Table of Content

15 February 2021, Volume 56 Issue 2

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Research Paper

Establishment of a risk predictive model of maternal hypothermia during caesarean section and its application effect test

KONG Shanshan, DENG Lu, SHEN Haiyan, LÜ Qian, LI Yuzhen, ZHENG Hong

2021, 56(2):  165-171.  DOI: 10.3761/j.issn.0254-1769.2021.02.001

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Objective To identify risk factors of maternal hypothermia during caesarean section,establish a risk prediction model,and test the application effect. Methods A total of 369 puerperas,who underwent caesarean section in 3 hospitals in Changsha City,Hunan Province from July 2018 to January 2019,were enrolled for this study and allocated into a hypothermia group and a non-hypothermia group based on whether hypothermia occurred during the caesarean section. Risk factors between hypothermia group（n=83） and non-hypothermia group（n=286） were compared using logistic regression for model construction. The goodness of fit of the model was verified by Hosmer-Lemeshow test. The predictive validity of the model was evaluated by the area under the ROC curve（AUC）. Result 7 factors,namely maternal body temperature after anesthesia,body mass index,subclinical hypothyroidism during pregnancy,intraoperative loss of fluid,intraoperative irrigation fluid in the abdominal cavity without warming,the time of active warming and preoperative ambient temperature,were included in the model. Logistic regression prediction model Hosmer-Lemeshow goodness-of-fit test showed that P=0.425. The area under the ROC curve was 0.888. When the best boundary value was -1.844,the sensitivity and specificity of the logistic model were 0.880 and 0.741,respectively. The accuracy of the model was 79.7%. It showed that the model had a good fitting effect and discriminating validity. Conclusion The risk prediction regression model had satisfactory prediction,high sensitivity and specificity,which can provide references for preventative treatment and nursing measures for high-risk mothers.

The effect of different feeding time during hemodialysis on the blood glucose and blood pressure in non-diabetes patients：a randomized crossover trial

MA Xun, XU Xianrong, WANG Ronghua, YANG Jiahui, CHI Mingzhu, LI Lingling, WANG Bei, HAN Qingyun, YANG Li, ZHU Yamei

2021, 56(2):  172-176.  DOI: 10.3761/j.issn.0254-1769.2021.02.002

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Objective To evaluate the effect of different feeding time during hemodialysis using glucose-free dialysate on the blood glucose and blood pressure in non-diabetes patients. Methods A randomized crossover study was conducted. 40 patients were randomized to 2 groups：the first group taking food at 1.5 hour during hemodialysis for 6 sessions and then taking at 2.5 hour during hemodialysis for 6 sessions;the second group taking food at 2.5 hour during hemodialysis for 6 sessions and then taking at 1.5 hour during hemodialysis for 6 sessions. The blood glucose and blood pressure per hour during hemodialysis were measured. The incidence of hypotension and hypoglycemia at different time points were compared between the 1.5-hour feeding and the 2.5-hour feeding. Results 39 patients were finally included,and glucose and blood pressure were all measured 234 times at each 5 time points（before hemodialysis,1 h,2 h,3 h and 4 h during hemodialysis） in 2 groups. Compared with the 2.5-hour feeding,the incidence of 2 h during hypoglycemia in the 1.5-hour feeding was significantly lower（ χ ²=17.641,P<0.001）. There was no statistical difference in the incidence of hypotension,average systolic blood pressure,average diastolic blood pressure,and pulse pressure difference between 1.5-hour feeding and 2.5-hour feeding during the whole course of dialysis（P>0.05）. The results of repeated measures analysis of variance showed that the levels of blood glucose were significantly higher at 2 h and 3 h in the 1.5-hour feeding than those in the 2.5-hour feeding（P<0.05）. Conclusion Compared to feeding at 2.5 hours,feeding at 1.5 hours can reduce the incidence of intradialytic hypoglycemia,but it did not increase the incidence of intradialytic hypotension in non-diabetic patients using sugar-free dialysate.

