Table of Content

15 November 2019, Volume 54 Issue 11

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Research Paper

The effects of high-intensity interval training on glucose and lipid metabolism index in patients with type 2 diabetes

WANG Yajing, ZHANG Chao, Lü Shaoping, LI Binghui, YAO Minxiu, YAN Huimin, WU Yingyu, YAO Liping

2019, 54(11):  1605-1609.  DOI: 10.3761/j.issn.0254-1769.2019.11.001

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Objective To evaluate the effects of high-intensity interval training on patients with type 2 diabetes in comparison of moderate-intensity continuous training.Methods Seventy patients with type 2 diabetes in a tertiary hospital from June to November 2018 were selected,and were randomly divided into the high-intensity interval training group and the moderate-intensity continuous training group with 35 cases in each group. The high-intensity interval training group used the method of alternating 1-min high-intensity training（70%~90% maximum heart rate） and 1-min low-intensity training,the time were increased step by step within the range of 10~30 min/d.The other group used moderate-intensity continuous training（50%~70% maximum heart rate）,each time continued to 20~30 min,accumulated 50 min/d. Each group performed 3 days per week and insisted on 12 weeks. After 12 weeks,the index changes of 2 groups of patients before and after intervention were compared,including fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,body mass index,exercise self-efficacy and compliance.Results After the intervention,the index of glucolipid metabolism was better than that before intervention in both group,and the difference was statistically significant（P<0.05）. The 2 h postprandial blood glucose,glycosylated hemoglobin,body mass index,exercise self-efficacy and compliance of the high-intensity interval training group were better than those of the moderate-intensity continuous training group,and the differences were statistically significant（P<0.05）.Conclusion High-intensity interval training and moderate-intensity continuous training can effectively change the level of blood glucose and lipid in patients with type 2 diabetes,but high-intensity interval training is better to improve the level of 2 h postprandial blood glucose,glycosylated hemoglobin,body mass index,exercise self-efficacy and compliance of patients than moderate-intensity continuous training.

Application and effect evaluation of marital self-disclosure intervention on the fear of cancer recurrence in young breast cancer patients

ZHANG Xianxian, ZHANG Lixia, JIA Zhihui, CHENG Yuanzun

2019, 54(11):  1610-1614.  DOI: 10.3761/j.issn.0254-1769.2019.11.002

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Objective To explore the effect of marital self-disclosure intervention on the fear of cancer recurrence in young breast cancer patients.Methods From March 2018 to January 2019,totally 62 young breast cancer patients were assigned into the experimental group and the control group with 31 cases in each group from a tertiary hospital in Zhengzhou. The experimental group was given self-disclosure intervention,and the control group was applied with conventional nursing. Before and 12 weeks after intervention,general information questionnaire,Fear of Progression Questionnaire-Short Form and Distress Disclosure Index Scale were used for evaluation.Results Ultimately,one patient in the experimental group withdrew,there were 30 patients in the experimental group and 31 patients in the control group. Before intervention,there was no significant difference in general data,self-disclosure and fear of cancer recurrence between the two groups（P>0.05）. After 12 weeks of intervention,the self-disclosure score of the experimental group was higher than that of the control group（P<0.05）,and the score of fear of cancer recurrence were lower than that of the control group（P<0.05）.Conclusion Marital self-disclosure intervention can effectively improve the self-disclosure level of young breast cancer patients and reduce their fear of cancer recurrence.

Construction and application of early activity management scheme for elderly patients with hip fracture

ZHANG Yan, WANG Tingting, CHE Lu, MA Yuan, WANG Shuang, GUO Yifeng, YANG Qiuling, XING Ying, ZHANG Hui, LIU Jing, GAO Na

