Chinese Journal of Nursing

Construction and preliminary application of early pulmonary rehabilitation grading scheme for patients with mechanical ventilation

WANG Lulu, XU Fengling, LIU Gang, ZHU Rui, HU Shaohua, SHAO Min, YU Benben

2020, 55(8): 1125-1132. DOI: 10.3761/j.issn.0254-1769.2020.08.001

Asbtract ( )

HTML ( )

PDF (1120KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To construct an early pulmonary rehabilitation grading scheme for patients with mechanical ventilation,and to explore effects of its application. Methods The Delphi method was used to construct an early pulmonary rehabilitation grading scheme for patients with mechanical ventilation. 100 patients with mechanical ventilation were selected as research subjects from January to December 2019,and they were randomly allocated into a rehabilitation group and a conventional group with 50 cases in each group. The conventional group adopted the conventional rehabilitation treatment and nursing care,while the rehabilitation group adopted an early pulmonary rehabilitation grading scheme. The differences in oxygenation index,partial blood carbon dioxide pressure,lactic acid value,acute physiology and chronic health evaluation,clinical pneumonia infection score,success rate of withdrawal,mortality,duration of mechanical ventilation,length of ICU stay,and ventilator-associated pneumonia,delirium,pressure ulcers,deep vein thrombosis and other complications between 2 groups were compared. Results On the 3rd,5th,7th,and 14th day of pulmonary rehabilitation,the oxygenation index of the rehabilitation group was significantly higher than that of the conventional group. On the 7th day of pulmonary rehabilitation,the partial blood carbon dioxide pressure,lactic acid value,acute physiology and chronic health evaluation,clinical pneumonia infection score in the rehabilitation group were significantly lower than those in the conventional group. The incidence of ventilator-associated pneumonia,deep venous thrombosis,death rate,duration of mechanical ventilation,length of ICU stay in the rehabilitation group were significantly lower than those in the conventional group. The withdrawal success rate in the rehabilitation group was significantly higher than that in the conventional group（all P values<0.05）. Conclusion The application of the early pulmonary rehabilitation grading scheme can improve the respiratory function and disease prognosis for patients with mechanical ventilation,shorten the time of mechanical ventilation and the length of ICU hospitalization,and reduce the occurrence of complications.

Development and construction of core competence index system of pulmonary rehabilitation for specialized nursing

LI Pingdong, GONG Yucui, CHEN Jieya, ZHANG Guolong, ZENG Qiuxuan, LI Jiaying

2020, 55(8): 1133-1139. DOI: 10.3761/j.issn.0254-1769.2020.08.002

Asbtract ( )

HTML ( )

PDF (1053KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective The aim of this study was to develop and construct a core competence index system for specialized nursing of pulmonary rehabilitation,which can provide references for the training and management of pulmonary rehabilitation nurses. Methods Literature review,group discussion and expert consultation were used to establish the index of the core competence for specialist nurses of pulmonary rehabilitation,and the analytic hierarchy process was adopted to confirm the weight of each indicator. Results This study employed a two-round Delphi method with recruitment of 26 nursing experts,and the effective recovery rate was 100%. The results of Ca（judgment coefficient）,Cs（familiarity coefficient） and Cr（authority coefficient） are 0.938,0.846 and 0.901,respectively. Besides,the Kendall coefficients of the two rounds were 0.108~0.227 and 0.126~0.264 respectively,which were statistically significant（P<0.001）. Finally,the core competence index for specialist nurses of pulmonary rehabilitation was formed,including 8 first-level indicators,30 second-level indicators and 113 third-level indicators. Conclusion The reliability and practical significance of the newly developed core competence index were relatively high,which could provide references for the training,examination,evaluation and accreditation of pulmonary rehabilitation nurses.

A longitudinal study of identification and predication of psychological distress trajectories among breast cancer patients

LI Lulu, LI Xiaomei, HAN Dongfang, LI Jiaying, ZHAO Wenqian, ZHANG Mengyue

2020, 55(8): 1140-1146. DOI: 10.3761/j.issn.0254-1769.2020.08.003

Asbtract ( )

HTML ( )