Construction and application of refined care training programme for ultra-low birth weight infants

TANG Yunfei, ZHU Tingli, HU Xiaojing

2021, 56(2):  177-182.  DOI: 10.3761/j.issn.0254-1769.2021.02.003

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Objective To construct,implement and evaluate the effectiveness of the refined nursing training programme for ultra-low birth weight infants. Methods A refined care training programme for ultra-low birth weight infants was constructed,including individualized development support,airway cluster care,nutritional feeding,establishment and management of vascular access,family participatory care,and selection and training of nursing staff in the neonatal intensive care unit. In March 2019,we implemented the training of refined care training programme for ultra-low birth weight infants,and applied the Korotkoff evaluation model to assess the training effects. Results After the training,97.0% of the nursing students were satisfied with the refined care content;94.1% of the nursing students were satisfied with the teaching methods; 91.2% of the nursing students were satisfied with the teaching environment;100% of the nursing students thought that their nursing attitudes had been changed after the training,and they believed that they had enhanced the nursing confidence of ultra-low birth weight infants. The theoretical assessment score of nursing students before the training was（59.7±13.6） points,and it was（88.4±6.2） points after the training with statistically significant differences（t=-14.763,P<0.001）. There were statistically significant differences in the development support such as smell,hearing and touch,pain control,arteriovenous catheterization,visual puncture,maintenance of peripheral central venous catheterization and manual reduction,in-situ tube replacement,umbilical arteriovenous maintenance,parental support model and kangaroo-style nursing technique before and after the training（P<0.05）. Conclusion The refined care training programme for ultra-low birth weight infants can effectively improve the nursing ability of nursing staff for ultra-low birth weight infants.

Special Planning——Nursing Informationalization

Development and application of management information system for the recognition and prevention of incontinence-associated dermatitis

ZHANG Yu, LIU June, CHANG Xiner, ZHU Xiaoping, ZHANG Yiling, ZHANG Chunyan, WANG Shuqin, JIA Yanrui

2021, 56(2):  183-188.  DOI: 10.3761/j.issn.0254-1769.2021.02.004

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Objective To develop the management information system of recognition,prevention and control of incontinence-associated dermatitis（IAD） and to explore its application effects in the prevention and nursing management of clinical incontinence dermatitis. Methods The management group of IAD was established,and the management information system of IAD identification and prevention and control was constructed. The man-machine interaction technology was used to develop four modules,including evaluation,grading,decision-making and nursing documents,so as to realize the functions of evaluation and early warning,intelligent interpretation of grading judgment, decision-making guidance and record preservation. It was officially put into clinical application in July 2019. The time-consuming,timely rate,accuracy rate,update rate and incidence rate of IAD were compared before and after the application of the system. Results After the application of the information system,the time to implement risk assessment of patients by nurses was shortened from（2.88±0.38） min to（1.44±0.45） min;the timely rate of risk assessment of IAD increased from 52.5% to 82.5%;the accuracy rate of assessment increased from 57.5% to 85.0%,and the update rate of risk assessment of IAD increased from 17.5% to 77.5%（P<0.05）. The incidence of IAD decreased from 16.0% to 11.8%（P>0.05）. Conclusion The management information system of recognition,prevention and control of IAD can provide accurate and objective decision-making bases for nurses,shorten the time for risk assessment of incontinence-associated dermatitis,improve the timely rate and accuracy of assessment,the dynamic updating rate of risk assessment and grading assessment,and help to improve the quality of skin care for incontinence-associated dermatitis.

The construction and application of intelligent information management system for donor human milk bank

WU Bo, LI Qiufang, YI Shengyue, LIN Rong, SHANGGUAN Xuejun, ZHANG Rui, WANG Hua

2021, 56(2):  189-193.  DOI: 10.3761/j.issn.0254-1769.2021.02.005

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Objective To construct an intelligent information management system of donor human milk bank,to establish a management information platform connecting of human milk donors,managers and recipients,to standardize and optimize the process,and to explore suitable human milk bank management methods suitable for China's national conditions. Methods From October 2017 to November 2019,the information management system of human milk bank was constructed including the following 5 functional modules,namely importing donor information,inputting milk information,managing donors' milk in and out,tracking adverse events,statistical analysis. The staff efficiency,the number of error events and breastfeeding rates were compared between July to August 2019 before the system application and October to December 2019 after the system application. Results Before and after the application of the management system of the donor human milk bank,the average operation time of the donor milk input for storage was reduced from 8min/portion to 2min/portion,and the average operation time of the donor milk out from the storage was reduced from 5min/portion to 1min/portion. The daily calculation of milk consumption by the staff was also changed from 1h daily to be automatically generated by the system. The backtracking time of milk source information was changed from 1.5h/person before application to automatic system correlation. The incidence of adverse events due to mis-delivery or near shelf life of donor milk decreased from 3 cases before application to 0 after application. The breastfeeding rate before and after system application increased from 65.11% to 69.74%,and the difference was statistically significant（χ ²=12.55,P<0.001）. Conclusion The intelligent information management system of human milk bank can help health care professionals to optimize the operation process,ensure the safety of donor human milk breastfeeding,and improve the breastfeeding rate in neonatal intensive care unit.

