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Table of Content

    15 April 2020, Volume 55 Issue 4
    Research Paper
    The experience of intolerance of uncertainty in patients with repeated hospital admission and no clear diagnosis:a qualitative study
    ZHAO Xia, ZHU Zheng, YU Minhong, ZHANG Qi, YING Qiaoyan
    2020, 55(4):  488-493.  DOI: 10.3761/j.issn.0254-1769.2020.04.001
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    Objective To understand the experience of intolerance of uncertainty in patient with repeated hospital admission and no clear diagnosis. Methods From December 2018 to March 2019,21 patients with repeated hospital admission and no clear diagnosis were recruited from a tertiary hospital in Beijing by maximum variation sampling. Semi-structured interviews were conducted to collect data. Results Ten themes were grouped into three major themes including the manifestations of intolerance of uncertainty in patients with repeated hospital admission and no clear diagnosis,the factors associated with intolerance of uncertainty,and needs of patients. Conclusion Effective communication between healthcare professionals and patients should be promoted to provide patients with comprehensive and clear information,and multidisciplinary diagnosis and treatment mode should be developed to enhance patient experience.
    The effects of multidisciplinary teamwork intervention for total knee arthroplasty patients with kinesiophobia
    CAI Libai, LIU Yanjin, LI Ying, CUI Miaoran, XU Yuan, DI Ruiqing, MENG Jiping, LIU Yangyang
    2020, 55(4):  494-499.  DOI: 10.3761/j.issn.0254-1769.2020.04.002
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    Objective To explore the effects of multidisciplinary teamwork intervention for total knee arthroplasty(TKA) patients with kinesiophobia. Methods A total of 106 TKA patients with kinesiophobia admitted from February 2018 to March 2019 in our hospital were enrolled as research subjects by a convenience sampling method.53 patients admitted from October 2018 to March 2019 were allocated into an experimental group, while 53 patients admitted from February to August 2018 were assigned into a control group. Multidisciplinary teamwork intervention was adopted in the experimental group with routine nursing care, while the control group only received routine nursing care. The differences of the 2 groups in the scores of kinesiophobia, knee function, pain severity in resting and exercising, the first activity time after getting out of bed, length of stay and hospitalization expenses were compared on discharge day. Results After the implementation of multidisciplinary teamwork intervention, the scores of kinesiophobia, pain severity in resting and exercising in the experimental group were lower than those in the control group(P< 0.05), and the score of knee function was higher than that in the control group(P< 0.05). In addition, the first activity time after getting out of bed, length of stay and hospitalization expenses in the experimental group were also better than those in the control group(P< 0.05). Conclusion The multidisciplinary teamwork intervention was scientific and reliable in TKA patients with kinesiophobia, which can reduce the incidence of kinesiophobia, relieve pain and accelerate the recovery of knee function effectively.
    Special Planning-Coronavirus Diease 2019 Nursing
    Establishment and implementation of standardized training program on prevention and control of coronavirus disease 2019 in general hospitals
    WU Xinjuan, GUO Na, CAO Jing, LI Zhen, JIAO Jing, ZHAO Yanwei, BO Haixin, WANG Wei
    2020, 55(4):  500-503.  DOI: 10.3761/j.issn.0254-1769.2020.04.003
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    Objective To develop a standardized training program for the prevention and control of coronavirus disease(COVID-19)infections in general hospitals and evaluate its effectiveness. Methods The training targets included medical staff and auxiliary staff. A working team with clear responsibilities was set up,and personalized training content was formulated. Online and offline training were adopted,and the effectiveness was tracked and evaluated by multiple methods. Results 7 days after the implementation of the standardized training program,the score of knowledge related to the prevention and control of nosocomial infection rose from 69.02±13.21 to 88.49±10.57 after the training for medical staff. The score of auxiliary staff was also improved from 62.38±13.05 to 75.86±12.19 with statistical significances(P< 0.05). The correct rate of questions and answers by supervisors on the spot rose from 82.69% to 92.31%,whilethe standard rate of wearing surgical masks increased from 85.36% to 92.86%,and the correct rate of hand hygiene increased from 92.31% to 96.30%. Conclusion The standardized training program for nosocomial infection prevention and control of COVID-19 in general hospitals has effectively improved the knowledge of nosocomial infection prevention and control,the standard rate of wearing masks,and the correct rate of hand hygiene for medical staff and medical assistants