PDF (1164KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To explore distinct trajectories of psychological distress on breast cancer patients from diagnosis to early survivorship,and to investigate whether sociodemographic factors,disease related factors,and personality characteristics can predict trajectories of psychological distress. Methods A prospective study was conducted. Breast cancer patients,who met inclusion and exclusion criteria,were followed up at 6 different timepoints,namely before surgery（T1）,before chemotherapy（T2）,after first chemotherapy（T3）,middle of chemotherapy（T4）,end of chemotherapy（T5）,and 2 months after chemotherapy（T6）. General information,personality,and psychological distress of patients were evaluated. Growth mixture modeling was used to identify trajectory patterns of psychological distress. Logistic regression was used to identify predictors of psychological distress trajectories. Results 3 distinct trajectories were identified and named as “high-stable distress group”“decreasing distress group” and “low-stable distress group”,accounting for 5.3%,57.2%,37.5%,respectively. Occupation（χ²=6.508,P=0.089）,income（χ²=5.237,P=0.073）,and personality（χ²=40.382,P<0.001） have effects on distress trajectories. But only personality was identified in Logistic regression as an independent predictor of psychological distress trajectories. Conclusion Breast cancer patients showed various psychological distress trajectories patterns from diagnosis to early survivorship. Most patients experienced low distress and had good adjustment following cancer diagnosis. Patients who belonged to depressive temperament were more likely to experience high-stable distress and should be given more attention.

Construction and application of the decision support system for pain management in hospitalized children

ZHAO Yongxin, GU Ying, ZHANG Xiaobo, LIU Fang, WAN Yanmin, FAN Yong

2020, 55(8): 1147-1153. DOI: 10.3761/j.issn.0254-1769.2020.08.004

Asbtract ( )

HTML ( )

PDF (1042KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To construct a decision support system for pain management in hospitalized children and to evaluate its effects. Methods Based on the theory of pain management and clinical decision support technology,a new pain management information system was constructed,integrating all aspects of nursing procedure,order processing and nursing task list. The system was trial-run in a tertiary comprehensive pediatric hospital from September 2018 to November 2019. The application effect of the new system was evaluated and compared through the quality of nursing document writing,the timeliness of doctor’s order processing and the experience of nurses before and after the use of the new system. Results After the application of the decision support system for pain management of hospitalized children,the quality of nursing document writing was significantly improved（P<0.05）;the timeliness of medical order processing before and after the use was 100%,and the difference was not statistically significant（χ²=0.012,P=0.913）;in the using experience of clinical nurses,the dimensions of "information quality","service quality","user satisfaction" and "net income" were improved. The differences were statistically significant（P<0.05）. Conclusion The new pain management decision support system improves the homogeneity,continuity,integrity and timeliness of pain management for hospitalized children,and nurses have good overall experience of this system.

Formulation and clinical practice of a chain management scheme of traumatic pain in children

FANG Jihong, WU Fengqin, Li Zhenyu, XIAO Yumei, WANG Yunyun, XIE Guoping, YIN Ying, XIE Kang, YE Hongwu, YAO Xiaoyan, LIU Junxia, SUN Jun

2020, 55(8): 1154-1158. DOI: 10.3761/j.issn.0254-1769.2020.08.005

Asbtract ( )

HTML ( )

PDF (808KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To formulate a chain management scheme for traumatic pain in children and to explore its clinical application effects. Methods From January to April 2019,113 children with limb fractures in Department of Pediatric Orthopedics of a tertiary specialty hospital were selected and allocated into an experimental group and a control group according to the chronological order. The experimental group was treated with the chain management scheme of traumatic pain,and the control group was treated with routine pain management plan. The pain scores within 48 hours after admission and within 48 hours after operation, parents’ satisfaction with pain control and the occurrence of negative emotions of anxiety and depression were compared between 2 groups. Results Compared with the control group,the pain scores in the experimental group were lower within 48 hours after admission and within 48 hours after operation;parents of the children were more satisfied with the pain control;the negative emotions such as anxiety and depression were significantly relieved;the differences were statistically significant（both P<0.05）. Conclusion The application of the chain management scheme for traumatic pain can effectively reduce the perioperative pain of children,relieve the anxiety and depression of parents,increase the satisfaction of parents towards pain control,and promote the comfort of children.

The current situation of premature infants’ weight catch-up growth at 12 months and its influencing factors

TANG Mengyan, LIU Xiaomei, PENG Wentao, LUO Biru

2020, 55(8): 1159-1163. DOI: 10.3761/j.issn.0254-1769.2020.08.006

Asbtract ( )

HTML ( )

PDF (832KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To explore the current situation and its influencing factors of preterm weight catch-up growth at 12 months,and to provide evidence-based advice for catch-up growth of preterm infants. Methods 308 preterm infants and their caregivers were investigated at 5 maternal and child health hospitals in Chengdu by general and feeding information questionnaires,and their weight was used as the outcome indicator of catching-up growth. Results The average weight of 308 preterm infants at 12 months was 9.07±1.08kg（6.8~14 kg）,among which 270（87.7%） achieved standard of satisfaction and 38（12.3%） failed. Logistic regression analysis showed that low gestational age（OR=0.661） was a risk factor,while regular child health care（OR=4.168） and enough milk volume intake（OR=4.501） were protective factors. Conclusion The current situation of preterm infants’ catch-up growth needs to be improved;maternal and child health hospitals should pay more attention to preterm infants’ catch-up growth,and provide high-quality child health care for premature infants.