Research development and application of intelligent supplies cabinet

HUANG Yujia, LI Yonggang, LAN Jun, ZHANG Qian, LI Qingyin, SHI Li

2021, 56(2):  194-198.  DOI: 10.3761/j.issn.0254-1769.2021.02.006

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Objective To improve the supplies management level,realize the informatization,standardization and process oriented supplies management,the cardiovascular surgery ICU（CSICU） nurses engaged in research and the use of Intelligent Supplies Cabinet. Methods Intelligent Supplies Cabinet was developed based on CSICU supplies management requirements,and the management experience of Intelligent Supplies Cabinet and high value consumables. CSICU supplies were classified into high-value consumables,aseptic packages and other consumables,which were attached with bar codes respectively and included in the Intelligent Supplies Cabinet. According to the treatment operation behaviors of doctors and nurses,the management mode of "doctor's order package" was implemented;the doctor's order was bound with corresponding supplies;the nursing use process was formulated and its use effects was evaluated. --Results-- The time of nurse obtaining high-value consumables,aseptic packages and other consumables were shortened（P<0.001）,and the accuracy of supplies acquisition were increased after Intelligent Supplies Cabinet was used. The accuracy and convenience of nurses obtaining supplies,the accuracy of calculating the cost and their overall satisfaction were improved（P<0.05）. Conclusion The development and implementation of Intelligent Supplies Cabinet optimized the nurse's supplies access process,improved working efficiency and nursing quality,and realized the information management of the whole process from supplies storage,use and billing.

Meta-synthesis of qualitative research on the real experience of telerehabilitation for stroke survivors

WANG Wenna, LIN Beilei, ZHANG Zhenxiang, ZHOU Bing, CHEN Gang, LÜ Pei, LIU Wenjun

2021, 56(2):  199-205.  DOI: 10.3761/j.issn.0254-1769.2021.02.007

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Objective To systematically review qualitative studies on the experience of telerehabilitation for stroke survivors,so as to provide references for clinical practice in China. Methods We searched databases including PubMed,Web of Science,PsycINFO,CINAHL,Cochrane Library,JBI,Scopus,CNKI,CBM,and WanFang Data from inception to June 2020,to collect qualitative studies related to telerehabilitation of stroke survivors. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. Meta-synthesis was used to integrate results. Results A total of 13 studies were included to extract 43 research results,and 4 synthesized findings were grouped from 13 categories according to their similarities,including the use attitude of stroke survivors to information and communications technology equipment;the perceived benefits of stroke survivors towards telerehabilitation;the perceived obstacles of stroke survivors towards telerehabilitation;the long-term telerehabilitation needs of stroke survivors. Conclusion As an alternative way of traditional rehabilitation,stroke telerehabilitation is affirmed with its effects by most stroke survivors. But in the future,we should pay attention to strengthen the telerehabilitation equipment and technical support,to build the whole-process peer support system of stroke telerehabilitation,and to enrich the content and form of telerehabilitation for stroke survivors to further improve its acceptance.

Application progress of virtual reality technology in patients' cardiac rehabilitation

JIN Jianfen, LU Jun, YU Mengying, ZHENG Beibei, LI Yimin, NING Li, TANG Amao, WU Qingqing, WANG Chaoqun

2021, 56(2):  206-211.  DOI: 10.3761/j.issn.0254-1769.2021.02.008

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Cardiac rehabilitation can help to reduce the total mortality of 13%~24% of patients and 31% of the hospital readmission rate within one year in the secondary prevention of cardiovascular disease. It's the first-level recommendation for cardiovascular disease prevention,but patients always have low compliance. The emergence of virtual reality technology has helped to break the limitations of traditional cardiac rehabilitation time,location and traffic,and to increase the participation of patients in cardiac rehabilitation,which has become an auxiliary means of cardiac rehabilitation. This article reviews the development,technical types,using methods,precautions and application effects of virtual reality technology in cardiac rehabilitation,and provides a reference for the development of virtual reality technology in cardiac rehabilitation in our country.

