Table of Content

15 October 2020, Volume 55 Issue 10

Previous Issue    Next Issue

Effects of multi-component exercise training on frailty and physical function in elderly diabetic patients in communities

ZHANG Shuang,CHEN Ying,SUN Naya,JIANG Zongliang,DU Jin,SONG Anni,ZHANG Weihong

2020, 55(10):  1445-1451.  DOI: 10.3761/j.issn.0254?1769.2020.10.001

Asbtract ( )   HTML ( )   PDF (1057KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate effects of multi-component exercise training on frailty and physical function in elderly patients with diabetes. Methods 94 eligible elderly patients with diabetes combined with frailty in communities were assigned to an intervention group and a control group by a residential grouping method,with 47 in each group. The control group received routine community nursing care,while on this basis,the intervention group was implemented with 12 weeks of multi-component exercise training（including training of aerobic resistance,balance and stretching）. The effects of the intervention were evaluated by indicators of short physical performance battery（SPPB）,the Chinese version of Tilburg Frailty Indicator,handgrip strength,walking speed and fasting blood glucose. Results After intervention,the scores of TFI,physical frailty,psychological frailty and fasting blood glucose in the intervention group were lower than those at baseline and in the control group（P<0.05）. SPPB scores in all dimensions and the total score,handgrip strength,walking speed were all higher than those at baseline and in the control group（P<0.05）. There was no significant difference in the scores of social frailty between 2 groups（P>0.05）. Conclusion Multi-component exercise training is helpful for diabetic patients with frailty in communities to improve their frailty status,blood glucose level and physical function.

An observational multicenter study on the relationship between preparation-to-colonoscopy interval and the intestinal preparation quality

YANG Wenbo,LI Hong,HE Liping

2020, 55(10):  1452-1457.  DOI: 10.3761/j.issn.0254-1769.2020.10.002

Asbtract ( )   HTML ( )   PDF (917KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To understand the status of the bowel preparation quality of outpatients with colonoscopy. To analyze the effect of interval time from the completion of bowel preparation to the start of colonoscopy on the quality of bowel preparation. Methods Demographic and clinical data of outpatients undergoing colonoscopy at digestive endoscopy center of 3 general hospitals in Fuzhou from April 2019 to September 2019 were collected.Chi-square test was used to screen the factors with statistical significance on the bowel preparation quality（P<0.10）. After statistical method of propensity value matching was used to eliminate the confounding factors,the differences in bowel preparation quality between different interval groups（divided into（2,3] h、（3,4] h、（4,5] h、（5,6] h、（6,7] h、（7,8] h、（8,∞） h） were compared by variance analysis. Results A total of 401 patients were enrolled in the study. After matching of 401 samples with propensity value matching,316 new samples were generated and the influence of confounding factors was excluded by test. Compared the data with analysis of variance,the quality of bowel preparation was different in different interval time groups.The quality of bowel preparation in group of（2,3] h was significantly better than groups of（4,5] h and（6,7] h. The quality of bowel preparation in group of（3,4] h was significantly greater than（6,7] h. There was no significant difference between 2 groups of（2,3] h and（3,4] h. There was no significant difference between any 2 groups in（4,5] h,（6,7] h,（7,8] h,（8,∞） h. Conclusion The quality of bowel preparation can be maintained at an optimal state of cleanliness within 2~4 hours between the completion of bowel preparation and the start of colonoscopy.

Special Planning-Orthopaedics Nursing

Formulation and application of a progressive balance training program after total hip arthroplasty

GU Bin,CHEN Xuna,ZHANG Qiankun,ZHANG Lijuan,MA Qian,YU Hong,CHEN Yongzhen,LUO Li

2020, 55(10):  1458-1464.  DOI: 10.3761/j.issn.0254-1769.2020.10.003

Asbtract ( )   HTML ( )   PDF (1262KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To develop a progressive balance training program and to explore effects of early rehabilitation after total hip arthroplasty. Methods Through evidence-based retrieval,in-hospital revision,and pre-experiment,the progressive balance training program after total hip arthroplasty was formulated. Totally 65 patients under total hip arthroplasty in the Department of Orthopedic Trauma,a tertiary hospital in Suzhou,were included from January to August 2019 by convenient sampling,with 36 patients in an experimental group and 29 patients in a control group by bed arrangement. The experimental group was given the progressive balance training on the basis of routine exercise,while the control group was given a routine exercise program. The Berg Balance Scale（BBS）,the Time Up and Go Test（TUGT）,and Modified Fall Efficacy Scale（MFES） were used to measure and compare the differences of rehabilitation between 2 groups at 1,2,4 and 8 weeks after operation. Results The results of repeated measurement analysis of variance showed that the time,interaction and inter group effects of BBS and TUGT were statistically significant（F_time=1 645.43,F_{time × group}=73.51,F_group=761.72;F_time=4 289.34,F_{time × group}=72.83,F_group=231.43,P<0.05）. Non-parametric test showed that there were significant differences in MFES scores between 2 groups at 4 and 8 weeks after operation（Z=-4.09,P<0.001;Z=-2.65,P<0.01）. Conclusion The progressive balance training program can accelerate the recovery of balance ability and walking ability of patients in the early stage of rehabilitation after total hip arthroplasty,improve fall efficiency of patients,and improve fear of falling of patients.