Evidence summary for prevention and management of feeding intolerance in preterm infants

LI Minmin, SI Zaixia, LIU Jin, LI Yuanyuan, YANG Lijuan

2020, 55(8): 1163-1168. DOI: 10.3761/j.issn.0254-1769.2020.08.007

Asbtract ( )

HTML ( )

PDF (799KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To select and obtain the best evidence on management and prevention of feeding intolerance in preterm infants,and to summarize the best evidence available. Methods We searched the UpToData,Joanna Briggs Institute（JBI）,Guidelines International Network（GIN）,National Guideline Clearing house（NGC）,National Institute for Health and Care Excellence（NICE）,Registered Nurses’ Association of Ontario（RNAO）,Scottish Intercollegiate Guidelines Network（SIGN）,Cochrane Library,PubMed,Embase,CINAHL,American Society for Nutrition（ASN）,and complementally searched the CNKI,the CBM and WanFang database,to collect relevant guideline,evidence summary,best practice information sheet,recommended practice,systematic review,expert consensus and original study. The time limit for the retrieval is from the inception of databases until August 30,2019. 2 investigators evaluated the quality of the included literature and extracted evidence from documents that met the quality criteria. Results Totally 11 articles were selected,and 18 pieces of best evidence were summarized,including the influencing factors of feeding intolerance,evaluation criteria,prevention,management and outcome indicators. Conclusion Our research summed up the best evidence on prevention and management of feeding intolerance in premature infants. In order to improve the quality of nursing care,selective evidence should be applied with the consideration of environment,conditions and patient’s willingness.

Expert consensus on diaper dermatitis nursing care for infants and toddlers/Pediatric Nursing Profressional Committee,Beijing Nursing Association

ZHANG Linqi, LI Yang, SONG Nan, YANG Qin, MENG Jingwen, SUN Jing, JIN Huiyu

2020, 55(8): 1169-1169. DOI: 10.3761/j.issn.0254-1769.2020.08.008

Asbtract ( )

HTML ( )

PDF (973KB) ( )

References | Related Articles | Metrics

Objective To formulate an expert consensus on diaper dermatitis nursing care for infants and toddlers,and to standardize the clinical nursing practice. Methods Literature searching/reviews and expert discussion meetings were used to formulate the main contents of the consensus. The consensus was then revised by 2 rounds of Delphi expert consultations and expert meetings. Results The final expert consensus on diaper dermatitis nursing care for infants and toddlers included 3 aspects of diaper dermatitis nursing care（evaluation,prevention/nursing care,treatment of infection）,and a total of 31 items. Conclusion Items in expert consensus on diaper dermatitis nursing care for infants and toddlers are concise and easy to implement,and the consensus is helpful to guide clinical practice of diaper dermatitis nursing care.

Expert consensus on nursing management of coronavirus disease 2019 patients with mechanical ventilation

XIANYU Yunyan, ZHANG Zhixia, ZHANG Meifang, HUANG Zheng, XIONG Furong, LU Li, LIU Wei, LU Xiaoqing, WEN Li, LIU Yu, BAI Jingshuang, GUO Shuming, TIAN Jiali, ZHANG Su

2020, 55(8): 1179-1179. DOI: 10.3761/j.issn.0254-1769.2020.08.011

Asbtract ( )

HTML ( )

PDF (1062KB) ( )

References | Related Articles | Metrics

Objective To standardize nursing management of coronavirus disease 2019（COVID-19） patients with mechanical ventilation. Methods The literature on COVID-19 and the occurrence and prevalence of infectious diseases in the past through databases such as Pubmed,Embase and CNKI were searched and collected by 14 nursing experts from 5 medical institutions in China. 2850 papers were screened and classified by the level of evidence quality. The first draft of the expert consensus was formed. Through 6 rounds of expert consultations and 6 online conference discussions,the items were adjusted and revised,and the final consensus was formed. Results The consensus constructed a mechanical ventilation nursing management system in COVID-19 patients,summarized the latest 9 items with 3 dimensions,including non-invasive positive pressure ventilation management,invasive mechanical ventilation management,infection control points. Conclusion This consensus covers all aspects of mechanical ventilation nursing management of COVID-19 patients. This consensus provides references and guidance for mechanical ventilation nursing management in COVID-19 patients,which is practical and scientific.