    Construction and application of online rapid pre-screening and triage system during epidemic of coronavirus disease 2019
    WANG Huafen, LU Fangyan, SHENG Di, YU Wei, LI Qin, LIANG Tingbo, JIN Chaohui
    2020, 55(4):  504-507.  DOI: 10.3761/j.issn.0254-1769.2020.04.004
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    Objective To develop an online rapid pre-screening and triage system during epidemic of coronavirus disease(COVID-19),and to accomplish intelligent,accurate,and quick pre-screening and triage,so as to provide the decision-support of early warning management for COVID-19 patients. Methods The online rapid pre-screening and triage system consists of 2 platforms,including patient self-report platform and administrator monitoring platform. The patient self-report platform included epidemiological history of COVID-19 exposure,fever and respiratory symptoms. The data of triage time,coincidence rate of intelligent triage and patient satisfaction from January 20 to February 3 in 2020 were collected from the administrator monitoring platform to evaluate the application effect of the system. Results A total of 1034 outpatients with fever completed the online pre-screeningand triage;174 patients(16.8%)were diagnosed by the intelligent decision-making triage to area B(area of suspected outpatients);65 patients(37.4%)were suspected with COVID-19 after the second triage;29 cases(44.6%) were finally diagnosed. Intelligent decision-making subdivision resulted in 860 cases(83.2%)in area A(general area),and there was no suspected and confirmed case found.The time for online rapid pre-screening and triage was(1.94±0.87)mins,which was significantly shorter than that of traditional manual triage(4.03±2.15) mins. The difference was statistically significant(t=-30.99,P<0.001);1 010 patients(97.7%) were satisfied with the rapid pre-screening and triage,and no complaints or adverse events occurred. Conclusion The online rapid pre-screening and triage system in fever clinics can early detect high-risk patients with COVID-19,ensure early warning and triage of suspected infected patients,and shorten the exposure time. At the same time,it can effectively shorten the waiting time in fever clinics,reduce the risk of cross-infection in hospitals,and improve patients' satisfaction.
    Referral process for newborn delivered by a suspected/confirmed COVID-19 mother
    LIU Huijuan, ZHANG Xin, ZHANG Xuefeng, YANG Ying, LIU Chunzi, DUAN Huijuan
    2020, 55(4):  508-510.  DOI: 10.3761/j.issn.0254-1769.2020.04.005
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    With the previous transfer experience of 3 neonates delivered by mothers with suspected coronavirus disease 2019(COVID-19) and the review of the relevant literature,the process of newborn referral is developed,including preparation and implementation of referral. Preparations before referral covers management of transfer personnel,establishment of transfer agencies,the set-up of green channels,etc. The specific implementation of referrals covers 7 aspects,including referral evaluation,grading of referral patients,principles of admission,referral personnel and material preparation,admission,and transfer out,etc. The purpose of this article is to ensure that newborns who are suspected/confirmed with COVID-19 are delivered safely,effectively,and quickly,to cut off the transmission of COVID-19 in newborn referrals,and to protect the life and health of newborns and medical staff.

    Development of cesarean section nursingprocess for pregnant women with coronavirus disease 2019
    WANG Ying, WU Qi, ZHOU Yuqiong, MA Yifang, SUN Xinxing
    2020, 55(4):  511-514.  DOI: 10.3761/j.issn.0254-1769.2020.04.006
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    The nursing care processof cesarean section for pregnant women with coronavirus disease(COVID-19) was developed based on the experience of emergency cesarean delivery on a case of COVID-19 woman with 35 weeks of gestation in our hospital,relevant global literature review,and the diagnosis and treatment guideline of COVID-19 issued by Chinese National Health Commission. This nursing process consists of 3 major parts(preoperative,postoperative and postoperative),covering environment/materials,surgical staff,pregnant women and newborns,etc. The ultimate aim is to protect the safety of expecting mothers,medical staff.