A literature review on the application of machine learning algorithms in pressure injury management

QU Chaoran, WANG Qing, HAN Lin, JIANG Xiaoying

2021, 56(2):  212-217.  DOI: 10.3761/j.issn.0254-1769.2021.02.009

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With the continuous advancement of nursing information management,the collection and reuse of a large number of multi-structure data and the close integration of the field of artificial intelligence have become a trend. There is a large number of multi-structure data in the management of pressure injury. The integration has gradually changed from cutting-edge technology to the actual application stage,and promoted the transformation of pressure injury management from "system management" to "data management". This article summarizes the application research of machine learning algorithms in pressure injury in the field of artificial intelligence from 3 aspects,namely application foundation,measuring and analyzing wounds,risk prediction model,and aims to promote the information management of pressure injury for references.

Specialist Practice and Research

Development and application of a multidisciplinary nursing program for recipients of living small bowel transplantation

LU Fangyan, TANG Saxiao, WANG Yan, CEN Luoxu, DAI Yanhong, WANG Huafen

2021, 56(2):  218-224.  DOI: 10.3761/j.issn.0254-1769.2021.02.010

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Objective To develop a multidisciplinary nursing program for recipients of living small bowel transplantation and to evaluate its effectiveness. Methods A multidisciplinary team was set up,consulting the guidelines,operation specifications and related literature according to the nursing difficulties. A multidisciplinary nursing program was developed,including nutrition management,infection prevention and control,rejection monitoring,immunosuppression,rehabilitation exercise,psychological interventions and continuous care. 6 adult recipients of living small bowel transplantation admitted to a level A tertiary hospital from August 2019 to March 2020 were selected, to carry out a multidisciplinary nursing program and to evaluate their postoperative rehabilitation. Results Among 6 recipients in this group,1 case was diagnosed enterococcus faecium infection with ascites culture. The infection was controlled after active interventions,and there was no acute rejection case. The 6 recipients were discharged from the hospital after their condition was stable,and the stoma was completed as scheduled within 3 months after the operation. The follow-up compliance after discharge reached 100%;blood drug concentration was well controlled. Conclusion The application of the multidisciplinary nursing program can reduce the incidence of complications,accelerate the process of postoperative rehabilitation,and ensure the safety of recipients during the transition period from hospital to family.

Research on the condition of medication discrepancy in hospital-family transitional period in elderly patients with type 2 diabetes mellitus

XUE Wenjun, NIU Xiaodan, WANG Yanhong

2021, 56(2):  225-232.  DOI: 10.3761/j.issn.0254-1769.2021.02.011

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Objective To evaluate the incidence,types,causes and influential factors of medication discrepancy in hospital-family transitional period in elderly patients with Type 2 Diabetes;to explore the effects of medication discrepancy in hospital-family transitional period on blood concentration. Methods 332 patients with Type 2 Diabetes discharged from a tertiary hospital in Lanzhou city from March to October 2019 were selected. A baseline survey was conducted before discharge. A week after the discharge,Summary of Diabetes Self-Care Activity（SDSCA）,Morisky Medication Adherence Scale with Eight-Item（MMAS-8） and the Chinese Version of the Medication Discrepancy Tool（MDT） were used to evaluate the patients by telephone follow-up. The fasting blood glucose and postprandial 2 h blood glucose were recorded. Binomial logistic regression analysis was run to identify the risk factors of medication discrepancy in hospital-family transitional period. The independent sample t test was used to analyze the relationship between the medication discrepancy and the blood glucose. Results The incidence of medication discrepancy in 332 patients within a week after discharge was 79.5%. The main type of discrepancy was the decrease in the types of medication. The results of Binomial logistic regression analysis showed medication discrepancy was affected by medication compliance,quantity of prescribed drugs and the diabetes self-management score. Compared with the patients without medication discrepancy,the fasting and 2 h postprandial blood glucose values of elderly Type 2 Diabetes patients with medication discrepancy were higher,and the difference was statistically significant（P<0.05）. Conclusion In the early post-hospital period,the incidence of medication discrepancy is higher in elderly patients with Type 2 Diabetes,and medication discrepancy can have adverse effects on blood glucose level of patients. Therefore,nurses should pay more attention to the management of medication discrepancy in elderly patients with Type 2 Diabetes,actively communicate and cooperate with pharmacists and doctors,and provide guidance for patients and their families on discharge medication,so as to ensure the safety of medication and the stability of blood glucose.