Formulation and application study on intelligent pain management program of patients after lumbar spine surgery

XU Huiping,ZHAO Hui,LI Dongzhe,GUAN Lina,MEI Zhanzhan,ZHANG Chunlin,LIU Yanjin

2020, 55(10):  1465-1469.  DOI: 10.3761/j.issn.0254-1769.2020.10.004

Asbtract ( )   HTML ( )   PDF (870KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To develop a intelligent pain management program and analyze effects for the post lumbar surgery patients. Methods A non-synchronous controlled study was conducted from a tertiary hospital in Zhengzhou. 115 patients from May 2018 to February 2019 were selected as the experimental group receiving intelligent pain management. Totally 120 patients who underwent post lumbar surgery in the Department of Orthopedics of our hospital from December 2017 to March 2018 were selected as the control group receiving routine nursing care. Pain and rehabilitation indicators of post lumber surgery patients before and after intervention by intelligent pain management were compared. Results There were statistically significant differences in pain assessment time of nurses,pain controlled time by nurses,most severe pain scores of patients after operation,patients’ satisfaction of pain relief,and length of stays between the 2 groups（P<0.05）. Conclusion Intelligent pain management can improve work efficiency of nurses and the pain status,shorten length of stays of the post lumbar surgery patients.

The development of rehabilitation behaviors of patients with total knee arthroplasty：a qualitative study

SHAN Yawei,CHEN Weijia,JIN Lijuan,CHEN Ru,LIN Rujia

2020, 55(10):  1470-1475.  DOI: 10.3761/j.issn.0254-1769.2020.10.005

Asbtract ( )   HTML ( )   PDF (1059KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the process and initiating factors of rehabilitation behaviors of knee osteoarthritis patients with total knee arthroplasty（TKA）. Methods A qualitative research guided by grounded theory was conducted,and data collected by semi-structured in-depth interviews with 12 patients of a tertiary orthopedic hospital in Shanghai from June to August 2019. Thematic analysis was adopted under the theoretical structure of ego depletion. Results 4 main reasons for ego depletion were identified,including symptom distress,deficiency in health knowledge and social support,negative life events and surgical stress. The impairment of controlling in cognition,emotion,attention and social interaction led to the impulse decision making,negative emotion,decreased motivation and social interaction failure,which eventually resulted in negative rehabilitation behaviors. Conclusion The negative rehabilitation behaviors of TKA patients are the outcomes of ego depletion,which is influenced by multifactor. The major aspects of self-control concluded from this theoretical framework could work as preferences to intervention strategies in promoting positive rehabilitation behaviors.

Evidence summary of early resistance training in patients after total hip arthroplasty

WANG Tian,LIU Xiaoyu,LU Haiying,SHAN Yawei,CHEN Weijia,JIN Lijuan

2020, 55(10):  1476-1483.  DOI: 10.3761/j.issn.0254-1769.2020.10.006

Asbtract ( )   HTML ( )   PDF (1235KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To retrieve,evaluate and obtain the relevant evidence of early postoperative activities for patients with total hip replacement,and to summarize the best evidence. Methods We systematically searched for evidence on resistance training of total hip replacement patients in BMJ Best Practice,UpToDate,JBI,NICE,SIGN,NZGG,Cochrane Library,PubMed,EBSCO,Science Direct,CNKI,Wanfang,VIP,CBM and other orthopaedics databases to collect relevant guidelines,best practice,systematic reviews,expert consensuses and original research. The timeframe of data search ran from January 1,2009 to April 20,2020. Results A total of 20 articles were included,including 2 guidelines,1 uptodate,6 randomized controlled trials,7 systematic reviews,2 expert consen-suses,1 case-control study and 1 cohort study. Combined with professional judgment,13 pieces of best evidence in 8 aspects were summarized,including assessment,time,intensity,ways,place,program,adverse reactions and monitor-ing of resistance training. Conclusion This study summarizes the best available evidence for early resistance training in patients with total hip arthroplasty,in order to provide evidence-based information for the clinical use of medical staff.

Research progress on geriatric orthopedic co-management care model in geriatric hip fracture patients

LIANG Xiaoqin,LU Xuemei,LIU June,PENG Guiling,JIA Yunyang,YANG Minghui

2020, 55(10):  1484-1489.  DOI: 10.3761/j.issn.0254-1769.2020.10.007

Asbtract ( )   PDF (773KB) ( )  

References | Related Articles | Metrics

With the deepening of aging process,geriatric hip fracture has become one of the world’s most serious public health problems. The prognosis of geriatric hip fracture patient is poor. Fragility Fracture Network calls for multidisciplinary cooperation to improve the functional outcome of hip fracture patients. The co-management care model,that is,orthopedic doctors and geriatricians jointly manage geriatric hip fracture patients,is an effective care model for geriatric hip fracture internationally. This paper focuses on the concept,generation and development of this model,the role of nurses,types of co-management care model,outcome evaluation indicators and other aspects,so as to provide a theoretical basis to effectively implement localized co-management care model for domestic medical institutions.