2019, 54(11):  1615-1620.  DOI: 10.3761/j.issn.0254-1769.2019.11.003

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Objective To explore and evaluate the effects of the management scheme of early activity for elderly patients with hip fracture.Methods Based on the postoperative activity model of the Affiliated Hospital of Southampton University of England,combined with the thoughts and practice of our hospital’s clinical nursing procedure,the early activity management scheme for elderly patients with hip fracture was formed. Totally 248 elderly patients with hip fracture treated in our hospital from January 1st,2017,to December 31st,2018,were selected as the experimental group,receiving early activity management scheme. 214 patients from January 1st,2014,to December 31st,2016,were selected as the control group,receiving routine nursing scheme. The differences in the first ambulation time,the longest walking distance 3 days after surgery,length of hospitalization,activity of daily living ability,and quality of life between two groups were compared.Results The first time of ambulation was （1.84±0.73） days in the experimental group and（5.23±2.17） days in the control group;the longest distance of walking in the experimental group was（82.55±23.12） m on the 3rd day after surgery,and that in the control group was（29.41±10.97） m;the length of hospitalization in the experimental group was（9.27±1.71） days,and that in the control group was（11.39±2.53） days,and there was significant difference between the two groups（P<0.05）. The scores of activity of daily living at discharge in the experimental group and quality of life 3 months after discharge were higher than those in the control group（P<0.05）.Conclusion The early activity management scheme for elderly patients with hip fracture is helpful for early ambulation,to shorten length of hospitalization and improve quality of life.

Special Planning — Pediatric Nursing

The study of novel food intaking scheme in perioperative pediatric patients the guidance of enhanced recovery after surgery concept

SHAN Xiaomin, JIANG Weihong, ZHU Jihua, FANG Xuelian

2019, 54(11):  1621-1625.  DOI: 10.3761/j.issn.0254-1769.2019.11.004

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Objective To study the feasibility and safety of shortening preoperative fasting time and early postoperative food intaking time under the guidance of Enhanced Recovery After Surgery（ERAS） concept in perioperative pediatric patients.Methods Pediatric patients undergoing elective surgery in urology department of a tertiary hospital in Zhejiang Province from November 15,2018,to March 15,2019,were selected and divided into the experimental group and the control group according to the time,in the experimental group,200 patients were treated with an individual diet plan according to the operation time;in the control group,200 patients were treated with traditional preoperative fasting methods. The actual preoperative fasting time and postoperative feeding time were compared between two groups,the clinical manifestation of thirst,hunger,crying,aspiration,postoperative nausea and vomiting,abdominal distension,and parents satisfaction were observed.Results Compared with the control group,the actual preoperative fasting time was significantly reduced in the experimental group（P<0.001）. There was no significant difference in the incidence of aspiration,postoperative nausea and vomiting and abdominal distension（P>0.05）. Perioperative thirst and hunger score,and crying rate in the experimental group were lower than those in the control group,parents satisfaction was higher,and the differences were statistically significant（P<0.01）.Conclusion Applying the concept of ERAS,it is safe and feasible to shorten preoperative fasting time and earlier postoperative food intaking time,which can reduce the discomfort and promote the early recovery of pediatric patients.

Construction and implementation of three-dimensional integrated education program for premature infants

HU Xiaojing, LI Liling, LIU Chan, LU Chunmei, QIAN Geping, Lee SK, CAO Yun

2019, 54(11):  1626-1629.  DOI: 10.3761/j.issn.0254-1769.2019.11.005

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Objective To construct and implement professional personnel-premature infant-parents three-dimensional integrated education program and observe its effects.Methods The three-dimensional integrated education team was established. Education curriculum was developed according to the characteristics of development of premature infants. Education platform was established,multiple approaches were set up including parents’ school,WeChat class,video education,bedside care teaching hand by hand,etc.Results After training,parents’ satisfaction score was（191.90±0.20）,which was significantly different from that before training（176.00±4.40）（t=-41.68,P<0.001）. There were significant differences in knowledge and information dimension,parental involvement dimension and professional personnel’s attitude dimension before and after training（t₁=-20.83,P₁<0.001;t₂=-27.30,P₂<0.001;t₃=-27.10,P₃<0.001）.Conclusion The three-dimensional integrated education program for premature infants can improve parents’ caring knowledge and ability,and improve their satisfaction with professional personnel’s attitude.

