Table of Content

10 March 2022, Volume 57 Issue 5

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Vascular Access Creation and Maintenance

Application comparison of different tip positions of midline catheters

ZHAO Linfang, CAI Zhiyun, FAN Xiaopeng, JIANG Fengya, ZHAO Lei, ZHAO Ruiyi

2022, 57(5):  517-524.  DOI: 10.3761/j.issn.0254-1769.2022.05.001

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Objective To compare the clinical effects of midline’s tip at different position. Methods From September 2020 to January 2021,a multi-center randomized controlled study was used to select 384 inpatients as the research subjects from 6 tertiary A general hospitals in Zhejiang province,Fujian province,Jiangsu province,and Liaoning province. They were randomly divided into 3 groups according to random numbers generated by Excel. The midline’s tips were located in the subclavian vein in the experimental group 1,in the axillary vein of the chest in the experimental group 2,and at the distal of the axillary vein in the control group. The incidences of catheter-related complications（including phlebitis,catheter-related thrombosis,catheter-related infections,catheter occlusion,catheter dislodgment,bleeding,oozing） were compared in 3 groups,as well as unplanned removal rate due to complications,catheter indwelling time,and the incidence of abnormal intima after midline removal. Results A total of 384 patients were included. The total incidence of catheter-related complications in experimental group 1,experimental group 2,and control group were 9.93%,14.63%,and 34.17%. Unplanned removal rate due to complications were 2.13%,4.07%,and 13.33% in 3 groups. Catheter indwelling time were 12.00（8.00,19.75） d,12.00（8.00,21.00） d,and 10.00（6.00,17.75） d. After the removal,the incidence of abnormal intima were 0.75%,1.69%,and 6.36%. The differences of 3 groups were statistically significant（P<0.05）. Among them,the differences in the total incidence of catheter-related complications and unplanned removal rate between the experimental group 1 and the control group,the experimental group 2 and the control group were statistically significant（P<0.017）;the difference between the experimental group 1 and the experimental group 2 was not statistically significant（P>0.017）. In terms of the catheter indwelling time,the difference was statistically significant between the experimental group 1 and the control group（P<0.017）. Conclusion When the tip of midline catheter is located in the axillary vein of the chest or subclavian vein,the incidence of catheter-related complications is lower,with longer indwelling time and better clinical outcome.

The status of central venous catheter closure for blood purification in ICU patients

WANG Gang, PAN Yueshuai, MENG Yanlei, LIN Hui, WANG Rui, WAN Xiangyu, WEI Lili

2022, 57(5):  525-531.  DOI: 10.3761/j.issn.0254-1769.2022.05.002

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Objective To investigate the current situation of central venous catheter closure for blood purification patients in ICUs,and to compare the differences between different hospitals. Methods In September 2020,the convenience sampling method was used to conduct an online survey of 228 ICU wards in 117 hospitals of 23 provinces. The survey included general information and the current status of the central venous catheter closure for blood purification patients in the ICUs. Results A total of 222 valid questionnaires were collected. Heparin was the most commonly used sealing liquid,followed by citric acid,and urokinase was the least. The concentration of heparin was mainly 1 250 U/ml,and the concentration of citric acid was mainly 4%. The dosage of the sealing solution was mostly 1 times the volume of the catheter;the frequency of sealing is more after each dialysis;the sealing method is mainly positive pressure combined with pulse sealing. The catheter was withdrawn before sealed;the number of withdrawals was mostly 2 times,and the withdrawal volume per time was mostly twice the catheter capacity. There are significant differences in terms of the concentration,dosage,frequency of sealing,number of withdrawals,withdrawal volume per time between tertiary hospitals and non-tertiary hospitals（all P<0.05）. Conclusion The selection,concentration,dosage,frequency of the sealing of the central venous catheter for blood purification in ICUs are not the same. It is recommended to formulate the nursing standards for sealing the central venous catheter for blood purification patients in the ICU to standardize the reasonable and effective sealing of the tube by clinical nurses.