Special Planning-Gestational Diabetes M ellitus Nursing

Analysis of blood glucose changes and nursing countermeasures in 24 hours after birth of the neonates delivered by mothers with gestation diabetes

FAN Tingting,FENG Suwen,JIN Ying,CHEN Danqing

2020, 55(10):  1490-1496.  DOI: 10.3761/j.issn.0254-1769.2020.10.008

Asbtract ( )   HTML ( )   PDF (980KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the trend and associated influencing factors of blood glucose in 24 hours after birth of the neonates delivered by gestation diabetes mellitus（GDM） mothers. Methods Mothers with a single birth and diagnosed with GDM during the pregnancy were enrolled from December 2017 to September 2018 in a tertiary women’s hospital in Hangzhou. Baseline data of the parturient women and neonates and blood glucose of the neonates at 3 h,6 h,12 h and 24 h after birth were collected. Results A total of 884 cases of GDM neonates were enrolled. Hypoglycemia occurred in 4 cases at 3 h and 6 h after birth respectively and no hypoglycemia occurred at 12 h and 24 h after birth. Besides,30 cases（3.39%）,19 cases（2.17%）,7 cases（0.81%）,7 cases（0.81%） of critical hypoglycemia（excluding repetitive critical hypoglycemia） occurred at 3 h,6 h,12 h and 24 h after birth,respectively. The incidence of critical hypoglycemia at 3 h was statistically associated with the mode of delivery（OR=3.834）,lactation volume （OR=7.006） and neonatal gender （OR=4.014）（P<0.05）. Lactation deficiency was the major risk factor of critical hypoglycemia at each time point（P<0.05）. Conclusion The incidence of hypoglycemia and critical hypoglycemia of rooming-in GDM neonates decreased gradually within 24 hours after birth. The blood glucose in GDM neonates at different time points was affected by multiple factors. Delivery mode,lactation volume,and gender were independent factors affecting critical hypoglycemia in GDM neonates at 3 h after birth. The implication for clinical practice was that hierarchical and targeted management should be conducted in caring rooming-in GDM neonates.

Establishment and obstacle analysis of evidence-based nursing indexes of blood glucose management in neonates delivered by mothers with gestational diabetes

CHENG Xiangwei,WANG Peihong,TU Fengming,ZHOU Yingfeng,YU Jiaohua,ZHANG Wen,WANG Huanhuan,LUO Libo,YAN Hongyu

2020, 55(10):  1497-1502.  DOI: 10.3761/j.issn.0254-1769.2020.10.009

Asbtract ( )   HTML ( )   PDF (922KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To comprehensively evaluate the clinical status of blood glucose management in neonates delivered by mothers with gestational diabetes in obstetrics，and to develop review indicators of evidence based nursing，analyze obstacles and contributing factors. Methods With JBI health care model as the evidence based theoretical framework，clinical problems were identified；literature retrieval，evaluation and evidence were collected；review indicators and review methods were developed. According to the results of baseline review,the obstacle factors were analyzed,and methods and countermeasures were developed. Result Totally 10 pieces of best evidence were included and 14 clinical review indicators were formulated,of which there are only 2 indicators with the compliance rate of 100%. After detailed analysis of the results,it is concluded that the main obstacles are the lack of process management,insufficient training of nurses on hypoglycemia and the lack of awareness of mothers and family members. The main contributing factors are strong leadership and team work. According to implementation of the corresponding countermeasures,compliance rates of 14 indicators were all above 90%,of which 10 were 100%. Conclusion The obstacles and contributing factors in practice were scientifically and comprehensively evaluated,and corresponding countermeasures were properly proposed,which can effectively promote the application of evidence in clinical practice.

Analysis of potential categories of pregnancy-related anxiety in patients with gestational diabetes mellitus

ZHANG Xianxian,ZHANG Lixia,JIA Zhihui,ZHANG Boya

2020, 55(10):  1503-1508.  DOI: 10.3761/j.issn.0254-1769.2020.10.010

Asbtract ( )   HTML ( )   PDF (1165KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the potential categories of pregnancy-related anxiety in patients with gestational diabetes mellitus（GDM）,and the different characteristics of each potential categories. Methods From December 2018 to May 2019,172 gestational diabetes mellitus patients were investigated by general information questionnaire,Pregnancy-related Anxiety Questionnaire（PAQ）,Vulnerable Personality Style Questionnaire（VPSQ） and Connor-Davidson Resilience Scale（CD-RISC）. Results Pregnancy-related anxiety in patients with GDM has 2 potential categories,namely high incidence of anxiety group（59.0%） and low anxiety-worry fetus group（41%）. Logistic regression analysis showed that college degree or above（OR=6.799）,adverse pregnancy history（OR=4.276） and susceptibility personality（OR=5.999） were risk factors for high incidence of anxiety（P<0.05）. Psychological resilience was protective factor for high incidence of anxiety（OR=0.940,P<0.05）. Conclusion GDM patients have obvious classification characteristics of pregnancy-related anxiety. Patients with high education,adverse pregnancy history and susceptibility personality have high incidence of anxiety,therefore,this population should be given more attention for caring. The low psychological resilience is related to the pregnancy-related anxiety,so it is necessary to develop the psychological resilience of patients,relieve their psychological stress,and alleviate their pregnancy-related anxiety.