Medical decision-making difficulties among parents of children with biliary atresia

LUO Xi, ZOU Ping

2019, 54(11):  1630-1633.  DOI: 10.3761/j.issn.0254-1769.2019.11.006

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Objective To explore the difficulties for parents when making medical decisions for their children with biliary atresia.Methods Totally 16 parents of children with biliary atresia were chosen using purposive sampling and in-depth interviews were conducted. Data was analyzed by Colaizzi’s seven-step method.Results Medical decision-making difficulties involved：the unmatched information and health literacy for decision-making,lack of effective information and emotional support,conflict between treatment and family condition, conflict between reality situation and pressure from public opinion.Conclusion Medical decision-making was influenced by parents’ personal factors, family factors and social factors. Nurses should assist parents in making appropriate decision in time to improve children survival rate and quality of life.

Effect of umbilical cord milking on related indexes of preterm infants：a Meta-analysis

ZHANG Yanyan, LUO Gongyin, XU Yuanli, YANG Runyu, WANG Cui, HU Yiyin, JIANG Mingjiao, TAO Ming

2019, 54(11):  1634-1639.  DOI: 10.3761/j.issn.0254-1769.2019.11.007

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Objective To explore the effect of umbilical cord milking on related indexes of premature infants.Methods PubMed,Embase,The Cochrane Library,Web of Science,CNKI,WanFang Data,VIP,Sinomed were searched for randomized controlled trials about preterm infants’ umbilical cord milking published from inception to February 2019. Two trained evaluators screened literatures,evaluated quality and extracted data independently,and Meta-analysis was implemented with Review Manager 5.3 software.Results Nine articles（7 in English,2 in Chinese） were included in the analysis,which involved 388 cases of umbilical cord milking（UCM） and 386 cases of immediate cord clamping（ICC）.The results of Meta-analysis showed that：①Compared with ICC,UCM could increase initial hemoglobin[SMD=0.75,95%CI（0.51,0.98）,Z=6.22,P<0.01],systolic blood pressure[MD=3.85,95%CI（0.75,6.95）,Z=2.44,P=0.01],diastolic blood pressure[MD=3.75,95%CI（1.20,6.31）,Z=2.88,P<0.01] and blood flows in superior vena cava;②Compared with ICC,UCM could decrease the number of blood transfusions[RR=0.72,95%CI（0.54,0.95）,Z=2.28,P=0.02],mechanical ventilation time[SMD=-0.31,95%CI（-0.57,-0.05）,Z=2.38,P=0.02] and sepsis[RR=0.73,95%CI（0.57,0.94）,Z=2.49,P=0.01];③There were no statistical differences in peak levels of bilirubin,numbers of preterm infants for phototherapy,incidences of polycythemia and intraventricular hemorrhage between two groups.Conclusion UCM improves the related indexes of preterm infants,reduces the need for blood transfusion,shortens the mechanical ventilation time,decreases the incidence of sepsis,and does not increase the risk of short-term adverse outcomes.

Specialist Practice and Research

Development of predictive model for post-thrombolysis hemorrhage in patients with acute ischemic stroke

CHANG Hong, ZHAO Jie, WANG Xiaojuan, ZHANG Jiajia, YAO Hui, CAO Wenya, FAN Kaiting, MA Qingfeng

2019, 54(11):  1648-1652.  DOI: 10.3761/j.issn.0254-1769.2019.11.010.

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Objective To establish a predictive model for post-thrombolysis hemorrhage in patients with acute ischemic stroke.Methods From January 2014 to December 2018,acute ischemic stroke patients who received rt-PA intravenously were recruited from an advanced stroke center at a tertiary hospital. General information,indicators related to hemorrhage,and blood test results were collected and analyzed using binary Logistic regression model.Results Among 924 recruited patients with acute ischemic stroke,566 had no bleeding complications within 36 hours after intravenous thrombolytic therapy（no bleeding group）,and 358 had bleeding symptoms（bleeding group）. The difference in hospitalization days between two groups was statistically significant（Z=-2.596,P=0.009）. Age,pre-thrombosis systolic pressure,history of falls,history of taking antithrombotic drugs,NIHSS score and DNT time were risk factors for hemorrhage. Based on the results,the predictive model was established and tested.Conclusion The incidence of peripheral bleeding after intravenous thrombolysis is higher,prognosis for patients with severe hemorrhage is poor. Attention should be paid to alert,prevention and treatment of hemorrhage. The predictive model is useful for providing reference for nursing observation,prevention and treatment of hemorrhage.