Consensus of nursing experts on prevention and control of psychiatric hospitals under coronavirus disease 2019 epidemic

XU Dongmei, SHAO Jing, WANG Shaoli, QIAN Ruilian, LI Shuanrong, WU Jianhong, XIAO Aixiang, MA Li, AN Fengrong, YANG Bo

2020, 55(8): 1180-1181. DOI: 10.3761/j.issn.0254-1769.2020.08.012

Asbtract ( )

HTML ( )

PDF (1488KB) ( )

References | Related Articles | Metrics

Objective To summarize and establish a systematic and refined nursing management system of psychiatric specialty during the period of prevention and control of coronavirus disease 2019（COVID-19）,so as to provide bases for the prevention and control of COVID-19 in psychiatric hospitals. Methods By combining consensus conference method with expert consultation method,the mental health professional committee of Chinese Nursing Association organized a number of psychiatric hospitals in China with the participation of 43 experts. This expert consensus was formulated with the analysis,discussions and summaries of the protective measures in psychiatric hospitals,combined with relevant national policies,academic guidelines,journal articles and literature. Results The consensus includes requirements for organizational management,environmental management and personnel management of prevention and control of COVID-19. Conclusion The consensus guides the prevention and control of COVID-19 in psychiatric hospitals through organizational management,environmental management and personnel management,with guiding significance for clinical practice.

Application of 2 cardiac output monitoring in patients with severe septic shock

ZHOU Runshi, CUI Na, LONG Yun, LI Zunzhu, LI Qi

2020, 55(8): 1181-1184. DOI: 10.3761/j.issn.0254-1769.2020.08.013

Asbtract ( )

HTML ( )

PDF (551KB) ( )

References | Related Articles | Metrics

Objective To investigate the performance of bioelectrical impedance without innovation by non-invasive cardiac output measurement（NICOM） and pulse indicated continuous cardiac output （PiCCO） methods in measuring the hemodynamic parameters among patients with severe septic shock,so as to provide references for clinical practice to lead non-invasive hemodynamic monitoring of patients with severe septic shock. Methods Patients with septic shock admitted to the ICU of a tertiary hospital in Beijing for hemodynamic monitoring from April to December 2017 were selected. Cardiac output（CO） and stroke volume variation（SVV） were monitored by NICOM and PiCCO respectively in the same patient,and the differences,correlation and consistency of 2 methods were compared. Results A total of 31 patients with septic shock were included,including 19 males and 12 females. No statistically significant difference was found between NICOM’s measurement of CO with 5.10（4.35,6.50）L/min and PiCCO’s measurement of CO with 4.89（4.34,6.23） L/min（Z=-0.786,P=0.430）. The difference of SVV with 13.00（11.00,16.00） detected by NICOM and SVV with 12.00（9.00,15.00）by PiCCO was statistically significant（Z=-2.607,P=0.009）. Correlation analysis showed that the Spearman correlation coefficient of CO determined by the 2 methods was 0.904（P<0.001,95%CI:0.932~1.135）,and the SVV correlation coefficient was 0.841（P<0.001,95%CI:0.601~0.786）,both of which have a significantly positive correlation. Blast-Altman analysis showed that the mean CO bias was 0.21 L/min（P=0.032,95%CI:-1.12~1.54） and the mean SVV bias was 1.56（P<0.001,95%CI:-2.56,5.68）. Conclusion The hemodynamic parameters of patients with severe septic shock monitored by NICOM were different from those monitored by PiCCO,but the correlation and consistency were satisfactory. Therefore,NICOM can be applied in clinical practice,which provides a new idea for the development of subspecialty of critical care.