Development and psychometric test of self-management scale for patients with gestational diabetes mellitus

ZHANG Xia,ZHANG Xin,WAN Jingjing

2020, 55(10):  1509-1513.  DOI: 10.3761/j.issn.0254-1769.2020.10.011

Asbtract ( )   HTML ( )   PDF (813KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To develop the Self-management Scale for Chinese Gestational Diabetes Mellitus（SMS-GDM）,and to test the reliability and validity of the scale. Methods Based on the theory of social cognition and health empowerment,the initial scale was formulated by semi-structured interviews,literature reviews and 2 rounds of Delphi expert consultations. A total of 226 gestational diabetes patients were selected to examine the reliability and validity of the scale. Results The scale consisted of 4 dimensions and 32 items. The Cronbach’s α coefficient of scale was 0.939;Spearman-Brown coefficient of scale was 0.780,and the test-retest reliability was 0.903. The content validity of the scale was 0.927. The exploratory factor analysis showed that the cumulative variance contribution rates of the 4 dimensions were 55.636%. Conclusion The scale is valid and reliable,and it can be applied to measure the self-management ability of gestational diabetes patients.

Evidence summary of exercise regimens for patients with gestational diabetes mellitus

LIU Ting,TAN Xiaoxue,XU Nafei,MI Yuanyuan,CHEN Yanping,XU Min

2020, 55(10):  1514-1519.  DOI: 10.3761/j.issn.0254-1769.2020.10.012

Asbtract ( )   HTML ( )   PDF (948KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To retrieve,appraise and integrate the available evidence of exercise regimens for gestational diabetes mellitus patients,and to provide foundation for decision-making in clinical nursing practice. Methods We searched the BMJ Best Practice,UpToData,Guidelines International Network（GIN）,Registered Nurses’ Association of Ontario（RNAO）,American Diabetes Association（ADA）,Chinese Medlive Guidelines Network,Cochrane Library,PubMed,CNKI,Wanfang Date to collect all articles on exercise regimens for gestational diabetes mellitus,including guidelines,systematic reviews,evidence summaries,recommended practice and expert consensuses. The retrieval period was from the inception to May 2019. JBI evidence appraisal and recommendation system was used to evaluate quality of studies and level of evidence. Results Totally 16 articles were selected,and a total of 31 items of best evidence were summarized from 8 aspects,including applicable population of gestational diabetes exercise interventions,benefits,risks,assessments,types,intensity,time and precautions. Conclusion Moderate exercise is safe and effective for patients with gestational diabetes. Clinical nurses should guide patients to exercise moderately during pregnancy by applying the best evidence with scientific nursing intervention.

Standards

Expert consensus on clinical practice of allergen skin prick test in children

Pediatric RespiratoryGroup of Pediatric Nursing Alliance of National Children Medical Center, Writing Committee: WANG Zijuan, LIU Yulin, LIU Enmei

2020, 55(10):  1520-1520.  DOI: 10.3761/j.issn.0254-1769.2020.10.013

Asbtract ( )   HTML ( )   PDF (841KB) ( )  

References | Related Articles | Metrics

Objective Skin Prick Test （SPT） is widely used in clinical practice,however,standard guidelines still remain blank. The establishment of an expert consensus of clinical practice in children can fill the gap of clinical practice guidelines to some extent,and provide references for the clinical operation of SPT in China. Methods In this study,we formulated clinical problems through the literature review and experts experience. The clinical problems were revised and improved through consensus meetings. Results The final consensus was formulated on indications,contraindications,applicable population,operation steps,interpretation of results,clinical manifestations and treatment measures of allergic reactions,frequently asked questions of SPT operation,etc. It is recommended that children’s allergen SPT is suitable for people aged 0-18 years. If children are suspected to be sensitized to one or several allergens,the allergen SPT can be conducted on one or both forearms due to different skin areas of children at different ages. Conclusion The consensus is highly operable with certain clinical value.

Specialist Practice and Research

Study on influencing factors of pulmonary infection in patients with hepatitis B virus-related acute-on-chronic liver failure

HU Zhengcui,CHEN Yi

2020, 55(10):  1521-1525.  DOI: 10.3761/j.issn.0254-1769.2020.10.014

Asbtract ( )   HTML ( )   PDF (744KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the current status and the influencing factors of pulmonary infection in patients with hepatitis B virus-related acute-on-chronic liver failure（HBV-ACLF）. Methods A retrospective analysis was performed for the clinical data of 238 HBV-ACLF patients who were hospitalized in a tertiary hospital in Shanghai from January 2017 to December 2019,so as to analyze the current status and the influencing factors of pulmonary infection. Results Among 238 patients with HBV-ACLF,53 patients suffered from pulmonary infection,and the infection rate was 22.27%.Binary logistic regression demonstrated that age,use of hormones and long-term use of antibiotics were independent risk factors for HBV-ACLF patients complicated with pulmonary infection. Conclusion HBV-ACLF patients with the older age,the use of hormones and the long-term use of antibiotics can increase the risk of pulmonary infection. In the treatment and nursing care process of HBV-ACLF patients,targeted interventions should be taken into consideration of the relevant influencing factors of pulmonary infection,so as to reduce the pulmonary infection rate of HBV-ACLF patients.