Application research of personality colors compass in communication between nurses and patients with breast cancer

WANG Lili, WU Yan, DU Yanming, PAN Jun, LIAO Yanyan, GU Zejuan

2019, 54(11):  1653-1657.  DOI: 10.3761/j.issn.0254-1769.2019.11.012

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Objective To explore the effects of application of personality colors compass in communication between nurses and patients in breast surgery.Methods Four-colors Personality Analysis was analyzed to study and design a color compass that could quickly and easily distinguish the personality characteristics of patients. Fifty cases of breast cancer patients admitted to the breast department of a tertiary hospital from January to March 2019 were selected as the experimental group,and 50 cases of breast cancer patients admitted to the department from October to December 2018 were selected as the control group. After admission,the experimental group tested their personality and got their own personality analysis by scanning QR codes. Nurses obtained the patients’ personality analysis through the back-stage management,identified corresponding character traits and communicating strategies found in the compass,then communicated with the patients. For the control group,nurses communicated with patients using routine way. Patients’ anxiety and depression scores,nursing work satisfaction,the communication ability of nurses before and after the application of Personality Colors Compass were compared between two groups.Results Anxiety score at discharge of cases in the experimental group was 5.75±1.73,depression score was 5.42±1.59. The total score of patients’ satisfaction with nursing services was 44.56±2.54. Anxiety score at discharge of cases in the control group was 9.22±2.58,depression score was 8.71±1.87. The total score of patients’ satisfaction with nursing services was 34.29±3.83（t=-7.794,-9.342,15.593,P<0.05）. After the application of Personality Colors Compass,the average communication score of nurses increased from 20.25±1.06 to 26.81±1.60（t=-13.672,P<0.05）.Conclusion The Personality Colors Compass reduces breast cancer patients’ anxiety and depression effectively,improves patients’ satisfaction with nursing services,and improves nurses’ communication skills.

Study on the status and influencing factors of health-promoting lifestyle in caregivers of patients with neuropsychiatric systemic lupus erythematosus

PAN Jinping, LI Xiangfeng, ZHANG Chunyan

2019, 54(11):  1658-1662.  DOI: 10.3761/j.issn.0254-1769.2019.11.011

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Objective To analyze the status and influencing factors of health-promoting lifestyle in caregivers of patients with neuropsychiatric systemic lupus erythematosus.Methods A cross-sectional study was performed on 80 caregivers of patients with neuropsychiatric systemic lupus erythematosus between January,2015,and January,2017,in Peking Union Medical College Hospital. A self-administered general information questionnaire,and Health Promotion Lifestyle Profile Ⅱ（HPLP-Ⅱ） questionnaire was completed,and influencing factors were analyzed.Results The mean age of the participants was（46.42±12.15） years. The mean lifestyle score was （116.82± 32.89）,with the subscale nutrition showing the highest score（25.35±5.69） and the subscale stress management showing the lowest score（11.35±5.96）. Linear regression showed that caregivers with length of caring <1 year,caregivers without chronic diseases,patients with high rate of occurrence of neuropsychiatric symptoms,and caregivers’ self-perceived burden were independent risk factors for health-promoting lifestyle in caregivers of patients with neuropsychiatric systemic lupus erythematosus.Conclusion Caregivers of patients with neuropsychiatric systemic lupus erythematosus had a moderate health-promoting lifestyle. Healthcare providers should help caregivers with short length of caring,caregivers without chronic diseases,patients with high rate of occurrence of neuropsychiatric symptoms,and caregivers’ self-perceived burden,to improve health-promoting lifestyle through health education,skill training and extended care.

Early rehabilitation exercise in total knee arthroplasty patients with kinesiophobia：a qualitative study

CAI Libai, LIU Yanjin, CUI Miaoran, GUO Yuru, ZHENG Shuangshuang, WANG Yanyan

2019, 54(11):  1663-1667.  DOI: 10.3761/j.issn.0254-1769.2019.11.013

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Objective To explore the real experience of total knee arthroplasty（TKA） patients with kinesiophobia towards early rehabilitation exercise.Methods A semi-structured interview was conducted with 14 TKA patients with kinesiophobia recruited by purposive sampling method,then the Braun’s analysis method was applied to analyze,induce,and refine themes of interview data.Results Four themes regarding early rehabilitation exercise were extracted,including fear of pain（increased sensitivity of pain,pain as a threat）,uncertainty about the effects of early rehabilitation exercise（fear of joint prosthesis falling off,unsure about the effect of early rehabilitation exercise,and inefficient exercise status）,high pressure（economic pressure and psychological pressure）,and lack of social support（lack of family support,deficient inprofessional technical support,and desire for social support）.Conclusion The TKA patients with kinesiophobia have obvious pain,low enthusiasm for early rehabilitation exercise,suffering great psychological pressure. Clinicians and nurses should pay attention to their exercise experience and provide necessary social support.