Effect of “accompany with heart” on self-efficacy of spouses of breast cancer patients during treatment

LIANG Jiagui, WANG Zhenyu, LIU June, LI Hui

2020, 55(8): 1185-1188. DOI: 10.3761/j.issn.0254-1769.2020.08.014

Asbtract ( )

HTML ( )

PDF (571KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To explore the effect of “accompany with heart” intervention program on cancer self-efficacy of spouses of breast cancer patients in the treatment period. Methods The design of pretest-posttest study was adopted. The spouses of 32 female breast cancer patients who were treated in breast departments in 4 affiliated hospitals of a Medical University in Beijing from April to May 2018 were selected. The intervention elements included undertaking,accompanying and communication. The intervention method was 45-minute face-to-face individual intervention. Before the intervention and 2 weeks after the intervention,the Cancer Self-Efficacy Scale-Spouse（CSES-S） and Self-Rating Anxiety Scale（SAS） were used for measurement. Results Before the intervention,the cancer self-efficacy and anxiety of spouses were（144.25±30.76） and （34.14±6.94）,respectively. 2 weeks after the intervention,the cancer self-efficacy of spouses increased to（163.91±26.74） and the anxiety decreased to（29.26±4.56）. The difference was statistically significant（t=-3.940,P<0.001;t=4.248,P<0.001）. Conclusion The intervention program of “accompany with heart” can improve the self-efficacy and reduce the anxiety of the spouses.

Analysis of characteristics of patients with atrial fibrillation distributed by different symptom clusters

GE Hongyue, LIN Mei, XU Zhiying

2020, 55(8): 1189-1196. DOI: 10.3761/j.issn.0254-1769.2020.08.015

Asbtract ( )

HTML ( )

PDF (1005KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To identify the composition of symptom cluster in patients with atrial fibrillation and to explore the differences in the distribution of symptom clusters on sociodemographic variables and disease characteristics. Methods A cross-sectional survey was conducted in 197 patients with atrial fibrillation in the arrhythmia clinic of a tertiary general hospital in Tianjin,using the general information questionnaire and the symptom subscale of the University of Toronto AF Severity Scale（AFSS） as data collection instruments. Symptom clusters were extracted by systematic cluster analysis,and the effects of sociodemographic variables and disease characteristics on the distribution of symptom clusters were determined by chi-square test,and Kruskal-Wallis H rank sum test. Results There were 3 symptom clusters in atrial fibrillation patients,including cardiac symptom cluster（palpitation,chest pain）,fatigue symptom cluster（dyspnea at rest,fatigue,vertigo） and exertional symptom cluster（dyspnea during activity,exercise intolerance）. Gender,type of atrial fibrillation,body mass index,CHA₂DS₂-VAS_C score,combined hypertension,coronary heart disease,and heart failure were the main factors affecting the composition of the symptom clusters. Conclusion Symptom clusters can be helpful for patients with atrial fibrillation to detect symptoms early and seek medical help in time,as well as to provide theoretical support for clinical staff to implement more accurate and comprehensive symptom management for atrial fibrillation patients.

Current status of screening and assessment of patients with dysphagia after stroke by nurses in Henan province

MA Keke, GUO Yuanli, DONG Xiaofang, YANG Caixia, ZHANG Pan, WANG Min, GAO Huanhuan

2020, 55(8): 1196-1200. DOI: 10.3761/j.issn.0254-1769.2020.08.016

Asbtract ( )

HTML ( )

PDF (662KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the current status of screening and assessment of patients with dysphagia after stroke by nurses in Henan province. Methods Convenience sampling was conducted in 55 hospitals in Henan Province to enroll nurses from stroke-related departments for questionnaire survey. The questionnaire was formulated by expert consultation method with Cronbach’s α coefficient of 0.832 and the content validity of 0.751. SPSS 25.0 was used to analyze the data. Results A total of 965 nurses from 29 tertiary hospitals and 26 secondary hospitals participated in the survey,and 942 collected questionnaires were valid,with a validity rate of 97.62%. Among the 10 judgment questions in the knowledge part,nurses correctly answered 8.36±1.46 questions. In the attitude part,93.71% of nurses thought they were able to help patients improve their swallowing disorder. 98.34% of nurses thought it was necessary to establish a multidisciplinary team for swallowing disorder management. In the practice part,only 36.52% of nurses followed the latest guidelines to screen the swallowing function of patients before the first bite of food,water or drugs. Conclusion The status of screening and assessment for patients with dysphagia after stroke by nursing staff in Henan Province is not optimistic. Some nurses cannot adopt the recommended instructions to guide clinical practice,and clinical nursing management staff should attach great importance to it and carry out evidence-based translation to improve the nursing quality.