    The handling methods and its effect of reusable medical instruments in COVID-19 infected patients
    ZHU Juan, YIN Shiyu, WANG Hui, LIU Yu, ZENG Tieying, WANG Ying
    2020, 55(4):  515-518.  DOI: 10.3761/j.issn.0254-1769.2020.04.007
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    During the epidemic of the coronavirus disease(COVID-19),our hospital has been designated for the treatment of critically ill patients with COVID-19. As a supply department for the aseptic supplies and materials,the sterilization and supply department center has taken various countermeasures in time according to the characteristics of the virus and relevant documents and guidelines issued by the government. The quarantine requirements of the sterilization and supply department center and personnel protection measures in each ward were determined;the work processes was updated; the optimization of human resources and staff training were implemented;the procedure of sterilization,recycling and cleaning of reused medical instruments contaminated with COVID-19 was revised;the coordinating management was practiced through various departments;a mechanism for smooth communication with medical rescue teams was established. These measures have ensured that the work has been progressed smoothly during the epidemic of COVID-19,and qualified aseptic supplies have been provided for the patients and medical staff. The experience hereby is summed up for your references.

    Special Planning-Cardiovascular Nursing
    Effects of inspiratory muscle training on cardiopulmonary function and exercise capacity of patients after percutaneous coronary intervention
    DUAN Juntao, LIU Congying, YU Guixiang, TONG Sumei, XU Shunlin
    2020, 55(4):  519-523.  DOI: 10.3761/j.issn.0254-1769.2020.04.008
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    Objective To explore the effects of inspiratory muscle training on cardiopulmonary function and exercise capacity in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods 99 patients receiving PCI were randomly allocated into a control group(49 cases) and an intervention group(50 cases). The control group was only given a 7-day cardiac rehabilitation program, while the intervention group was added with the inspiratory muscle training on this basis. The maximum inspiratory pressure(MIP) and the Five-Times-Sit-to-Stand Test(FTSST) were used to evaluate the effectiveness of the interventions at post-baseline, 7 days after intervention, and 4 weeks after discharge. 6-minute walk test(6MWT) and cardiopulmonary exercise testing were used to evaluate the improvement of cardiopulmonary function at 4 weeks after discharge.Results The results of MIP and FTSST showed improvement in the intervention group and the control group after 7 days of intervention and 4 weeks after discharge. The improvement in the intervention group was better than that in the control group at 4 weeks after discharge(MIP increased 20.22%, 9.31%, and FTSST time decreased respectively 15.64%, 4.75%).The results of ANOVA for repeated measurement are also statistically significant;there were statistical differences in the 6MWT, peak oxygen consumption, and oxygen uptake efficiency slope between the intervention group and the control group at 4 weeks after discharge(P<0.05).Conclusion Routine cardiac rehabilitation and the inspiratory muscle training can improve the cardiopulmonary function and exercise capacity in patients with acute myocardial infarction after PCI.
    Development and evaluation of four-stage early rehabilitation program for patients with acute heart failure in compensatory period
    WANG Hong, CHENG Qing, LI Yingxin, ZHANG Qianqian, XU Hongfeng
    2020, 55(4):  524-528.  DOI: 10.3761/j.issn.0254-1769.2020.04.009
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    Objective To develop a four-stage early rehabilitation program in patients with acute heart failure in compensatory period and evaluate its effects,so as to provide references for their early rehabilitation activities. Methods A research team of early rehabilitation program was established,and a four-stage early rehabilitation program for patients with acute heart failure was initially formulated after literature retrieval and semi-structured interviews. The final plan was formed after the expert panel evaluation. A total of 200 patients with acute heart failure admitted to CCU from April 2017 to June 2019 were recruited by convenient sampling method with 100 patients in the control group and 100 patients in the experimental group. The control group received the regular activity plan,while the experimental group was provided with the four-stage early rehabilitation program. The Minnesota Quality of Life Scale,the 6 min walking test,the average length of hospitalization,the forced expiratory volume in one second (FEVl),and the brain natriuretic peptide(BNP) were adopted as monitoring indicators. Results The Minnesota quality of life in the experimental group scored(52.64±5.60) points,which was lower than(56.89±6.59) points(t=-4.877,P< 0.001) in the control group. The distance of 6 min walking test group was(279.86±84.66) m and it was better than(248.78±93.73)m(t=2.441,P=0.016) in the control group. The average length of CCU hospitalization in the experimental group was(8.97±2.80) d,which was less than(10.48±3.80) d(t=-3.182,P=0.002) in the control group. The FEVl in the experimental group was(2.18±0.49) L,which was higher than(1.92±0.35) L(t=4.338,P< 0.001) in the control group. The BNP level in the experimental group was(697.88±135.58) pg/ml which was smaller than(755.29±141.74) pg/ml(t=-2.905,P=0.004) in the control group. Conclusion The four-stage early rehabilitation program can formulate an individualized activity strategy based on patients' heart function,and guarantee the safety of early activities through team management methods,which can effectively improve the quality of life of patients with acute heart failure,promote the rapid rehabilitation of cardiopulmonary function,and shorten hospitalization time.