Application of micro-video combined with action-oriented teaching in hospitalized patients with urostomy

LI Jinrong,FU Guifen,MENG Youxuan,LIAO Junjuan,YANG Chun,PAN Jiemiao

2020, 55(10):  1526-1530.  DOI: 10.3761/j.issn.0254-1769.2020.10.015

Asbtract ( )   HTML ( )   PDF (767KB) ( )  

References | Related Articles | Metrics

Objective To evaluate the effect of micro-video combined with action-oriented teaching on health education in patients with urostomy after ileal conduit urinary diversion. Methods A total of 86 patients with urostomy after ileal conduit urinary diversion from January to December 2018 in our hospital were enrolled. According to the hospitalization time,42 patients were selected in the experimental group and 44 patients in the control group. The patients in experimental group received the health education program of micro-video combined with action-oriented teaching and the patients in the control group received routine health education program. The self-care ability for urostomy,rate of complication and satisfaction of health education were compared between 2 groups. Results The score of self-care ability for urostomy in the experimental group was significantly higher than that in the control group（14.18±3.92 v.s. 9.2±4.6,P<0.05）. The incidence of skin inflammation around the stoma was 2.4%（1/42） in the experimental group,significantly lower than 18.2%（8/44）in the control group. The satisfaction of health education in the experimental group was significantly higher than that in control group（91.41±6.47 v.s. 85.25±11.71,P<0.05）. Conclusion The application of touch media combined with action-oriented teaching for health education can effectively improve self-care ability for urostomy in patients and reduce the incidence of stoma related complications.

Nursing Management

Investigation on health education literacy of pediatric clinical nurses and analysis of influencing factors

LIU Meihua,ZHU Lihui,ZHANG Yuxia,ZHANG Linqi,LIN Yan,SHAN Yuying,ZENG Bingying,HUA Yun,ZHOU Yun,ZENG Liemei,ZHAO Xiufang,PENG Jianxiong,LIU Huayan

2020, 55(10):  1531-1536.  DOI: 10.3761/j.issn.0254-1769.2020.10.016

Asbtract ( )   HTML ( )   PDF (777KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the current status and influencing factors of health education literacy of clinical pediatric nurses in China,so as to help clinical managers to formulate targeted training programs and provide references for the improvement of health education literacy of clinical nurses. Methods Pediatric nurses from 31 provinces and cities at all levels in the country were selected as survey subjects by the method of general survey,and a self-made “Pediatric Nurse Health Education Literacy Questionnaire” was distributed to investigate the knowledge,attitude and practice of health education literacy of nurses. The influencing factors of health education literacy were analyzed by multiple linear regression method. Results A total of 15,800 questionnaires were collected,of which 15,765 were valid with an effective recovery rate of 99.78%. 31 provinces,autonomous regions and municipalities nationwide participated in this survey. The knowledge of health education literacy of nationwide pediatric nurses scored（37.80±4.46）;the score of attitude was（31.74±3.60）;the practice scored（77.03±7.76）. Multiple linear regression analysis showed that professional titles,related publications,and the attendance of related trainings were main influencing factors of health education literacy of pediatric nurses（P<0.05）. Conclusion The health education literacy of pediatric clinical nurses in China was at a medium level,which needs to be further improved. Active participation in various forms of training could help nurses form a complete framework of health education and improve the holistic level of health education literacy. Nursing managers should provide effective trainings for nurses based on clinical needs and make joint efforts to improve the health education literacy of pediatric clinical nurses.

Research on the construction and application of Internet Nursing Service Platform

TIAN Yutong,ZHANG Yan*,HOU Xiaohua,REN Haiyan,ZHANG Yanli,NIU Shuqin,QIU Xiaohui,TAN Heyan

2020, 55(10):  1537-1542.  DOI: 10.3761/j.issn.0254-1769.2020.10.017

Asbtract ( )   HTML ( )   PDF (911KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To design and develop an Internet Nursing Service Platform（herein after referred to as the platform）and to evaluate its application effects,in order to provide references for the development of internet nursing services. Methods The platform was designed and developed based on Internet Nursing Service Pilot Program with 3 ports for clients,nurses and platform management system,22 services including basic care,maternal and child care,specialist care,and 30 inspection services. 1 municipal hospital and 5 township-level hospitals were selected for trial operation,and the focus group interview was used to evaluate the platform effects. Results As of March 2020,the platform had a total of 247 registered nurses,7 411 users and 1 941 completed orders. The top 3 services were the determination of neonatal percutaneous bilirubin,replacement of gastric tube and nasal feeding,and general dressing change. The systematic evaluation rate and telephone follow-up satisfaction were both 100%. 4 themes were summarized from the focus group interviews,namely meeting the professional care needs of home patients,promoting the home health of patients,enhancing professional sense of value,unsolved platform problems in application practice. Conclusion The operation of the platform provides an innovative access to ensure the health of patients at home,and provides continuous nursing services. However,the operating mechanism and service staffing need to be further improved to ensure the effective operation of this platform.