Improvement and application of PICC subcutaneous tunnel needle

LIU Qifen, LIU Xingling, ZHANG Shuzhen, LI Yue’e, ZHENG Jing, ZHANG Junfeng

2022, 57(5):  532-535.  DOI: 10.3761/j.issn.0254-1769.2022.05.003

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Objective To improve the subcutaneous tunnel needle and the method of establishing subcutaneous tunnel for PICC,and to explore its application effect. Methods The improved subcutaneous tunnel needle consists of 3 parts,including needle handle,solid needle core and needle head. The needle head has an arc chamfering structure,which can realize the stable connection between the catheter and the needle head. Patrticipants from a tertiary hospital in Guangdong Province were selected by convenience sampling. 97 tumor patients from November 2019 to January 2021 were allocated into an experimental group,while 115 tumor patients from August 2018 to October 2019 were in the control group. The experimental group received the improved subcutaneous tunnel needle via a 30°~45° degree with venipuncture for PICC catheterization under B-ultrasound,while the control group was treated with Seldinger technique for PICC catheterization under B-ultrasound. The amount of bleeding and the highest pain score,the incidence of bleeding and exudation at the puncture point 24 hours after the operation,the incidence of catheter prolapse within a month after the operation,the incidence of allergic dermatitis,the incidence of mechanical phlebitis,and the comfort of the patients’ arms at a month after the operation were compared between the 2 groups. Results The amount of bleeding and the highest pain score in the experimental group were higher than those in the control group,and the difference was statistically significant（P<0.001）. The incidence of bleeding and exudation at the puncture point 24 hours after the operation,the incidence of catheter prolapse within a month after operation and the incidence of allergic dermatitis in the experimental group were lower than those in the control group（P<0.05）,but the incidence of mechanical phlebitis within a month after operation in the 2 groups was not statistically significant（P=0.484）;a month after operation,the arm comfort of the experimental group was higher than that of the control group,and the difference was statistically significant（P<0.001）. Conclusion The improved subcutaneous tunnel needle and subcutaneous tunnel establishment method can reduce the incidence of blood and fluid leakage,catheter prolapse and allergic dermatitis at the puncture point,and improve the postoperative arm comfort of patients,but they could not increase the incidence of mechanical phlebitis.

Effect of prolonging the maintenance interval for totally implantable venous access ports on complications in patients during the period of non-treatment：a meta-analysis

WANG Xifeng, JU Yang, YANG Yiqun

2022, 57(5):  536-543.  DOI: 10.3761/j.issn.0254-1769.2022.05.004

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Objective To evaluate the effect of prolonging the maintenance interval for totally implantable venous access ports on complications in patients during the period of non-treatment by meta-analysis. Methods We searched CNKI,VIP,Wanfang,CBM,PubMed,Cochrane Library,Embase and Web of Science databases for publications that examined the effect of prolonging the maintenance interval during the period of non-treatment from the inception of databases to October 6,2021. 2 reviewers independently conducted the literature screening,data extraction and quality assessment. Meta-analysis was then performed by RevMan 5.3 software. Results A total of 11 publications including 2 268 patients were included. The meta-analysis showed that compared with the intervals less than 4 weeks,there were no statistically significant differences in the incidence of catheter-related total complications[RR=0.82,95%CI（0.56,1.19）,P=0.30],occlusion[RR=0.84,95%CI（0.54,1.31）,P=0.44] or infection[RR=1.47,95%CI（0.38,5.73）,P=0.58] for the intervals longer than 4 weeks. Descriptive analysis indicated that prolonging the maintenance interval did not increase the incidence of thrombosis,but significantly reduced maintenance costs. Conclusion Prolonging the maintenance interval of totally implantable venous access ports is safe and feasible without increased incidence of complications,which can reduce economic costs. More high-quality randomized controlled trials are needed for verification of the optimal maintenance interval.

Evidence summary for the prevention and management of port-related venous thromboembolism in cancer patients

LU Jia, XIE Kaihong, CHEN Wensi, CHEN Xiaomin

2022, 57(5):  544-550.  DOI: 10.3761/j.issn.0254-1769.2022.05.005

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Objective To search,evaluate and integrate the relevant evidence on the prevention and management of port-related venous thromboembolism（VTE） in cancer patients,and to provide references for clinical practice. Methods We searched CNKI,the BMJ Best Practice,UpToDate,Cochrane Library,JBI Database,CINAHL,Embase,PubMed,China Guideline Clearinghouse（CGC）,Scottish Interhospital Guidelines Network（SIGN）,National Guideline Clearinghouse（NGC）,American Intravenous Nurses Society（INS）,National Comprehensive Cancer Network（NCCN）,American Society of Clinical Oncology（ASCO）,European Society for Medical Oncology（ESMO）,and Registered Nurses’ Association of Ontario （RNAO） for relevant guidelines,systematic reviews,evidence summaries,recommended practices,and expert consensuses. The retrieval period is from the inception of databases to March 10,2021. Results A total of 12 articles were enrolled,including 4 clinical practice guidelines,5 systematic reviews,1 evidence summary and 2 expert consensuses. Totally 30 pieces of best evidence were summarized from 6 aspects,namely VTE risk assessment,catheter placement and maintenance,screening and diagnosis,prevention,management and treatment and health education. Conclusion This study summarized the best evidence on the prevention and management of port-related VTE in cancer patients. Nurses and nursing managers can select and apply the evidence according to clinical situation and patients’ wishes,so as to form a scientific,evidence-based,cancer port-related VTE prevention and management scheme,and improve nursing quality.