    A survey of quality of life in patients with myocardial infarction after returning to work
    DU Ruofei, WANG Panpan, CHEN Changying, WANG Tao
    2020, 55(4):  529-534.  DOI: 10.3761/j.issn.0254-1769.2020.04.010
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    Objective To investigate the quality of life in patients with myocardial infarction after returning to work,and to analyze the influencing factors so as to provide basis for developing targeted intervention and secondary prevention of cardiovascular disease. Methods General information questionnaire,Medical Outcomes Study Short Form -8(SF-8),Health Promoting Lifestyle Profile II,Medical Coping Modes Questionnaire and Social Support Rating Scale were used to investigate 326 patients with myocardial infarction who had returned to work after discharging from Departments of Cardiology in 3 tertiary hospitals in Zhengzhou by convenience sampling method. Results The total score of quality of life in patients with myocardial infarction after returning to work was(28.03±2.55),and the 3 aspects with lower scores were social function(2.48±1.09),emotional role(2.22±0.87) and mental health(2.38±0.88). Multiple linear regression analysis showed that the influence factors of quality of life were health responsibility,nutrition,exercise,self-realization,stress coping,objective support,subjective support,utilization of social support,coping,yield,time to return to work,number of stents installed,income and complications,whether to participate in and complete cardiac rehabilitation(P<0.05)。Conclusion The quality of life of patients with myocardial infarction needs to be improved after they return to work. Targeted interventions should be carried out according to the factors affecting the quality of life,so as to improve the quality of life of patients with myocardial infarction after returning to work,and to help patients return to society better.
    Systematic review on managing barriers and intervention of medication adherence in heart transplant recipients
    GONG Chen, DAI Qi, SHI Runze, TONG Beibei, KANG Xiaofeng
    2020, 55(4):  535-541.  DOI: 10.3761/j.issn.0254-1769.2020.04.011
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    Objective To synthesize the best available evidence regarding managing barriers and medication adherence in patients underwent heart transplant. Methods Studies from January 2008 to December 2019 in Cochrane Library,PubMed,Embase,ScienceDirect,CIHNAL,JBI,CNKI,and Wangfang Data,were searched. Content analysis was used for descriptive analysis after screening and appraising. Result Totally 23 articles were included,including 9 cross-sectional studies,6 cohort studies,3 longitudinal studies,3 before-after studies and 2 RCTs. The rates of Medication nonadherence in heart transplant recipients ranged from 9% to 70%. Barriers to medication adherence included individual patient-related factors,disease-related factors,socioeconomic factors. Interventions included medication plan,cognitive education,behavioral intervention,emotional support,etc. Conclusion Adolescents,feelings of remorse and guilt,poor social support and lower socioeconomic status and so forth were barriers for medication adherence. It is of great importance to identify barriers,and design tailored interventions to improve adherence.