Current situation and influencing factors of exit-site care in peritoneal dialysis patients:a multicenter cross-sectional survey

ZHU Jinrong, ZHANG Li, LIAO Yumei, HUANG Huie, SU Chunyan

2020, 55(8): 1201-1205. DOI: 10.3761/j.issn.0254-1769.2020.08.017

Asbtract ( )

HTML ( )

PDF (708KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the status of exit-site care among peritoneal dialysis patients through a multicenter survey in Beijing and Shenzhen,and to analyze the influencing factors of patients’ exit-site care practice. Methods A self-designed questionnaire was used to investigate the exit-site care practice of 1,204 peritoneal dialysis patients who were followed up regularly in 12 peritoneal dialysis centers from Beijing and Shenzhen. The practice of exit-site care was divided into 5 dimensions:aseptic technique,assessment of exit-site,dressing change,catheter protection method and catheter fixation,with a full score of 50. Results The general score of exit-site care of 1,204 peritoneal dialysis patients in Beijing and Shenzhen was 44.76±5.85,while the scores of exit-site assessment and aseptic technique were relatively low. Univariate analysis showed that with or without history of exit-site infection,different operators and different locations of catheter outlet had different scores of exit-site care practice（P<0.05）. Multiple linear regression results showed that the factors influencing the general score of exit-site care practice were dialysis duration,infection history,dressing change operator,patient education level and catheter outlet location with an order from high to low. Conclusion The practice status of exit-site care in peritoneal dialysis patients from Beijing and Shenzhen was generally acceptable,while the practice of exit-site care assessment and aseptic technique were relatively poor. Further retraining would be needed,especially for patients with long dialysis time and a history of infection.

Study on illness uncertainty and influential factors of inpatients with cirrhosis and their family caregivers

XU Li, LI Meng, NAN Shiying

2020, 55(8): 1206-1211. DOI: 10.3761/j.issn.0254-1769.2020.08.018

Asbtract ( )

HTML ( )

PDF (757KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective The study aimed to investigate current status of illness uncertainty of inpatients with cirrhosis and their family caregivers and to explore related psychosocial factors. Methods Participants were selected by convenient sampling. Cirrhotic inpatients and their family caregivers were included by 1:1 match. Mishel Uncertainty in Illness Scales for Adults and Family Members were used respectively for patients and their family caregivers to evaluate illness uncertainty. Hierarchical linear regression was adopted to explore related influencing factors. Results The average score of illness uncertainty in cirrhotic inpatients and family caregivers were（84.82±12.92） and（92.49±12.66）respectively. The most important factor affecting illness uncertainty of patients and family caregivers was the unpredictable feature of the process and prognosis of illness. Hierarchical linear regression showed that the illness uncertainty of cirrhotic inpatients was affected by patients’ social support（β=-0.269,P=0.045） and caregivers’ illness uncertainty（β=0.380,P<0.001）. The illness uncertainty of family caregivers was affected by self-perceived friend support （β=-0.739,P=0.036）,patients’ family support （β=-0.700,P=0.031） and the patients’ illness uncertainty （β=0.333,P<0.001）. Conclusion Illness uncertainty was common among cirrhotic inpatients and their family caregivers. The illness uncertainty of cirrhotic inpatients and family caregivers can have an interactive effect on each other. More attention to illness uncertainty should be paid to both cirrhotic patients and their family caregivers in order to facilitate early comprehensive intervention.

Risk factors of obstructive intestinal obstruction among patients with ileal spontaneously closed intubation stoma

WANG Feixia, WANG Qunmin, PAN Zhe, WANG Qin, SHENG Qinsong, ZHONG Zifeng

2020, 55(8): 1212-1216. DOI: 10.3761/j.issn.0254-1769.2020.08.019

Asbtract ( )

HTML ( )

PDF (704KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective By analyzing the cases of intestinal obstruction caused by the blockage of protective ileal intubation,this study aims to conclude experience and novel guidance for the further clinical nursing.Methods In this retrospective case-control study design,45 patients with intestinal obstruction due to the block of protective ileal intubation were included in the cases group,and 180 patients（1 : 4） were randomly selected from the 324 patients who received the same operation without intestinal obstruction as the control group. All the patients were treated in the First Affiliated Hospital of Zhejiang University School of Medicine from January 2015 to October 2019. The general information,BMI（body mass index）,comorbidities,relative laboratories results,perioperative situations,the frequency of intubation care were analyzed using logistic regression to investigate the risk factors. Results Results indicated that body mass index（OR=2.123）,postoperative abdominal infection（OR=11.119）,extubation time（OR=0.193）,and weekly follow-up intubation maintenance（OR=24.121） were the independent risk factors. Conclusion In order to prevent the occurrence of intestinal obstruction after ileal intubation,the control of postoperative infection and shorter exintubation time plays a key role in the recovering process. Regular and high quality intubation care is also necessary to the patients,especially to the overweight cases.