Community Care

The effects of adaptive computer-based cognitive training on community-dwelling elder people

GONGYE Huijuan,LIU Yu,TIAN Jiali,GUO Guifang

2020, 55(10):  1543-1548.  DOI: 10.3761/j.issn.0254-1769.2020.10.018

Asbtract ( )   HTML ( )   PDF (726KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective The research aimed to analyze the immediate training effects of adaptive computer-based cognitive training among community-dwelling elderly. Methods 74 senior people from 4 communities in Beijing were conveniently sampled and then allocated into an intervention group and a control group according to their order with 37 people in each group. The intervention group and the control group received 6 weeks of adaptive cognitive training(5 times/week，20 mins/time),respectively. The general cognitive function，memory，executive and attention function were evaluated before the intervention and at the completion of intervention. Results 61 elderly people completed all data collection. The results showed as following. (1)General cognitive function：the scores of Montreal Cognitive Assessment Scale of Beijing version were improved(P<0.05) in 2 groups after the intervention. Compared with the control group，the score of the intervention group was improved(P<0.05). (2)Memory function：in the intervention group，the numbers of immediate recall，short delayed recall，long delayed recall and recognition were improved(P<0.05). (3)Executive function：the test time of TMT and SCWT-3 were significantly shortened(P<0.05). (4)Attention function：the scores of digit span were not improved significantly(P>0.05) in both groups. Conclusion The computer-based cognitive training has positive training effects on the cognitive function of community-dwelling elderly. The training effect of the adaptive cognitive training is better.

Basic Nursing

Effects of continuous aspiration of subglottic secretion on different suction negative pressures in rabbits

JIANG Man,AO Xin,YANG Xinchao

2020, 55(10):  1549-1553.  DOI: 10.3761/j.issn.0254-1769.2020.10.019

Asbtract ( )   HTML ( )   PDF (766KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the effects of different suction pressures on trachea mucosa of rabbits through animal experiments in order to find a safe and effective method of continuous aspiration of subglottic secretion. Methods Using self-control method,the commonly used suction pressures during clinical practice for continuous aspiration of subglottic secretion were chosen. A total of 40 healthy white rabbits were randomly divided into Group A and Group B. Group A：40~60 mmHg,Group B：60~80 mmHg. Subglottic flushing was performed in 2 groups at intervals of 4 hours. Sputum volume and subglottic-supraglottic detention volume within 1 week for 2 groups were recorded. On the fourth day of mechanical ventilation and at the end of the experiment,the amount of visible bloody fluid with naked eyes and positive cases of occult blood test in 2 groups were recorded. Meanwhile,the changes of airway mucosa were observed under microscopes in 2 groups. Results There were no significant differences in sputum volume,subglottic-supraglottic detention volume and visible bloody fluid with naked eyes between 2 groups（P>0.05）. Positive occult blood tests of retained substances on the 4th and 7th days of mechanical ventilation,the number of cases in Group B were significantly higher than those in Group A（P<0.05）. Tracheal mucosal injury under electron microscopy：4th day,Group B（IV degree）>Group A（I degree）;7th day,Group B（V degree）>Group A（I degree）. In Group B,the degree of airway mucosa injury was more serious in different time periods,and it was aggravated with the extended length of mechanical ventilation. Conclusion On the premise of maintaining safe and effective suction,continuous subglottic suction with constant negative pressure of 40~60 mmHg and intermittent subglottic flushing for 4 hours can not only ensure the suction effect,but also reduce damage to airway mucosa.

Vascular Acces Nursing

Research of injury-free needle placement method on the maintenance of totally implantable access port on the chest wall of tumor patients

ZHU Yawen,FENG Yuezhen,XIAO Aihua,TAN Liping

2020, 55(10):  1554-1559.  DOI: 10.3761/j.issn.0254-1769.2020.10.020

Asbtract ( )   HTML ( )   PDF (1028KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To observe the effect of 2 placement methods of sphenoid needle on the maintenance of totally implantable access port（TIAP） on chest wall of tumor patients. Methods The differences of flushing amount between forward placement group of the injury-free needle and the back placement group were compared by in vitro experiment. 193 tumor patients who had been implanted into the infusion port for the first time were selected as the research subjects and were randomly divided into the forward placement group and the back placement group. The infusion speed and the degree of catheter blockage were compared between 2 groups. The differences of the fixation effect and the comfort degree of the injury-free needle between 2 groups were compared when they were implanted into the port seat at different positions. Results In vitro experiment,the amount of flushing in the back group was（4.20±0.67） ml,which was significantly lower than that in the forward group（6.51±0.92） ml（P<0.05）. In clinical trials the infusion speed in the forward group was（183.96±9.23） d/min,which was significantly higher than that in the back group（151.02±10.11） d/min（P<0.001）. The incidence of catheter blockage was similar in 2 groups（P=0.413）. When the access port seat was close to the armpit,the fixation effect of the injury-free needle in the forward placement group were better than that in the back placement group （P<0.001）,and the comfort of the forward placement group was better than it in the back placement group（P<0.001）. When the infusion port seat was close to the midline of the clavicle,there was no statistically significant difference in injury-free needle application and fixation effects between 2 groups（P=0.416）,and there was no statistically significant difference in patient comfort （P=0.457）. Conclusion For the maintenance of TIAP on the chest wall of tumor patients,less amount of flushing was required in vitro in the backward group than it in the forward group. When the infusion port seat is close to the axilla,the forward placement group is better for application and fixation with higher comfort degree,and the infusion speed is faster.