Development of a self-care scale for patients with chronic obstructive pulmonary disease and the test of its reliability and validity

TANG Ting, LIU Kouying, DOU Bei, ZHA Huixian

2021, 56(2):  233-238.  DOI: 10.3761/j.issn.0254-1769.2021.02.012

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Objective To develop a self-care scale for patients with chronic obstructive pulmonary disease（COPD）and to test its reliability and validity. Methods Based on the middle-range theory of self-care of chronic illness,the theoretical dimension and item pool of the self-care scale were preliminarily constructed by literature review,brainstorming and referring to the previous scales. Delphi method,item analysis and exploratory factor analysis were used to select items and determine dimensions of the scale,so as to form a formal scale. A total number of 202 patients with COPD were surveyed to test the reliability and validity of the scale. Results The Self-Care Scale for Patients with COPD included 3 dimensions and 29 items,and the contribution rate of the cumulative variance of the 3 factors was 60.33%. The Cronbach's alpha coefficient,the split-half reliability coefficient,and the content validity index of the scale were 0.899,0.928 and 0.940,respectively. The total score and scores in each dimensions of the scale were positively correlated with the total scores of the self-management scale（P<0.01）. Confirmatory factor analysis showed that the scale had good construct validity. Conclusion The Self-Care Scale for Patients with COPD is reliable and valid for measuring the self-care level of patients with COPD.

The impact of stigma on care burden in primary caregivers of schizophrenics

LIU Shoujuan, ZHANG Yanhong, TANG Mingwen, CHENG Yin

2021, 56(2):  239-244.  DOI: 10.3761/j.issn.0254-1769.2021.02.013

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Objective To explore the relationship between stigma,social support and care burden of primary caregivers of patients with schizophrenia. Methods The primary caregivers of 455 hospitalized patients with schizophrenia were investigated by a self-compiled general information questionnaire,Zairt Caregiver Burden Interview,Perceived Detraction-Discrimination Scale and Social Support Rating Scale. Results Stigma was a significantly positive predictor of caregiver burden（B=1.592,P<0.001）. It was also a significant predictor of social support（B=-1.506,P<0.001）. Stigma had a significantly indirect effect on the burden of care for primary caregivers of schizophrenics through social support,and the 95% confidence interval was[0.340~1.076],which showed that the mediating effect of social support accounts for 42.4% of the total effect. Conclusion Nurses should develop intervention strategies based on pathways that affect the burden of care to reduce the level of stigma of primary caregivers,provide more social support,and reduce the burden on caregivers.

Effects of anxiety about pregnant women in the first and third trimesters on the delivery modes

QIAN Shuhua, ZHU Xinli, SHEN Beibei, ZHOU Huixin, DING Yan

2021, 56(2):  245-249.  DOI: 10.3761/j.issn.0254-1769.2021.02.014

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Objective To explore the effects of anxiety on pregnant women in the first and third trimesters on delivery modes,in order to improve the labor outcomes. Methods Maternal data from November 2017 to June 2019 in the Obstetrics and Gynecology Hospital of Fudan University information system were extracted after psychological assessment of pregnant women in the first or third trimester. An anxiety group and a non-anxiety group were divided according to the Generalized Anxiety Disorder Scale（GAD-7scale）,and the delivery modes of 2 groups with propensity score matching were compared. Results After propensity score matching,447 pairs of anxiety groups and non-anxiety groups in early trimesters and 53 pairs in late trimesters were successfully matched;there was no significant difference in delivery modes between anxiety groups and non-anxiety groups in early trimesters（ χ ²=1.620,P=0.203）;there were significant differences in delivery modes between anxiety groups and non-anxiety groups in late trimesters（ χ ²=4.330,P=0.037）. Pregnant women in the anxiety group tended to choose cesarean section. Conclusion Results showed that anxiety in the first trimester had no effect on the choice of delivery modes,but anxiety in the third trimester might increase the incidence of cesarean section. It is suggested that cesarean section rates can be reduced by alleviating anxiety in the third trimester,so as to improve the labor outcomes.

The psychological experience of juvenile poisoning suicide patients：a qualitative study

YE Minghui, HU Yingying, HE Chunlei, DONG Chaoqun, YANG Yeqin, LU Zhongqiu

2021, 56(2):  250-254.  DOI: 10.3761/j.issn.0254-1769.2021.02.015

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Objective To understand the psychological experience of juvenile patients committing poisoning suicide,so as to provide references for clinical nurses to carry out relevant preventive interventions. Methods The phenomenological method was used,and 11 adolescents committing poisoning suicides admitted to Wenzhou hospital from June to December 2019 were interviewed by semi-structured interviews,and the data was analyzed by Colaizzi seven-step method. Results 4 themes were extracted,including the lack of effective communication,unbearable situation,uncontrolled emotion and contradictory self-view. Conclusion Juvenile poisoning suicide patients have many needs and problems in psychological care,psychological growth and self-emotional regulation. Nurses should provide these juveniles based on their psychological experience,in order to promote their physical and mental health.

