagnosis rate.

Investigation and analysis of factors related to hyperglycemia in ICU patients undergoing enteral nutrition

ZHANG Shan, PANG Xufeng, WAN Xiangyu, LIN Hui, WANG Fengtao

2019, 54(9):  1349-1353.  DOI: 10.3761/j.issn.0254-1769.2019.09.013

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Objective To investigate the status of hyperglycemia during enteral nutrition therapy in non-diabetic ICU patients and explore the related risk factors.Methods Relevant information of 176 non-diabetic patients who received enteral nutrition from January 2018 to September 2018 in two ICUs of a tertiary hospital in Qingdao was retrospectively analyzed adopting case control study design.Results Thirty-seven patients developed hyperglycemia,and the incidence was 21.02%. Patients with and without hyperglycemia were statistically different in age（OR= 1.12）,APACHE Ⅱ score（OR=1.41）,nasal feeding speed（OR=1.15）,the type of nutrient solution（OR=0.45）,parenteral nutrition（OR=3.01）,antibiotics（OR=1.77）,mechanical ventilation（OR=7.16）,surgery（OR=43.99）,and feeding pathway（OR=6.11）.Conclusion Age,higher APACHE Ⅱ score,increased nasal feeding speed,short peptide and haplotype enteral nutrient solution,parenteral nutrition,mechanical ventilation,surgery,application of nasointestinal tube are risk factors of hyperglycemia during enteral nutrition therapy in non-diabetic ICU patients.

Effect of family function and pregnancy life events on second child pregnant women in their third trimesters

XIAO Meili, LIU Dan, YANG Dongqi, YAN Chunli, LEI Jun

2019, 54(9):  1354-1358.  DOI: 10.3761/j.issn.0254-1769.2019.09.014

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Objective To investigate the level of the antenatal depressive symptoms and its relationship with family function and pregnancy life events among second child pregnant women in their third trimesters.Methods From July to October 2018,306 pregnant women with “second child” in late pregnancy who underwent regular obstetric examination in the obstetric clinic of a tertiary hospital in Changsha were selected as the subjects of study and investigated with Chinese version of Edinburgh Postpartum Depression Scale,Family APGAR Index,Life Events Scale for Pregnant Woman.Results The prevalence of antenatal depressive symptoms among second child pregnant women was 36.3%,severe depressive symptoms was 7.5%. The total scores of live events,subjective events and objective events of OE2 and OE3 were significantly and positively correlated with EPDS（P<0.05）. The total scores and dimension scores of family function were significantly and negatively correlated with EPDS（P<0.01）. Regression analysis indicated that lower education level,pregnancy complications,family intimacy,subjective events and objective events of OE3 were influencing factors of antenatal depressive symptoms.Conclusion The prevalence of antenatal depressive symptoms among second child pregnant women in their third trimesters is common,especially the women with lower education level,having pregnancy complications,poor family intimacy and occurring severe pregnancy life events are prone to suffer depressive symptoms. Therefore,health care worker should take effective measures to decrease the occurrence of antenatal depressive symptoms.

Women’s experiences of termination of pregnancy for a fetal anomaly during the postpartum period：a qualitative study

ZHOU Xiaoli, YANG Mengye, QIAN Jialu, SUN Shiwen, WU Mengwei, XIAO Yunxia, YU Xiaoyan

2019, 54(9):  1359-1363.  DOI: 10.3761/j.issn.0254-1769.2019.09.015

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Objective To explore the real experiences of pregnant women underwent termination of pregnancy due to fetal anomaly during the postpartum period,in order to provide reference and develop targeted interventions to improve women’s mental state.Methods Using phenomenological method,combined with the General Anxiety Scale（GAS） Generalized Anxiety Disorder Scale and the Patient Health Questionnaire,13 abnormal fetal induced labor women who visited the postpartum clinic of a maternity hospital in Hangzhou from June to September 2018 were selected as subjects. After 42 days of induced labor,participants were interviewed and assessed with the Psychological Scale. The interview content was analyzed by Colaizzi’s 7-step method.Results Four themes emerged as the psychological experience of women with abnormal induced abortion during postpartum period：①Women suffered from varying levels of anxiety and depression during postpartum period;②Coexisting of negative and positive experiences;③ Multiple factors aggravating negative experiences during postpartum period;④ Obviously insufficient social support for women during postpartum period.Conclusion Psychological experience of women underwent termination of pregnancy due to fetal anomaly during the postpartum period is not optimistic,which should attract attention of hospitals,communities and families.