Design and application of misaspiration risk screening table for patients after neurologic tumor surgery

SHI Qian, LIU Meng, LU Junshuai

2019, 54(11):  1668-1672.  DOI: 10.3761/j.issn.0254-1769.2019.11.014

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Objective To design a misaspiration risk screening table for patients after neurologic tumor surgery,and to provide a scienfitic and effective tool for early screening the occurrence of misaspiration of those postoperative patients.Methods The literature analysis and Delphi method were used to establish the aspiration risk rate screening table for brain tumor surgery patients. Patients who underwent neurological tumor resection from January to June 2018 were selected as the control group,and patients who underwent neurological tumor resection from July to December 2018 were selected as the experimental group. The “Kubota drinking water test” was used in the control group for screening the aspiration risk rate;the experimental group was treated with aspiration risk rate screening table to investigate the aspiration risk. The detection rate of aspiration risk,the incidence of aspiration and the average length of hospital stay were compared in these two groups.Results The application of the aspiration rate screening table in patients after excision of brain tumor improved the detection rate of aspiration risk（P<0.001）,reduced the incidence of aspiration rate（P<0.001） and shortened the average length of hospital stay（P<0.05）.Conclusion The application of the aspiration rate screening table can increase the detection rate of aspiration risk,make nursing staff quickly and accurately assess the risk of aspiration of hospitalized patients and then apply the individualized prevention strategies according to different levels of risk in different patients to reduce the occurrence of aspiration,shorten the average length of hospital stay,and improve the quality of medical treatment and nursing.

Investigation on the status of doula delivery

HUANG Chuanya, JIANG Mei, XU Xinfen, LUO Biru

2019, 54(11):  1673-1676.  DOI: 10.3761/j.issn.0254-1769.2019.11.015

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Objective To investigate the status quo of China’s doula delivery and analyze the reasons why it has not been carried out,so as to provide references for developing appropriate midwifery technology training and formulating relevant policies in the future.Methods From December 2017 to November 2018,a self-designed questionnaire was used to investigate the current situation of doula delivery in 1 213 secondary and above midwifery medical institutions in 22 provinces,municipalities or autonomous regions.Results Of the 1 213 hospitals,679（56.0%） of the hospitals carried out doula delivery,410（60.4%） started doula delivery when the mouth of the uterus opened to 3 cm,523（77.0%） continued doula delivery to the fourth stage of labor,hospital staff in 393（57.9%） hospitals mainly used working time to complete doula delivery,in 606（89.2%） hospitals midwives performed Doula delivery,433（63.8%） of the hospitals had doula instruments. The main reasons for not carrying out doula delivery were insufficient personnel,insufficient space and no fee could be charged.Conclusion The technology of doula delivery has not been widely popularized in China,and the development status is uneven. Doula delivery should be supported in human resources,space and economy.

Nursing Management

A survey of current working situation of specialist nurses in 226 secondary and tertiary hospitals in mainland China