Nursing Management

Correlation analysis between resilience and career development of nurses

HAN Binru, CHEN Xi, XU Fengxia, LI Qiuping, WANG Si, GANG Tingting

2021, 56(2):  255-259.  DOI: 10.3761/j.issn.0254-1769.2021.02.016

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Objective To explore the relationship between resilience and career development of nurses in China,and to provide references for promoting their career development. Methods From November to December 2019, 71 477 nurses across the country were selected as survey subjects by convenient sampling method. The data was collected by means of Connor-Davidsion Resilience Scale and Career Development Questionnaire,and the status of career development,resilience and correlation analysis were conducted. Results The total score of resilience of nurses was（90.49±15.71）,and the total score of career development of nurses was（123.42±19.57）. There was a significant positive correlation between resilience and career development（r=0.618,P<0.001）. The results of multiple stratified regression analysis showed that resilience was included in the influencing factor model of nurse career development（F=4,474.791,P<0.001）,which could independently explain 37.3% variation of nurse career develop-ment. Conclusion The higher level of resilience of nurses could predict the lower level of professional development of nurses. Nursing managers should give more attention to the level of nurse resilience and adopt scientific methods to improve it,so as to promote the career development of nurses.

Clinical Practice

Nursing care of a patient with bile leakage and duodenal leakage in liver transplantation with portal vein semi transposition

SHANG Yunxian, HAN Xueli, ZENG Qiaoling, LUO Xinchun, YE Haidan

2021, 56(2):  260-264.  DOI: 10.3761/j.issn.0254-1769.2021.02.017

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This paper summarizes the nursing experience of a patient with bile leakage and duodenal leakage after liver transplantation with portal vein semi transposition. Nursing points：nursing care of bile leakage and duodenal leakage;nursing care of refractory ascites;nursing care of malnutrition and nutritional support;follow-up after discharge. After careful treatment and nursing care,the patient recovered and was discharged from the hospital. Up to now,there was no discomfort symptoms and liver transplantation function was normal.

Nursing care of a patient with pseudoaneurysm complicated by femoral artery blood sampling

YU Pengfei, CHEN Huijuan, ZHAO Feifan, ZHAO Liting

2021, 56(2):  265-268.  DOI: 10.3761/j.issn.0254-1769.2021.02.018

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This paper summarized the nursing experience of an elderly patient with atrial fibrillation for more than 10 years,and long-term oral warfarin with abnormal coagulation function. Femoral artery blood sampling caused arterial branch damage,pseudoaneurysm formation,and hemorrhagic shock. The nursing experience was summarized from the analysis of causes of iatrogenic pseudoaneurysm,the first aid and nursing of hemorrhagic shock,postoperative nursing of femoral artery exploration and complications prevention. After active treatment and care for 14 days,the patient improved and was discharged.

Nursing care of a child with anterior mediastinal lymphoma complicated with severe airway obstruction

XIE Wangfang, LOU Xiaofang, ZHU Jihua, XU Bin

2021, 56(2):  269-271.  DOI: 10.3761/j.issn.0254-1769.2021.02.019

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The rescue and nursing of a child with anterior mediastinal lymphoma complicated with severe airway obstruction were summarized. The operations include rigorous observation and monitoring of the child’s condition,rapid and effective application of extracorporeal membrane oxygenation under cardiopulmonary resuscitation;close observation of the child’s vital signs during extracorporeal membrane oxygenation,dynamic assessment of airway obstruction symptoms. After careful treatment and nursing,the extracorporeal membrane oxygenation machine was successfully evacuated after 70.5 hours of operation. The child returned to a stable condition on the 7th day of admission and was transferred to the department of hematology for continuous specialized treatment.

Nursing care experience of 3 children with blastic plasmacytoid dendritic cell neoplasm

CHEN Xiuping, WANG Yanqing, ZHU Jihua

2021, 56(2):  272-275.  DOI: 10.3761/j.issn.0254-1769.2021.02.020

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This paper summarizes the nursing experience of 3 children with blastic plasmacytoid dendritic cell tumor. Nursing points include skin and mucous membrane nursing,medication nursing,illness observation,strengthening of protective isolation,exercises guidance,attention to parents’ psychological intervention and health education. At present,these 3 children are in remission. All the skin lesions have been healed without nursing complications.