Clinicall Practice

Nursing care of a coagulation disorder patient after treatment of ECMO for H5N6 infection and severe ARDS

MO Hongping,ZHOU Yi,LIN Yeqing,ZENG Qiaojun,HUANG Yuehua,CAI Min,WANG Jiwen,FENG Xiaoling

2020, 55(10):  1560-1563.  DOI: 10.3761/j.issn.0254-1769.2020.10.021

Asbtract ( )   HTML ( )   PDF (671KB) ( )  

References | Related Articles | Metrics

To summarize the nursing experience of a patient with human infection H5N6 avian influenza with severe acute respiratory distress syndrome after Extracorporeal Membrane Oxygenation（ECMO） treatment with a coagulation disorder. Nursing highlights： Establish a multidisciplinary medical and nursing team,initiate emergency deployment of nursing human resources,and strictly isolate and control infection; dynamically monitor blood coagulation function to ensure the safety of ECMO treatment; prevent complications and reduce the risk of bleeding in patients; attach importance to respiratory exercises; strengthen early rehabilitation treatment; implement early psychological interventions to relieve patients’ anxiety and fear. After careful treatment and care,the patient recovered and was discharged.

Evidence Synthesis Research

Evidence summary of prevention of intraoperative acquired pressure injury in adult patients

LIU Xiaoli,WANG Ling,WEI Yanshu,WU Xiaozhou

2020, 55(10):  1564-1570.  DOI: 10.3761/j.issn.0254-1769.2020.10.022

Asbtract ( )   HTML ( )   PDF (919KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To collect,evaluate and integrate the available evidence of prevention of intraoperative acquired pressure injury,and summarize the best evidence. Methods Registered Nurses’ Association of Ontario,National Institute for Health and Clinical Excellence,Scottish Intercollegiate Guidelines Network,National Guideline Clearinghouse,Guidelines International Network,Medlive.cn,British Medical Journal Best Practice,UpToDate,Cochrane Library,Joanna Briggs Institute Library,PubMed,CINAHL,Embase,CNKI,WanFang Data,National Pressure Injury Advisory Panel,Wound Ostomy and Continence Nurses Society,the Association of perioperative Registered Nurses were researched to collect literatures including guidelines,systematic reviews and consensuses. The time limit for the retrieval is from the inception of databases until Decemeber 2019. The JBI evidence appraisal and recommendation system was used to evaluate the quality of studies and the level of evidence. Results 17 pieces of literature were retrieved,including 4 guidelines,12 systematic reviews and 1 consensus. Combined with the judgment of clinical experts,totally 27 peices of evidence were summarized,including risk assessment,skin assessment,position management,patient handover,temperature control,education and training,etc. Conclusion The prevention program of multi-section joint and multi-discipline cooperation should be formed according to the evidence. In the application and implementation of evidence,the best evidence should be selected according to the characteristics of the hospital and the clinical environment,and the management of patients should be standardized to reduce the incidence of intraoperative acquired pressure injury.

The effects of early ambulation in patients with acute myocardial infarction after emergency PCI：a systematic review

GU Yuqing, LI Qingyin, WU Jie, LIU Yuwen

2020, 55(10):  1571-1577.  DOI: 10.3761/j.issn.0254-1769.2020.10.023

Asbtract ( )   HTML ( )   PDF (893KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To evaluate the effects of early clinical activities in patients with acute myocardial infarction after emergency percutaneous coronary intervention（PCI）. Methods PubMed,EMBASE,Cochrane Library,CINAHL,CBM,Wanfang data and CNKI were retrieved by computer for the related clinical randomized control trials on the effects of early ambulation in patients with acute myocardial infarction after emergency PCI. The quality of articles was appraised by the Cochrane Handbook（5.1.0）,and Meta-analysis was carried out with Revman 5.3 software. Results A total of 8 clinical randomized controlled trials were included,with a total sample size of 586 cases,of which 5 were grade A and 3 were grade B. Meta-analysis showed that compared with the control group,the score of left ventricular ejection fraction[MD=5.75,95%CI（4.52,6.99）,P<0.001] was significantly higher in the experimental group than it in the control group. However,there was no significant difference in the 6-minute walking distance between 2 groups at the time of discharge. The total hospital stay was significantly shortened[MD=-3.84, 95%CI（-6.65,-1.02）,P=0.008];the incidence of adverse cardiac events[RR=0.44,95%CI（0.25,0.75）,P=0.003] was significantly reduced in the early intervention group after 6 months of discharge,and the quality of life was significantly improved. Conclusion The early ambulation for patients with acute myocardial infarction is conducive to the recovery of cardiopulmonary function,which can reduce the length of hospital stay,effectively prevent the occurrence of cardiac endpoint events,and improve the quality of life.