NIE Shengxiao, ZHAO Jin, SUN Hong

2019, 54(11):  1677-1681.  DOI: 10.3761/j.issn.0254-1769.2019.11.016

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Objective To investigate the current working situation of specialist nurses（SN） in secondary and tertiary hospitals in mainland China,so as to provide references for usage and administration of SN.Methods Two hundred and twenty-six hospitals in 24 provinces （cities or autonomous regions） were investigated using a self-designed questionnaire developed by Department of Continuing Education of Chinese Nursing Association（CNA）.Results Three thousand and eighty SNs worked on clinical nursing positions,accounting for 75.2% of all SNs in the investigated hospitals trained by CNA. SNs in 72.6% of the hospitals worked throughout the hospital,and in 41.1% of the hospitals SNs worked outside the hospital. In the aspect of working content,SNs in over 80% of the hospitals had participated in making care plans for critical patients,discussion of intractable cases,nursing consultation,teaching and researching. Besides,SNs in 59.3% of the hospitals had worked in nursing outpatient clinics. However,only 17.3% of the SNs undertook scientific research tasks as project leaders. Compared with secondary hospitals,more tertiary hospitals provided chances for SNs to work outside the hospital,in nursing outpatient clinics,make care plans for critical patients,undertake nursing teaching and scientific research tasks as project leaders（P<0.05）.Conclusion SNs worked mainly on clinical practice position. The workplace of SNs had been expanded. The working abilities of SNs had been improved. However,SNs’ scientific research ability needs to be enhanced. Compared to those in secondary hospitals,nurses in tertiary hospitals worked in more workplaces,and have been better used.

The current situation of work and family conflict of female nurses with a second child

XU Fengxia, HUANG Yeli, LI Yuqing, MA Xiuli

2019, 54(11):  1682-1687.  DOI: 10.3761/j.issn.0254-1769.2019.11.017

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Objective To understand the work and family conflict of female nurses who have a second child in China under the comprehensive two-child policy and analyze its influencing factors.Methods By means of network questionnaire survey,information of work and family conflict scores of 5,104 nurses who had a second child and 5,372 female nurses with one child in China were collected,and the influencing factors of work and family conflict of female nurses with a second child were analyzed by multiple linear regression method.Results The score of work-family conflict for female nurses who had a second child was（43.46±12.37）,female nurses who had one child were（42.22±11.86）,and the difference was statistically significant（t=-5.238,P<0.05）. Multiple linear regression analysis showed that job title,the level of the hospital,the preparation for second child,and working family support were the influencing factors of work-family conflict for female nurses（P<0.05）.Conclusion Female nurses who have a second child perceive a higher level of work-family conflict. Working family support is an important influencing factor for work-family conflict. Nursing managers can implement family friendly policy,support policies,etc.,to prevent further impacts of work-family conflict.

Design and application of informationalized nursing dashboard in general wards

LU Yao, SHI Tingqi, CHENG Jianping, SUN Yujiao, WANG Juan, LIU Jingjing

2019, 54(11):  1688-1692.  DOI: 10.3761/j.issn.0254-1769.2019.11.018

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Objective To design and develop a two-dimensional informationalized nursing dashboard for clinical nurses’ decision-making in general wards,so as to solve the manual identification of patients’ important information and cross-space communication,providing nurses with accurate and intuitive information display and communication channels.Methods The information items of the two-dimensional informationalized nursing dashboard were confirmed by current situation investigation,literature search and expert meeting. Data were automatically acquired from the hospital information platform,and then were analyzed,classified and presented. After used by nurses in general wards in our hospital for half a year,its effects were evaluated using interview method.Results The nursing informationalized dashboard extracted key information from two dimensions（whole wards and single patient）,including 62 items in four categories,namely 15 items of patient data,37 items of nursing evaluation,9 items of nursing tasks,and 1 item of remark information. It realized the direct reading and real-time updating of data,improved working efficiency of nurses and brought positive psychological feelings to nurses.Conclusion The two-dimensional informationalized nursing dashboard can realize automatic information transmission,resource sharing and change the inherent clinical nursing working mode,which is practical and innovative.

Nursing Education

Application of parallel medical records in clinical internship of undergraduate nursing students

ZHENG Yunhui

2019, 54(11):  1693-1696.  DOI: 10.3761/j.issn.0254-1769.2019.11.019

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Objective To explore the effects of parallel medical records on improving the empathy ability and practice effect in undergraduate nursing students.Methods On the basis of completing the internship tasks of basic nursing as planned in the intensive teaching practice of Fundamentals of Nursing,nursing students were required to record the story and experience of patients’ medical treatment as well as their psychological feelings with listening ears and plain language,and share them in class. Jefferson Scale of Empathy for Nursing Students was used to evaluate students’ empathy.Results The score of empathy ability of nursing students was increased from（79.83±3.94） to（105.52±8.46）（t=-17.837,P<0.001）. Meanwhile,opportunities for clinical practice were increased,and professional identity and sense of responsibility was improved significantly.Conclusion The introduction of parallel medical records into the intensive teaching practice of Fundamentals of Nursing is helpful to improve the empathy ability of nursing students,enhance the relationship between nursing students and patients,and promote the transformation of nursing students’ roles,which can improve the effects of internship.