Construction of a management norm for nurse-led clinics in Guangdong Provinc

FAN Fan, LIN Wenxuan, YAN Feifei, ZHOU Xuezhen

2020, 55(8): 1217-1223. DOI: 10.3761/j.issn.0254-1769.2020.08.020

Asbtract ( )

HTML ( )

PDF (919KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To construct a scientific management norm for nurse-led clinics in Guangdong Province. Methods The first draft was initially on the basis of literature review and qualitative interviews. Two rounds of expert consultation were conducted on 13 experts by the Delphi expert consultation method. Results The expert active coefficient of the two rounds of expert consultation is 100%,and the expert authority coefficient is 0.91. The coordination coefficients of the first,second and third level items in the second round of expert consultation were 0.193,0.369,and 0.300（P<0.01）.The final draft of the norm for nurse-led clinics in Guangdong Province includes four items（environment,qualification of the outpatient nurses,content and characteristics of the nurse-led clinics,evaluation of results of the nurse-led clinics） in the first level,15 items in the second level,and 56 items in the third level. Conclusion The norm for nurse-led clinics in Guangdong Province is scientific and reasonable,and it can provide guidance for the development of specialized nurse-led clinics.

A survey of the position management status for orthopedic specialist nurses

FAN Xiaoqi, LIU Juan, XIE Hongzhen, LI Weihua, BAI Zhaohui

2020, 55(8): 1223-1228. DOI: 10.3761/j.issn.0254-1769.2020.08.021

Asbtract ( )

HTML ( )

PDF (819KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the current situation of position management of orthopedic specialist nurses（OSN） in China,and to provide references for the formulation of relevant management systems. Methods A self-designed questionnaire was used to facilitate the investigation of the status and satisfaction of the post management of 560 OSN in 28 provinces/municipalities across the country. Results In terms of the management system of OSN,there were only 49.29% of the participants whose hospitals had special management systems for specialist nurses,and 20.89% of the hospital management system was not transparent. Furthermore,the specific rules in employment,level management,performance appraisal,continuing education and training,and post incentive system in those hospitals were different. As for the postpractice of OSN,74.64% of the participants didn’t change their work positions,and their main jobs were still direct clinical nursing practices,but the development of orthopedic advanced nursing practical activities were limited. Job management satisfaction was 56.96%,and only 9.46% had the intention to leave. Most of them（72.86%）were confident about the development and prospects of OSN. Conclusion The satisfaction of post management is at a medium level,as it is at the initial stage,and the advanced nursing practice activities are gradually carried out. The whole team has high professional commitment and considerable development and prospects. It is necessary for the state,hospitals and individuals to work together with their efforts to establish a scientific,rational and perfect system for postmanagement of OSN,so as to improve the growth and strength of OSN team.

Investigation on professional identity of hospice nurses

WU Jijun, LIN Qin, FU Mengxue, LIU Xiangmin, YANG Junrong, WANG Hongyan, LIANG Xiaoli, ZHANG Xiangeng

2020, 55(8): 1229-1233. DOI: 10.3761/j.issn.0254-1769.2020.08.022

Asbtract ( )

HTML ( )

PDF (651KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the status of professional identity of hospice nurses and analyze its influencing factors. Methods Totally 172 hospice nurses from 5 cities（Beijing,Changchun,Shanghai,Luoyang,Deyang）were selected and surveyed by the Nurses’ Professional Identity Rating Scale,the Chinese version of the Career Success Scale and the Chinese version of the Nurses’ Psychological Capital Scale. Single-factor analysis and multiple linear regression analysis were adopted to explore the influencing factors of professional identity. Results The score of professional identity of hospice nurses was（87.76±8.70） at a moderate level. The score of career success was（33.26±5.19）;the score of psychological capital was （72.13±14.77）. Correlation analysis showed that the professional identity of hospice nurses was positively correlated with career success and psychological capital（P<0.001）. Multiple linear regression analysis showed that the initiative to actively engage in this position,monthly salary,unit type and career success were influencing factors of professional identity. Conclusion The professional identity of hospice nurses is at a moderate level and needs to be improved. The hospice care institutions should actively promote the career success of hospice nurses and guide them to take the initiative to engage in hospice care in order to enhance their professional identity.