Self-perception of patients receiving glucocorticoid maintenance therapy：a qualitative study

CHEN Rumeng, FU Rong, XU Renju

2019, 54(9):  1364-1368.  DOI: 10.3761/j.issn.0254-1769.2019.09.016

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Objective To understand the real experience of patients with systemic lupus erythematosus（SLE） receiving glucocorticoid maintenance therapy.Methods Sixteen patients with systemic lupus erythematosus receiving glucocorticoid maintenance therapy were interviewed using semi-structured interview and data were analyzed by Colaizzi’s seven-step method.Results Four themes were extracted：theme 1：insufficient knowledge of patients on glucocorticoids;theme 2：reduced subjective well-being of patients;theme 3：increased self-perceived burden of patients;and theme 4：patients’ self-identification and acceptance. theme 2 included four sub-themes：self-realization constraints,marital and reproductive crisis,image disorders,lifestyle changes;and theme 3 included three sub-themes：increased negative emotions,increased economic burden,and insufficient social support.Conclusion SLE patients treated with long-term glucocorticoid maintenance therapy have multiple burdens and demands in physical,psychological and social aspects. Nursing staff should pay more attention to these patients,timely and targeted counseling intervention should be conducted to improve patients’ self-perception during maintenance treatment.

Investigation of iatrogenic skin injury in infants in neonatal intensive care unit

YANG Tongling, HU Xiaojing, Lü Tianchan

2019, 54(9):  1369-1372.  DOI: 10.3761/j.issn.0254-1769.2019.09.017

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Objective To investigate the status of iatrogenic skin injury in infants in neonatal intensive care unit（NICU） and analyze its related factors.Methods From July 1st,2017,to December 31st,2017,a self-designed questionnaire was used to collect incidence and distribution of iatrogenic skin injury in 384 infants in NICU from a tertiary hospital,and related factors were analyzed.Results The incidence of iatrogenic skin injury in infants was 15.1%. The causes of iatrogenic skin injury in infants included peeling of adhesive tape,continuous positive airway pressure,nasal skin pressure by tracheal intubation,skin pressure by percutaneous oxygen saturation probe,and diaper dermatitis. Multivariate logistic regression analysis showed that the independent risk factors of NICU infants’ iatrogenic skin injury were days of hospitalization and birth weight（P<0.05）.Conclusion The incidence of iatrogenic skin injury in infants is high. Infants with less birth weight,less gestational weeks,and longer length of hospitalization,are more likely to develop iatrogenic skin injury.

Nursing Management

Current status of targeted temperature management for cardiac arrest patients：a survey of nurses in Beijing

MA Li, DU Lanfang, MA Qingbian, GE Baolan, CUI Man

2019, 54(9):  1373-1377.  DOI: 10.3761/j.issn.0254-1769.2019.09.018

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Objective To investigate the current status of targeted temperature management （TTM） for patients following cardiac arrest（CA） among nurses in Beijing.Methods Using convenience sampling method,791 emergency department and ICU nurses from 22 hospitals in Beijing were investigated from September to December 2017. Self-designed questionnaire was used to collection data on general characteristics of nurses and their cognition and practice of TTM for cardiac arrest patients.Results Totally 791 nurses completed the survey（87.9%）. Among these nurses,87.1% did not know the concept of TTM,84.8% did not know the concept of Therapeutic Hypothermia（TH）. Only 6.4% of the nurses stated that TTM would be conducted in cardiac arrest patients. Only 4 of 32 departments,5.7% of the nurses had implemented TH for cardiac arrest patients. Main reasons for no implementation of TH were absence of TH in department and lack of relevant knowledge. For those had performed TTM,TH was reported to be conducted with using cold intravenous fluid infusion and ice bag,ice cap,and ice blanket more frequently,whereas external advanced surface cooling gel pads and intravascular cooling were rarely used.Conclusion Very few nurses know the TTM concept and only a small number have implemented TTM. The knowledge and practice of TTM among nurses in Beijing are insufficient and needed to be further improved.