The application of six-step love communication micro-video teaching materials in communicational ability training of newly recruited nurses

YU Shenmei, FENG Jia, ZHANG Qiuxia, SHAO Cuimei, YU Xiulin, JIN Jingfen

2019, 54(11):  1697-1700.  DOI: 10.3761/j.issn.0254-1769.2019.11.020

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Objective To explore the training effects of six-step love communication micro-video teaching materials on communicational ability training among newly recruited nurses.Methods Seventy-five nurses newly recruited in 2017 were divided into the experimental group and the control group,according to odd and even numbers. Thirty-eight nurses in the experimental group were trained by the six-step love communication micro-video teaching materials. Thirty-seven nurses in the control group were trained by traditional teaching method combining with clinical practice. The training process lasted 4 weeks. After training,the two groups were evaluated by the same theoretical and clinical tests,and a self-made questionnaire was used to investigate nurses’ evaluation of communication training.Results In the experimental group,89.5% of the nurses had excellent scores,while 32.4% of the nurses in the control group got excellent scores,and the difference was statistical significant（P<0.05）. For the experimental group,satisfaction in terms of training method,content,clinical application and increasing of self-confidence,was higher than those in the control group,and the differences were statistical significant（P<0.05）.Conclusion The utilization of six-step love communication micro-video teaching materials can enhance newly recruited nurses’ theoretical and clinical communication test scores,improve communication ability,skills,and confidence,and the teaching satisfaction is significantly better than traditional approach.

Community Care

Pathway analysis of impact of social support network,self-efficacy and health promotion behavior on healthy aging among older adults

WU Fan, SHENG Yu

2019, 54(11):  1701-1706.  DOI: 10.3761/j.issn.0254-1769.2019.11.021

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Objective To explore the impact of social support network,self-efficacy and health promotion behavior on healthy aging of elderly in community,and to analyze the influence path.Methods From July to December,2017,a cross-sectional survey was conducted among 485 older adults in four districts of Beijing. Data were collected by using the Lubben Social Network Scale,Medical Outcomes Study Social Support Survey,Self-rated Abilities for Health Practices Scale,the Health-Promoting Lifestyle Profile II and Healthy Aging Instrument.Results The total score of healthy aging of older adults was（120.62±23.15）. Neighborhood relationship had both direct and indirect effects on healthy aging,and the total effect was 0.225. Family support had the strongest effect on promoting healthy aging（β=0.194）. Self-efficacy could directly and indirectly affect healthy aging,and the total effect was 0.701.Conclusion The overall level of healthy aging of older adults was at the upper middle level,but the scores of cognitive function and social participation dimension were low. Neighborhood relationship,family support and self-efficacy were the key factors affecting healthy aging of individuals.

Vascular Access Nursing

Application of one-insertion subcutaneous tunneling technique for Power PICC placement via ultrasound

WANG Aijun, ZHENG Xing, XU Xiaofen, LUAN Xiaorong

2019, 54(11):  1707-1711.  DOI: 10.3761/j.issn.0254-1769.2019.11.022

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Objective To explore the effect of one-insertion subcutaneous tunneling technique for Power peripherally inserted central catheter（PICC） placement via ultrasound.Methods A total of 963 patients with malignant tumors treated in our hospital from January 2016 to December 2018 were enrolled,including 493 patients in the experimental group and 470 patients in the control group. The experimental group adopted the one-insertion subcutaneous tunneling technique to place Power PICC,and the control group adopted the routine method. Chi-square test was used to analyze the incidence of complications in two groups;Cox regression were used to analyze the influencing factors of catheter extrusion and obstruction;survival curve was used to reflect the occurrence of catheter extrusion and obstruction in both groups.Results The incidence rates of catheter extrusion and obstruction in the experimental group were significantly lower than those in the control group[aHR=0.304,95%CI（0.137,0.677）,P<0.01;aHR=0.304,95%CI（0.097,0.958）,P<0.05]. Demographics and disease characteristics had no significant impacts on catheter extrusion and obstruction（P>0.05）.Conclusion One-insertion subcutaneous tunneling technique can effectively reduce complications after placement,which is a safe and effective technique to place Power PICC.