    Risk factors of major adverse cardiovascular events in ST elevation myocardial infarction patients after percutaneous coronary intervention:a Meta-analysis
    YAN Fanghong, LIU Huan, JIANG Wenhui
    2020, 55(4):  542-548.  DOI: 10.3761/j.issn.0254-1769.2020.04.012
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    Objective To identify risk factors of major adverse cardiovascular events(MACEs) in ST elevation myocardial infarction(STEMI) patients after percutaneous coronary intervention(PCI). Methods Embase,Medline,Scopus,CNKI,CBM,WanFang Data,VIP,ProQuest Dissertations and Theses-A&I and Clinical Trials. gov were searched to collect studies from January 1st,2008 to December 31st,2018 on risk factors of MACEs. Study screening,data extraction,quality appraisal and meta-analysis were conducted by 2 reviewers independently. Results 35 studies,involving 43,839 patients were included. The statistically significant risk factors were female(OR=4.17),advanced age(OR=2.84),red cell distribution width≥13%(OR=2.04),abnormal renal function(OR=2.23),glucose≥11 mmol/L(OR=1.82),non-O blood type(OR=1.75),triple-vessel disease(OR=1.75),glycated hemoglobin fraction≥5.7%(OR=1.63),painless STEMI(OR=1.56),longer symptom-onset-to-balloon time(OR=1.48) and hypertension(OR=1.27). Conclusion The risk factors of MACEs in STEMI after PCI include female,advanced age,red cell distribution width≥13%,abnormal renal function,glucose≥11 mmol/L,non-O blood type,triple-vessel disease,glycated hemoglobin fraction≥5.7%,painless STEMI,longer symptom-onset-to-balloon time and hypertension.
    Specialist Practice and Research
    Application and effects of standard operation procedure of pain management in patients with transcatheter arterial chemoembolization
    WANG Yuqin, LIU Yuping, WANG Yaling, ZHENG Wen, CHEN Xuan
    2020, 55(4):  558-562.  DOI: 10.3761/j.issn.0254-1769.2020.04.015
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    Objective To explore the construction and effects of standard operation procedure(SOP) of pain management in patients undergoing transcatheter arterial chemoembolization(TACE). Methods Patients in the experimental group received SOP of pain management,while patients in the control group received routine pain care of TACE. The degree of pain,the effect of pain and the satisfaction of pain control were compared between 2 groups. Results Among patients with mild and moderate pain,the main effect of time and the interaction effects of each group were significant,and the degree of pain relief in the experimental group was significantly better than that in the control group(P< 0.05). However,among patients with severe pain,the main effect of time was significant(P< 0.05);the interaction effect was not significant(P>0.05),and there was no significant difference in the degree of pain relief between 2 groups(P>0.05). The effect of pain in the experimental group was lower than that in the control group,and the satisfaction of pain control education and control methods were better than those in the control group(P< 0.05). Conclusion SOP of pain management in TACE patients can alleviate the pain symptoms of patients with mild and moderate pain,and improve the pain outcomes of patients,and enhance patient satisfaction.
    Development of a competency evaluation system for nursing care of AIDS patients
    HUANG Ying, FENG Zhixian, HUANG Chunmei, XU Yan
    2020, 55(4):  563-568.  DOI: 10.3761/j.issn.0254-1769.2020.04.016
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    Objective To develop a Chinese competency evaluation system for nursing care of AIDS patients. Methods The evaluation system was developed through literature review,group discussion,semi-structured interviews,and two rounds of Delphi expert consultations. Results The effective recovery rates of questionnaire in two rounds was 93.8% and 100%,respectively. During the second round,the authority coefficient was 0.838,and the coordination coefficients of three level indicators were 0.451,0.323,0.255 respectively(P< 0.001) regarding the importance,and 0.436,0.304,0.248 respectively(P< 0.001) regarding the operability. The final competency evaluation system for nursing care of AIDS patients consisted of 4 first-level indicators (including core knowledge system,technical ability for whole-course management of AIDS,ability for safety and risk prevention,ability for social intervention) 13 second-level indicators and 33 third-level indicators. Conclusion The competency evaluation system is scientific,practical,and specific,and it has implications for management and training of clinical nurses in AIDS caring.