The development and psychometric test of Geriatric Nursing Competence Scale for Clinical Nurses

WEI Lin, LIANG Hao, LU Yongmei, MO Miaomiao, ZHANG Xiaopei, CAI Min

2019, 54(9):  1378-1384.  DOI: 10.3761/j.issn.0254-1769.2019.09.019

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Objective To develop a scale for measuring geriatric nursing competence of Chinese clinical nurses and to test its reliability and validity.Methods Based on TEMA model of geriatric care competence,through literature analysis and Delphi method combined with small sample pilot test,the geriatric nursing competence scale for clinical nurses was preliminarily developed. A total of 500 nurses were recruited for pilot investigation to screen items,and 1,567 nurses were selected for formal investigation to test the reliability and validity.Results The Geriatric Nursing Competence Scale for Clinical Nurses consisted of 3 first-level items,10 second-level items,and 43 third-level items. Exploratory factor analysis extracted three factors that explained 66.828% of the total variance. The Cronbach’s alpha coefficient,the split-half reliability coefficient,the test-retest coefficient and the content validity index were 0.978,0.902,0.802 and 0.980,respectively. Confirmatory factor analysis showed the scale had good construct validity.Conclusion The Geriatric Nursing Competence Scale for Clinical Nurses has good validity and reliability. It can be used as a tool to measure geriatric nursing competence in Chinese clinical nurses.

Community Care

A study on classification model of elderly care services

XIAO Wenwen, YIN Li, XIE Hong

2019, 54(9):  1385-1389.  DOI: 10.3761/j.issn.0254-1769.2019.09.020

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Objective To explore classification model of care services for the aged,based on measurement of length of care and analysis of its influencing factors.Methods Using convenience sampling method,187 elderly people in a pension institution in Tianjin were surveyed in May 2018,including capacity assessment of the elderly,care services and their frequency.Results The ability of daily living,mental state,perception and communication of the aged were influencing factors of the length of care. On the basis of these four factors,the elderly care services were divided into six levels by decision tree model analysis,which explained 77.87% of this model.Conclusion Based on the assessment results of the elderly’s ability,care services for the elderly is divided into six levels with significant differences by measurement of length of care. The classification of service level will provide the basis for the classification of the elderly care services in different modes,and it is also the basis for reasonable pricing and resource allocation of elderly care services.

Vascular Access Nursing

Effect of different exercise modes on preventing catheter related thrombosis in cancer patients with peripherally inserted central catheter

ZHANG Ying, LI Aimin, GUAN Chenyang, SUN Qiaozhi, LIU Yanjin, ZHANG Shumin, LIU Qian, HOU Xiaojing

2019, 54(9):  1390-1393.  DOI: 10.3761/j.issn.0254-1769.2019.09.021

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Objective To investigate the effect of different exercise modes （handgrip exercise,grip functional exercise,finger exercise） on preventing catheter related thrombosis（CRT） after the PICC placement in cancer patients.Methods The cancer patients with PICC in our tumor ward from November 2015 to December 2016 were divided into three groups-the handgrip exercise group,the grip functional exercise group,the finger exercise group. The incidence and severity of CRT were observed and compared among the three groups within three months after catheterization.Results Within three months after catheterization,the incidence of CRT in the three groups was 31.44%,21.28%,12.05%,respectively. The total incidence and the incidence in first week after PICC catheterization of CRT in three groups were statistically significant（ χ ²=15.357,P<0.001; χ ²=7.700,P=0.021）. The incidence and severity of CRT in finger exercise group was lower than the other two groups.Conclusion Finger exercise in cancer patients with PICC catheterization can reduce the incidence and ease the severity of CRT. The finger exercise method is simple and easy to implement without increasing costs,and patients are willing to accept it.