Evidence Synthesis Research

Effects of water-based exercise on lower limb function in patients with Parkinson’s disease：a Meta-analysis

LI Qin, CHEN Miaohong, SHEN Manxuan, XU Lingxiu, RUAN Yun

2021, 56(2):  276-282.  DOI: 10.3761/j.issn.0254-1769.2021.02.021

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Objective To systematically evaluate the effect of water-based exercise on lower limb function and quality of life in patients with Parkinson’s disease. Methods A systematic search of Web of Science,PubMed,EMBASE,the Cochrane Library,CNKI,WanFang Data and CBM databases was carried out to collect randomized controlled trials on water-based exercise for Parkinson’s disease from inception to April,2020. 2 reviewers independently screened the literature according to inclusion and exclusion criteria,extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software. Results Totally 10 RCTs involving 318 patients were included. The results of Meta-analysis showed that water-based exercise was superior to the conventional physical therapy in balance function[MD=2.92,95%CI（1.07,4.77）,P=0.002],gait function[MD=-1.37,95%CI（-2.42,-0.33）,P=0.010] and quality of life[MD=-2.71,95%CI（-0.50,-0.02）,P=0.04]. However,there was no statistically significant difference in the improvement of lower limb muscle strength[MD=-2.05,95%CI（-4.70,0.59）,P=0.13] and motor function[MD=-1.50,95%CI（-3.70,0.69）,P=0.18] in Park-inson’s patients. Conclusion Compared with the conventional physical therapy,water-based exercise can improve the balance function,gait function and quality of life of Parkinson’s patients significantly,but it has no significant effect on the improvement of lower limb muscle strength and motor function. Due to the limitation of the quantity and quality of the study,the conclusion of this study needs to be confirmed by further high quality research.

Evidence summary of oral nutritional supplements in perioperative patients

XIONG Zhaoyu, KE Hui, LI Suyun, HUANG Haiyan, YU Jiaohua, CHEN Jianping, JIN Xiaowei

2021, 56(2):  283-288.  DOI: 10.3761/j.issn.0254-1769.2021.02.022

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Objective To search and select the evidence on oral nutritional supplements in perioperative patients,and to summarize the latest and best evidence. Methods We retrieved the UpToDate,BMJ Best practice,International Practice Guideline Registry Platform,National Institute for Health and Care Excellence （NICE）,Guidelines International Network（GIN）,Registered Nurses Association of Ontario（RNAO）,Scottish Intercollegiate Guidelines Network（SIGN）,European Society for Clinical Nutrition and Metabolism（ESPEN）,American Society for Parenteral and Enteral Nutrition（ASPEN）,Joanna Briggs Institution（JBI）,Cochrane Library,Pubmed and CBM,and collected relevant guidelines,clinical decisions,evidence summaries,systematic reviews and expert consensuses. 2 researchers independently evaluated the quality of the included literature,and extracted and summarized the evidence from the included literature. Results Finally,14 articles were included in this summary,including 2 guidelines,2 clinical decisions,6 expert consensuses and 4 systematic reviews. 16 pieces of latest and best evidence were summarized,including indications,recommended dosage,health education,preoperative nutrition,postoperative nutrition,bariatric surgery and post-discharge nutrition. Conclusion The study summarized the latest and best evidence of oral nutrition supplements in perioperative patients,and provided evidence-based nutritional interventions for malnutrition perioperative patients,which may improve the nutritional status and postoperative clinical outcomes and ensure the security of patients.

Review

Application progress of shared decision-making in ICU

ZHU Yizhen, ZHANG Shuang, GUAN Yuzhu, MENG Meng, LI Lezhi

2021, 56(2):  289-294.  DOI: 10.3761/j.issn.0254-1769.2021.02.023

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Shared decision-making,the core in patient-centered care,is a collaborative decision-making process between healthcare providers and patients or their surrogates,taking into account the best available scientific evi-dence,while considering the patient’s values,goals and preferences. Shared decision-making helps patients or their surrogates formulate more informed decisions through active participation in the decision and enhanced unders-tanding of prognosis,various treatment and nursing interventions. In order to provide references for the application of shared decision-making in ICU,this article introduces significances and applications of shared decision-making in ICU,analyzes the influencing factors from 3 aspects including patients,healthcare providers and assessment tools,and proposes suggestions for the application of shared decision-making in the ICU.