    Symptoms and psychological experience of cervical cancer patients after radical hysterectomy:a qualitative research
    ZHENG Yingying, LÜ Hongying, CHEN Zhengfei, FENG Suwen
    2020, 55(4):  569-573.  DOI: 10.3761/j.issn.0254-1769.2020.04.017
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    Objective To explore the experience and psychological feelings of cervical cancer patients after radical hysterectomy,so as to provide a valid basis for medical staff to fully understand the postoperative symptoms of patients,improve symptom management,and promote rehabilitation. Methods Semi-structured interviews were performed by phenomenology in 12 cervical cancer patients after radical hysterectomy. Data was analyzed by Colaizzi's method of data analysis. Results 4 themes were extracted,including the physiological aspect (fatigue,urinary dysfunction and impaired function of lower limbs); the psychological aspect (stigma,regret of unsuccessful self-prevention of disease and concern about recurrence of the disease); the family aspect (changes of marital intimacy and concern about resuming normal sexual life); the social aspect (reduced social value and self-identity,and changes of social activities and working methods. Conclusion Cervical cancer patients still face many problems during postoperative recovery stage). Medical staff should evaluate and intervene patients' physical and mental health during rehabilitation period in a timely manner,in order to improve patients' physical and mental health as well as quality of life.
    Construction of indicators of hematology nursing quality
    LIU Shujia, JIANG Hua, LI Kuixing, YU Minhong, MA Weiguang, JIN Aiyun, FANG Yun, ZHANG Binghua, ZHU Xiaming, YAN Xia
    2020, 55(4):  574-577.  DOI: 10.3761/j.issn.0254-1769.2020.04.018
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    Objective To construct indicators of hematology nursing quality. Methods Based on Donabedian's “structure-process-result” quality management model,24 experts were selected by Delphi method from 22 tertiary hospitals and nursing schools in 11 provinces and municipalities for 2 rounds of consultations to screen,modify and determine the sensitive indicators of hematology nursing quality. Results The positive coefficient was 100%, authority coefficient were 0.911,0.917 and Kendall harmony coefficient were 0.399 and 0.393,respectively. Finally,the sensitive indicators of hematology nursing quality were constructed,which included three levels of indicators(three first-level indicators,seven second-level indicators and 38 third-level indicators). The variation coefficient of each indicator was less than 0.25. Conclusion The development process of indicators is scientific,and the results are reliable,and the indicators are practicable,which can be valuable for the improvement of hematology nursing quality.
    Nursing Management
    Development of the Narrative Competence Scale and its test of reliability and validity
    MA Wanzhen, GU Ping, ZHANG Jingjing, YI Huaixiu
    2020, 55(4):  578-583.  DOI: 10.3761/j.issn.0254-1769.2020.04.019
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    Objective To develop an instrument for measuring narrative competence of medical staff and to test its reliability and validity. Methods The research was completed under the guidance of the Storytelling/Narrative Theory,the Story Theory as well as Nodding's Care Theory. Combined with literature analysis and interviews with 17 narrative medicine/narrative nursing staff,the Narrative Competence Scale was constructed. The items were formed by Delphi technique and pilot survey,and 607 medical staff were surveyed to test the reliability and validity of the scale. Results The Narrative Competence Scale consisted of 27 items with 3 dimensions(accumulated variance contribution rate of 65.02%),The total scale's Cronbach's α coefficient was 0.950,the split-half reliability was 0.935,the one month test-retest reliability was 0.717(P< 0.001),the content validity index was 0.89. The Narrative Competence Scale was positively correlated with JSE-HP,CAI(P< 0.001). Conclusion The Narrative Competence Scale has good reliability and validity,which is suitable for the evaluation of medical narrative ability of medical staff in China.