Evidence Synthesis Research

A meta-analysis of the effects of dual-task and single-task training on improvement of gait and balance in the elderly

ZHANG Huixin, CHEN Jianxin, ZHANG Ruili, LI Huijuan, WU Jingmei

2019, 54(9):  1400-1405.  DOI: 10.3761/j.issn.0254-1769.2019.09.024

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Objective To compare the effects of dual-task training and single-task training on gait and balance performance in healthy older adults.Methods Electronic databases including Cochrane Library,Medline,EMBASE,Web of Science,PubMed,Ovid,CINAHL（EBSCO） and China National Knowledge Internet were searched. Randomized controlled trails that assess the effects of dual-task training and single-task training in healthy older adults were included. Meta-analysis was conducted using Revman 5.3.Results Totally 18 studies with a population of 775 were reviewed and pooled for meta-analysis. Dual-task training was superior to single-task training in improving gait speed and step length（P<0.05）,the effects of dual-task training and single-task training were equal in the improvement of balance performance（P>0.05）.Conclusion Compared with the traditional single-task training,the dual-task training can better improve the gait speed and step length of the elderly. The effects of dual-task training on the balance performance needs further discussion.

Evidence summary for nutritional risk screening and assessment in patients with pulmonary tuberculosis

FANG Xuee, MAO Yanjun, TANG Lingling, CAI Liping, LI Yuru, JIANG Hua, SU Limin, ZHU Difei, FAN Lin, CHEN Wei

2019, 54(9):  1406-1409.  DOI: 10.3761/j.issn.0254-1769.2019.09.025

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Obiective To select and obtain the best evidence of nutritional risk screening and assessment for hospitalized tuberculosis patients,and summarize the best available evidence. Methods We searched the Cochrane Library,PubMed,Embase,CINAHL,CBM,Wanfang,CNKI,VIP databases,and complementally searched the Medlive website,the Medsci website,European Society of Enteral Parenteral Nutrition,American Society of Enteral Parenteral Nutrition,American Society of Dietitians,Chinese Society of Enteral Parenteral Nutrition and Chinese Nutritionist Network from inception to February 1,2019,to collect relevant evidence for screening and assessment of nutritional risk in tuberculosis patients,including guidelines,expert consensus,evidence summaries,systematic reviews and diagnostic studies. Results Totally 8 articles were selected,including 3 guidelines,1 systematic review,and 4 diagnostic studies. Finally,7 items of best evidences were summarized. Conclusion Clinically,doctors and nurses should select appropriate nutritional risk screening tools and nutritional assessment indicators for tuberculosis patients in contact with them.When applying evidence,it is necessary to select evidence according to hospital characteristics and clinical environment,and establish nutritional risk screening and assessment system,work flow and practice standards for tuberculosis patients.

Overseas Knowledge

Translation,revision and assessment of reliability and validity of the Quality of Oncology Nursing Care Scale

LI Yingying, WEI Wanhong, HU Yanli, YAO Ying, SONG Xiaoqi, LI Ying

2019, 54(9):  1436-1440.  DOI: 10.3761/j.issn.0254-1769.2019.09.033

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Objective To translate and revise the Quality of Oncology Nursing Care Scale（QONCS） into Chinese,then to assess the reliability and validity of the Chinese version of the Quality of Oncology Nursing Care Scale（C-QONCS）.Methods Standard forward-back translation techniques were used in the translation of the QONCS according to the Brislin translation model. Cross-cultural revision of the translated QONCS was carried out through group discussion and pilot test. Totally 612 patients with advanced cancer were recruited and investigated using general information questionnaire and the C-QONCS by convenient sampling,and its reliability and validity were assessed.Results The C-QONCS had 5 dimensions：being supported and confirmed（16 items）,spiritual caring（6 items）,sense of belonging（5 items）,being valued（4 items）,being respected（3 items）. The Cronbach’s a coefficient for the overall scale was 0.946,and ranging from 0.735 to 0.928 for each domain. Split-half reliability was 0.879 for the overall scale,and 0.683~0.864 for each domain. Test-retest reliability was 0.867 for the overall scale,and 0.837~0.889 for each domain. Analysis of content validity of the C-QONCS indicated that I-CVl was at least 0.86,S-CVl was 0.97.Conclusion The reliability and validity of C-QONCS are satisfactory and well meet the requirements of psychological measurement,indicating C-QONCS is a reliable and valid instrument in the context of Chinese culture,and can be used to assess the quality of oncology nursing care.