Research progress on delirium in end-of-life patients with hospice care

FAN Rongrong, LI Xuying, WEI Tao, HUANG Xinjuan, TAN Yan, LI Jinhua

2021, 56(2):  295-299.  DOI: 10.3761/j.issn.0254-1769.2021.02.024

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With the development of hospice care,the quality of life at the end of life receives much attention,and the research on the symptom control of terminal-stage patients is increasing. Delirium is one of the most common symptoms in terminal-stage patients,which is characterised by high incidence,high rate of missed diagnosis and high risks. Delirium extends the hospitalization cycle,increases the economic burden,increases the risk of falling,stress injury and accidental extubation,and accelerates the death process. Although an interdisciplinary team is advocated to manage delirium,the effect still remains unsatisfactory with inadequate cognition,evaluation and intervention,reducing the quality of hospice care.The paper reviews the characteristics of delirium,commonly used assessment tools,risk factors,drug and non-drug interventions for the development of effective delirium management programs for terminal-stage patients.

Application progress of intervention mapping in nursing care

YOU Aolin,LIU Ping,LI Yanan,LIU Shu,LUAN Xiaorong

2021, 56(2):  300-304.  DOI: 10.3761/j.issn.0254-1769.2020.02.025

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This review will introduce the concept and implementation steps of intervention mapping and its application in pre-hospital prevention,in-hospital care and post-hospital rehabilitation. Pre-hospital prevention includes prevention and control of infectious diseases and early screening of diseases,promotion of maternal and child health,control of risk factors and improvement of unhealthy lifestyles. In-hospital care includes promoting clinical application of new nursing technologies and talent training,doctor-patient communication and information exchange,health education and risk assessment. Post-hospital rehabilitation includes self-management of chronic diseases and health behavior changes,postoperative rehabilitation care of patients and cancer survivors. In addition,to promote and better use in China and improve the quality of clinical nursing intervention,we summarize the advantages and limitations of the intervention mapping.

Work readiness of newly graduated nurses：a review

HE Lifang, HUANG Hongyu, LI Chunyan, LI Xiaoying

2021, 56(2):  305-309.  DOI: 10.3761/j.issn.0254-1769.2021.02.026

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The transition from university to workplace is a challenge for newly graduated nurses. Work readiness has a direct impact on the transition of them from graduates to clinical nurses,and it is also considered as an indicator of the potential on their job performance,promotion and career advancement. In this review,the concept,components and evaluation tools of work readiness of newly graduated nurses are synthesized,and the influencing factors of their work readiness and the measures to improve it are introduced,in order to enhance the attention and understanding of nursing managers to the work readiness,to train and retain more professional registered nurses,and to provide references for related research.

The development process and enlightenment of public health nurses

ZHANG Yan, SHI Yan, XUE Shuhao, QIN Ying, TIAN Yutong, XU Bing

2021, 56(2):  310-314.  DOI: 10.3761/j.issn.0254-1769.2021.02.027

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This paper reviews the development of public health nurses（PHN） in the United Kingdom,the United States and China,and summarizes the development characteristics of PHN from the aspects of role origin,core competence training,qualification accreditation,practice scope and workplace. PHN improve population health by emphasizing prevention and promotion of health behaviors,and their work contents include 5 functional modules and 17 intervention measures. The enlightenment of domestic nursing education is that training PHN is an important measure to meet the needs of public health,and the development of PHN needs the support of the government,academic organizations,educators and so on.

Overseas Knowledge

The Chinese version translation of the quality scale of maternal discharge guidance and its reliability and validity test

LI Wen, WEI Lili, ZHANG Yan, WANG Jingyuan, YUE Chongyu, ZHU Yongjian, WANG Siyao, PAN Yueshuai, CHEN Kai

2021, 56(2):  315-320.  DOI: 10.3761/j.issn.0254-1769.2021.02.028

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Objective The purpose is to translate the Quality of Discharge Teaching Scale-New Mother Form（OB-QDTS）,and to test the reliability and validity of the Chinese version of the scale and to evaluate the feasibility of applying this scale in the field of domestic science. Methods According to the Brislin model to translate and back-translate the original English version,the Chinese version of the scale was determined after cultural adjustment and pretesting on the scale. According to the survey criteria,195 postpartum mothers in Qingdao were selected to evaluate the reliability and validity of the scale from October 2019 to January 2020. Results The Chinese scale retains 27 items,and 2 common factors were extracted after exploratory factor analysis. The cumulative variance contribution rate reached 69.562%. The item-level content validity index of the Chinese OB-QDTS is 0.83~1.00;the scale-level content validity index is 0.96;the Cronbach’s α coefficient of the total table is 0.953;the split-half reliability is 0.889.Conclusion The Chinese version of OB-QDTS has good reliability and validity,and it can be used to evaluate the quality of postpartum mothers discharge guidance in the context of Chinese culture.