Evidence Synthesis Research

Effects of resistance training on bone mineral density in patients with postmenopausal osteopenia or osteoporosis：a meta-analysis

LIANG Yanting, SHANG Hongyan, XING Manxia, LIU Jianghong, SUN Longfeng

2019, 54(11):  1722-1728.  DOI: 10.3761/j.issn.0254-1769.2019.11.026

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Objective To identify the effects of resistance training on bone mineral density in patients with postmenopausal osteopenia or osteoporosis using meta-analysis.Methods We performed a systematic search in PubMed,CINAHL,Embase,Web of Science,Wanfang,CNKI and CBM to collect studies about effects of resistance training on bone mineral density in patients with postmenopausal osteopenia or osteoporosis published from inception to April 2019. Meta-analysis was performed using RevMan 5.3 software after two independent reviewers conducted independent literature screening,data extraction,and literature quality evaluation according to inclusion and exclusion criteria.Results Seven studies were recruited,including 698 cases. The results of meta-analysis showed that resistance training had a positive effect on bone mineral density at the lumbar spine in patients with postmenopausal osteopenia or osteoporosis compared with conventional exercise. The combined effect was statistically significant[MD=0.02,95%CI（0.00,0.05）,P=0.04]. Resistance training had no significant effect on bone mineral density at the femoral neck[MD=0.01,95%CI（-0.00,0.02）,P=0.17],hip[MD=0.01,95%CI（-0.01,0.02）,P=0.41],greater tro-chanter[MD=0.01,95%CI（-0.00,0.03）,P=0.16]and serum osteocalcin[MD=1.44.95%CI（-2.23,5.12）,P=0.44].Conclusion Resistance training significantly improved bone mineral density in the lumbar spine,but did not improve bone mineral density in the femoral neck,hip,greater trochanter and serum osteocalcin in patients with postmenopausal osteopenia or osteoporosis. At present,there is insufficient evidence for the effects of resistance training on bone mineral density in patients with postmenopausal osteopenia or osteoporosis,the sample size varies greatly,and more high-quality studies are needed for future research.

Quality evaluation and content analysis of existing clinical practice guidelines related to fall prevention in the elderly

WANG Yumei, LI Ling, XIONG Lijuan, YUAN Jinrong, XIA Man, LIU Aihong, TIAN Yuan, Li Jia, LI Xin

2019, 54(11):  1729-1734.  DOI: 10.3761/j.issn.0254-1769.2019.11.027

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Objective To evaluate the quality and analyze content of existing clinical practice guidelines related to fall prevention in the elderly,and to provide reference for developing clinical practice guidelines suitable for domestic health care settings.Methods National Guideline Clearinghouse（NGC）,Guidelines International Network（GIN）,National Institute for Health and Clinical Excellence（NICE）,Scottish Intercollegiate Guidelines Network（SIGN）,Registered Nurses Association of Ontario（RNAO）,Joanna Briggs Institute（JBI）,PubMed,Embase,CINAHL,CNKI,Wanfang,and CBM were searched to collect clinical practice guidelines related to fall prevention. Guidelines meeting inclusion criteria were evaluated using AGREE II instrument and content was analyzed.Results A total of 13 clinical practice guidelines were included,2 were grade A recommendation,9 were grade B recommendation and 2 were grade C recommendation. The 6 domains with highest scores were scope and purpose（96.01%）,clarity（81.34%）,participants（64.24%）,eligibility（51.60%）,applicability（51.28%）,independence（44.44%）. Finally 7 themes including 27 items were extracted by content analysis.Conclusion Overall,the quality of existing clinical practice guidelines related to fall prevention in the elderly is not good that should be improved in eligibility,applicabilty and editorial independence,the contents of the guidelines are extensive but need to be further improved.

Review

Author

2019, 54(11):  1740-1745.  DOI: 10.3761/j.issn.0254-1769.2019.11.029

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