Construction of clinical practice training index system for pain specialist nurses based on core competence

RUAN Xiaofen, YAO Meiqi, FENG Yan, CHEN Jie, LÜ Bifang, WEI Guofang

2020, 55(8): 1234-1238. DOI: 10.3761/j.issn.0254-1769.2020.08.023

Asbtract ( )

HTML ( )

PDF (717KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To establish an index system of clinical practice training for pain specialist nurses,and to provide references for standard clinical practice training of pain specialist nurses. Methods Guided by the core competence theory,items of clinical practice training indicators were established by literature review and semi-structured interviews,and then 20 experts were invited to participate in a 2-round consultation to retrieve the indicators. Results The positive coefficients of 2 rounds of consultations were 100%. Authority coefficient was 0.881. The Kendall Coordination Coefficients of module indicators,primary indicators,and secondary indicators were 0.512,0.455,and 0.423,respectively（P<0.01）. The finalized index system of clinical practice training for pain specialist nurses included 4 module indicators,5 primary indicators,and 21 secondary indicators. Conclusion The index system of clinical practice training for pain specialist nurses based on core competence is scientific and reliable,which can provide a reference for clinical practice training of pain specialist nurses in China.

Evidence summary for clinical application of needle-free infusion connector

HAN Liu, YANG Hongyan, LIU Fei, WANG Yi, XIAO Yanyan, DING Yanming

2020, 55(8): 1239-1246. DOI: 10.3761/j.issn.0254-1769.2020.08.024

Asbtract ( )

HTML ( )

PDF (1086KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To comprehensively retrieve and analyze evidence related to clinical application of needle-free infusion connector,and summarize the best evidence. Methods The databases of evidenced based resources were searched by computer,including BMJ best practice,Uptodate,et al. In addition,complementary search of the comprehensive databases in both Chinese and English was conducted to collect literature including clinical decision support system,evidence summary,guideline,expert consensus from January 2014 to May 2019. 3 researchers evaluated the quality of the included literature independently. With the help of external experts and the standardized data extraction,eligible literature was selected for analysis. Results 13 pieces of evidence were included with 1 clinical decision support system,5 evidence summaries,5 guidelines,and 2 expert consensuses. A total of 36 recommendations were obtained and classified into 6 different aspects,namely policy recommendations,disinfection recommendations,flushing and sealing pipe,type of joint and its replacement,and cautions in use. Conclusion Health caregivers and other medical staff should regulate their behaviors based on the evidence of the needle-free infusion connector,develop policy specifications for the clinical application of needle-free infusion connector,refine its management and training content,optimize the clinical behavioral standards for the selection,replacement,disinfection,and sealing of needle-free infusion connector in practice to ensure patient safety.

Summary of the best evidence of early muscle strength training in stroke patients

CHEN Xiaoyan, WANG Ya, HUANG Juan, WU Juan, ZHONG Yueping

2020, 55(8): 1253-1259. DOI: 10.3761/j.issn.0254-1769.2020.08.027

Asbtract ( )

HTML ( )

PDF (784KB) ( )

Figures and Tables | References | Related Articles | Metrics

Objective To collect and summarize the latest relevant evidence of early muscle strength training for stroke patients at home and abroad,so as to provide a reference for the establishment of a scientific program of early muscle strength training after stroke. Methods We systematically searched in UpToDate,Joanna Briggs Institute evidence-based health care center database,National Guideline Clearinghouse,National Institute for Health and Care Excellence,Registered Nurses’ Association of Ontario,American Association of Critical-Care Nurses,National Stroke Foundation of Australia,Cochrane Library,PubMed,Web of Science,Dutch Medical Abstracts database,CNKI,Wanfang database,VIP database and Chinese biomedical literature database for all evidence on early muscle strength training for stroke patients,including guidelines,system reviews,best practice information booklets,evidence summaries,expert consensuses and original research. The retrieval time is from the establishment of the databases to October 30,2019. 2 researchers independently evaluated the quality of literature,and extracted the literature that met the standards with their professional judgment. Results A total of 18 pieces of literature were included,including 5 guidelines,1 evidence summary and 12 systematic reviews. The best evidence includes evaluation,intervention timing,intervention plan,muscle strength training interventions,quality control,effect evaluation and economic benefits. A total of 28 pieces of evidence are summarized. Conclusion We summarized the best evidence of early muscle strength training for stroke patients,and provided evidence-based references for clinical staff to carry out evidence application. It is suggested that the clinical staff should actively carry out the early muscle strength training for stroke patients in combination with the specific situation of the room,the willingness of patients and the evidence of promoting factors,obstacles and coping strategies. At the same time,the evidence should be updated dynamically to ensure the quality.

Table of Content