    Development of a nurse training indicator system against workplace violence based on behavioral objectives theory
    WU Yingyu, HUANG Xia, JIA Peipei, WANG Yajing, WANG Bin, WANG Hongmei, LU Xueping
    2020, 55(4):  584-588.  DOI: 10.3761/j.issn.0254-1769.2020.04.020
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    Objective To develop a nurse training indicator system against workplace violence,in order to provide references for training courses against workplace violence for clinic nurses. Methods Based on behavioral objectives theory,literature reviews,semi-structured interviews,Delphi technique and Analytic Hierarchy Process were used to determine the nurse training indicator system and the weight of each index against workplace violence. Results The experts' positive coefficients were 95.24%,95.00% respectively in 2 rounds of Delphi technique. In terms of training aims,authority coefficient was 0.828,and the coefficient of concordance was 0.333(P< 0.001) in the second round. In terms of training contents,authority coefficient was 0.803,and the coefficient of concordance was 0.263(P< 0.01) in the second round. In the final indicator system,training aims consisted of 6 first-level indicators and 25 second-level indicators;training contents consisted of 3 first-level indicators,8 second-level indicators and 29 third-level indicators. Conclusion The nurse training indicator system against workplace violence based on behavioral objectives theory was scientific and reliable,which can provide valuable references for training courses against workplace violence for clinic nurses.
    Investigation on the status of training of diabetes specialist nurses in China
    ZHAO Fang, YUAN Li, ZHANG Mingxia, XIAO Lingfeng, XING Qiuling, WANG Qun, ZHOU Yingxia, MO Yongzhen, LI Rao
    2020, 55(4):  590-594.  DOI: 10.3761/j.issn.0254-1769.2020.04.021
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    Objective To investigate the status of training of diabetes specialist nurses(DSN) in different provinces and cities nationwide in China.Methods Totally 3918 DSN in China were investigated by a self-designed questionnaire via WJX platform in October 2018 by convenience sampling.Results After training of DSN,theoretical knowledge received the most improvement of(4.70±0.54),and scientific research ability had the least improvement of(3.83±1.06). The overall capacity improvement of DSN in eastern region was significantly better than that in western region(P<0.05).Conclusion The training of DSN in different regions is relatively good,but there is still much room for improvement in scientific research ability,and the overall ability of DSN has obvious regional differences. It is recommended to form national standardized DSN training system,expand and standardize regional DSN training programs to improve the construction of talent teams of DSN.
    Community Care
    Development of a simple judgment card for classification of nursing care level for home-stayed stroke patients
    DING Chunge, ZHANG Zhenxiang, LIU Xiaohong, TANG Qilan, MEI Yongxia, LIN Beilei, XU Hui
    2020, 55(4):  595-599.  DOI: 10.3761/j.issn.0254-1769.2020.04.022
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    Objective To develop a simple judgment card for nursing care level classification for home-stayed stroke patients,in order to lay the foundations for nurses in the community health service centers to provide professional care services for home-stayed stroke patients. Methods Nursing classification evaluation indicator system for home-stayed stroke patients was adopted by the research group to comprehensively evaluate 210 stroke patients. The analytic hierarchy process and weighted rank sum ratio method were used to explore the classification of nursing grades in stroke patients. Results The regression equation constructed by the weighted rank sum ratio method is Y=0.807 1-0.060 8 × probit. 66 cases were classified as the first-level nursing care,31 in the second-level nursing care,32 in the third-level nursing care,and 81 in the fourth-level nursing care. Conclusion The simple judgment card for classification of nursing care level for home stayed stroke patients is science-based and convenient,and it has strong practical significance in reasonable allocation of community health human resources to meet the professional care needs of home-stayed stroke patients.
    Vascular Access Nursing
    Best evidence summary for peripheral arterial catheterization insertion and maintenance in adult ICU patients
    WANG Yi, HAN Liu, YUAN Cui, WANG Fang, WANG Ying
    2020, 55(4):  600-606.  DOI: 10.3761/j.issn.0254-1769.2020.04.023
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    Objective To retrieve,appraise and summarize the best evidence of the insertion and maintenance of peripheral arterial catheterization among adult ICU patients. Methods We searched literature from the Registered Nurses' Association of Ontario(RNAO),National Institute for Health and Care Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),Guidelines International Network(GIN) and Chinese Medive etc.,coupled with database search including PubMed,CINAHL,Embase,UpToDate,Joanna Briggs Institute(JBI),CNKI,WANFANG to collect relevant guidelines,evidence summaries,recommended practice,and expert consensuses. The timeframe of data search ran from the inception of the databases to September 2019. 3 researchers evaluated the quality of the literature independently. With the help of external experts,eligible literature was selected for analysis. Results Totally 13 articles were selected,including 1 clinical decision,3 guidelines,7 evidence summaries,and 2 expert consensuses. Finally,27 items of best evidence were synthesized into 10 categories including education & training,catheter selection,catheter insertion and auxiliary technology,catheter label,skin sterilization and aseptic technique,dressing selection and replacement,transducers,pressure monitoring system,flush solution and replacement time. Conclusion This study summarized the best evidence for insertion and maintenance of peripheral arterial catheterization,and added supplemental evidence to standardize the management of arterial catheter in clinical practice,which may reduce the incidence of catheter-related complications and ensure the security of patients.