Review

Introduction of theoretical substruction and analysis of its utilization

XIAO Xueling,Nancy R. Reynolds,WANG Honghong

2020, 55(10):  1578-1582.  DOI: 10.3761/j.issn.0254-1769.2020.10.024

Asbtract ( )   HTML ( )   PDF (665KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Theoretical substruction includes extract concepts from the high and abstract level to low and concrete level, and it is the process to develop operational concepts and display the process in a diagram,which makes theories more practical. This review described the concept and utilization of theoretical substruction,explained the process in detail with an example（the self-regulatory HIV/AIDS symptom management model）,and addressed the key points and difficulties in this process. This study could provide evidence to develop theoretical systems specific to Chinese nursing.

Research progress on daily interruption of sedation on children with mechanical ventilation

DING Yaping,ZHU Jihua,ZHOU Hongqin,XIA Shanshan

2020, 55(10):  1583-1587.  DOI: 10.3761/j.issn.0254-1769.2020.10.025

Asbtract ( )   HTML ( )   PDF (672KB) ( )  

References | Related Articles | Metrics

Daily interruption of sedation (DIS) refers to the continuous use of sedative drugs in the process, daily for a short time to stop sedative drugs, until the patient gradually awake, can make the corresponding action according to the instructions, and then give the sedation treatment again.The origin and development of daily interruption of sedation（DIS） was introduced in this article,and the implementers,implementation targets,intervention methods and evaluation tools were explained. This article also analyzed and discussed the application effect of DIS in children with mechanical ventilation sedation,and made relevant suggestions,in order to provide references for China to carry out related practices.

Research progress on non-pharmacological interventions for the frail elderly

ZHANG Jie,ZHANG Dandan,WANG Haiyan

2020, 55(10):  1588-1592.  DOI: 10.3761/j.issn.0254-1769.2020.10.026

Asbtract ( )   HTML ( )   PDF (625KB) ( )  

References | Related Articles | Metrics

Frailty is a common geriatric syndrome that seriously affects the quality of life and health outcomes of the elderly. However,frailty is a reversible process,and it can be delayed or improved by effective interventions. At present,non-pharmacological intervention is the most important intervention. This paper reviews the research progress of exercise intervention,nutrition intervention,multi-factor intervention and other intervention methods in recent years,so as to provide references for management of frail elderly. Meanwhile,it summarizes the effect evaluation indexes of non-pharmacological intervention,in order to provide the basis for carrying out related research and exploring effective non-pharmacological interventions for the frail elderly.

Research progress on nursing care of patients in a persistent vegetative state

GAO Yan,ZHAO Jingpu,WANG Yulong,LIANG Weirong,ZHANG Jing,ZHOU Yixia,ZHOU Juan,DONG Zhiyuan,WANG Dong,WEN Qiong

2020, 55(10):  1593-1597.  DOI: 10.3761/j.issn.0254-1769.2020.10.027

Asbtract ( )   HTML ( )   PDF (751KB) ( )  

References | Related Articles | Metrics

Persistent vegetative state（PVS） is a special state of unconsciousness after severe brain damage. Due to a lack of effective treatment methods,it imposes heavy burdens on both individuals and society. The care of PVS patients mainly relies on nursing care,which is difficult and complicated. However,there has been no clinical guideline to ensure the quality of care. The purpose of this article is to review the literature concerning nursing care on consciousness recovery,nutritional support,prevention of complications,psychological support and education for family caregivers of PVS patients. It was anticipated that this review will provide references to improve nurses’ knowledge on the care of PVS patients and to construct clinical guidelines and pathway on nursing care.

Research progress on early readmission of patients after percutaneous coronary intervention

WANG Ya,CHENG Jifang,LIU Chongbin,SONG Jianping

2020, 55(10):  1598-1601.  DOI: 10.3761/j.issn.0254-1769.2020.10.028

Asbtract ( )   HTML ( )   PDF (552KB) ( )  

References | Related Articles | Metrics

The prognosis of patients after percutaneous coronary intervention（PCI） has uncertainties,such as recurrent angina pectoris,chest pain,recurrent acute myocardial infarction and so on,resulting in early readmission of patients after PCI. Early readmission after PCI not only increases the economic burden of patients,but also increases the social medical burden. In order to reduce the early readmission after PCI and reduce the economic and social medical burden of patients,it is very important to understand the reasons,influencing factors and intervention methods of early readmission after PCI. This paper introduces the concept and incidence of early rehospitalization of patients after PCI,analyzes its influencing factors,and puts forward the methods of reducing the early readmission from the aspects of drug management,lifestyle intervention and emotional management.