    Evidence Synthesis Research
    Resilience of cancer patients:a systematic review of qualitative studies
    WANG Quanlan, LI Huiping, YANG Yajuan, ZHANG Ting, CHEN Juanjuan, WU Danyan
    2020, 55(4):  614-620.  DOI: 10.3761/j.issn.0254-1769.2020.04.026
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    Objective To systematically evaluate the qualitative research on resilience of cancer patients,and to provide bases for better clinical nursing interventions. Methods 7 English databases(the Cochrane Library,Medline,CINAHL,Embase,PubMed,Web of Science、Psyc INFO) and 4 Chinese databases(CBM,CNKI,VIP,WANFANG) were chosen to retrieve litetature from inception to June 2019 on resilience of cancer patients. The literature was evaluated by the JBI Critical Appraisal Tool for qualitative studies in Australia(2016). Integrated method was applied to integrate the results. Results Totally 42 findings were extracted from 10 qualified studies. The 42 findings were integrated into 8 categories and finally 3 synthesized results were summarized from the 8 categories. Integration result 1:The development of resilience is the process of dynamic circulation(with negative crisis period,regulatory growth period,positive transformation period,and cycle strengthening period). Integration result 2:The obstructive factors of resilience include individual factors(negative response,false cognition,symptoms and body image disturbance)and environmental factors(traditional sociocultural environment,medical environment,family burdens). Integration result 3:The protective factors of resilience include individual factors(positive psychology and coping style,recovery experiences,religion,self-disclosure,altruism and behavior) and environmental factors(family factors,medical care,interpersonal support). Conclusion The development of resilience is a process of dynamic cycle,influenced by the individual and environmental factors. Clinical nursing staff should give targeted nursing measures according to the influencing factors of different stages,promote the formation and development of patients' resilience and improve the quality of life of patients.
    Best evidence summary for target temperature management of patients after cardiac arrest
    ZHANG Yuman, SONG Chunxia, ZHENG Xiaoli, KONG Dong, ZHANG Ting, MA Chaoqun, YANG Lijuan
    2020, 55(4):  621-627.  DOI: 10.3761/j.issn.0254-1769.2020.04.027
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    Objective To retrieve,evaluate and integrate best practice evidence for targeted temperature management after cardiac arrest. Methods According to the “6S” evidence model,UpToDate,Joanna Briggs Institute(JBI),National Guideline Clearinghouse(NGC),National Institute for Health and Care Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),New Zealand Guidelines Group(NZGG),Queensland Clinical Guidelines(QCG),Australian Government National Health and Medical Research Council(NHMRC),Guidelines International Network(GIN),Registered Nurses' Association of Ontario(RNAO),the Chinese Cochrane Center,medlive.cn,American Heart Association(AHA),European Society of Cardiology(ESC),European Resuscitation Council(ERC),International Liaison Committee on Resuscitation(ILCOR),Australian Resuscitation Council(ARC),PubMed,Chinese Biology Medical literature database(CBM) and Wanfang Med Online were searched. The evidences were about targeted temperature management for adult patients who recover spontaneous circulation from cardiac arrest but are still comatose,including clinical decision,guidelines,evidence summary and expert consensus. Two researchers evaluated the quality of the included literature,as well as extracted and summarized the evidence that met the quality criteria. Results A total of 11 articles were included,including 1 clinical decision,6 guidelines,1 evidence summary,3 expert consensuses. Finally,24 pieces of best evidences were summarized. Conclusion This study summarizes the best evidence on targeted temperature management after cardiac arrest,which can provide evidence-based supports for medical staffs.