Research progress of PICC catheter related blood stream infection risk prediction model

LI Ke, YANG Zhennan

2022, 57(5):  551-554.  DOI: 10.3761/j.issn.0254-1769.2022.05.006

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PICC catheter related blood stream infection is one of the serious complications of PICC,which affects the treatment and prognosis of patients. This paper reviews the construction process,basic information and predictive performance of a risk prediction model of PICC catheter related blood stream infection. The domestic and foreign research progress was summarized in order to provide references for the construction and application of the risk prediction model. This paper provides a basis for clinical medical staff to early identify the high-risk population of PICC catheter related blood stream infection and provide the intervention timely.

Specialist Practice and Research

Construction and application of a nursing plan for diabetic patients with bowel preparation quality

CAI Lihua, LI Hong, HE Liping, WANG Lizhen

2022, 57(5):  555-562.  DOI: 10.3761/j.issn.0254-1769.2022.05.007

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Objective To construct a nursing plan for the quality of bowel preparation of diabetic patients,and to explore effects of its application. Methods The Delphi expert consultation method was used to construct a nursing plan for the intestinal preparation of diabetic patients. The plan includes 4 times of intestinal preparation intervention,5 key points of intestinal preparation intervention and 15 guiding contents of nursing intervention. 300 patients who underwent colonoscopy in the digestive endoscopy center of a tertiary general hospital in Fujian Province from August 2020 to January 2021 were selected as the research subjects,using the experimental research method. The research participants are grouped in chronological order,and finally 150 cases were included in the actual research subject control group and 150 cases in the experimental group. The control group was given regular bowel preparation guidance,and the experimental group used diabetic colonoscopy on the basis of routine care. The adequacy rate of bowel preparation,the detection rate of adenoma,the compliance of bowel preparation and the occurrence of adverse reactions of the 2 groups were compared. Results The bowel preparation adequacy rate,colon adenoma detection rate,and bowel preparation compliance ratio of the experimental group were all higher than those of the control group（P<0.05）. The number of cases of nausea,abdominal distension and hypoglycemia in bowel preparation in the experimental group were Less than it in the control group（P<0.05）. Conclusion The application of the intestinal preparation nursing intervention program for diabetic patients can effectively improve the bowel preparation adequacy rate,the detection rate of polyps,and the compliance of intestinal preparation;reduce the occurrence of adverse reactions during the intestinal preparation process,and alleviate the intestinal preparation of patients.

Best evidence application of phase Ⅰ cardiac rehabilitation in transcatheter aortic valve replacement patients

MAO Yue, XU Jianfeng, LI Mei, ZHU Beibei, YANG Danyan, MO Quanfeng, HE Jie

2022, 57(5):  563-568.  DOI: 10.3761/j.issn.0254-1769.2022.05.008

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Objective To investigate the application of best evidence for phase I cardiac rehabilitation in transcatheter aortic valve replacement（TAVR） patients into clinical practice and to evaluate its effectiveness. Methods The best evidence for phase I cardiac rehabilitation in patients with TAVR was summarized using an evidence-based care approach,and an evidence-based practice protocol was developed. The best evidence application strategy was constructed after a baseline review and analysis of barriers,and it was implemented in the cardiology department of a tertiary care hospital in Zhejiang Province from September 30 to December 31,2020. The indicators of patients before and after the application of evidence and the implementation rate of the reviewed entries were compared. Results The length of stay of patients after TAVR was shortened from 5（1,7） d at the baseline review to 3（1,6） d（P=0.016）. The percentage of cardiac function of New York Heart Association（NYHA） class I at 30 days postoperatively increased from 31.63% to 72.09%（P<0.001）,and the Katz index also improved（P=0.032）. After the application of best evidence,the rates of review indicators increased from 0~77.55% to 59.30%~100%,with a statistically significant difference（P<0.001）. Conclusion Best evidence application for phase I cardiac rehabilitation in patients undergoing TAVR can shorten patient length of stay,improve patient clinical outcomes,and standardize nurse behaviors.

Experience of the specialist nurse team in the multidisciplinary outpatient care on weight-loss

GUO Xiaodi, ZHU Yanhua, YANG Yi, SHAN Lingling, LIU Shuhong, WANG Yuchan, ZENG Yongmei, CHEN Yanming, HU Xiling

2022, 57(5):  569-575.  DOI: 10.3761/j.issn.0254-1769.2022.05.009

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Objective To summarize the valuable experience of the specialist nurse team in the multidisciplinary outpatient care on weight-loss. Methods The team consists of diabetes nurses,nutrition nurses,rehabilitation nurses,psychiatric nurses and traditional Chinese medicine nurses,providing a comprehensive assessment,individualized weight management and follow ups based on metabolic,nutritional and behavioral aspects for patients in outpatient setting. Results Our specialist nurse team followed 47 patients for 6 months.Body weight,total cholesterol（TC）,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C） and insulin resistance index（HOMA-IR） were significantly reduced compared to baseline. Moreover,the prevalence of unhealthy lifestyle,anxiety and depression was also significantly lower than baseline（P<0.05）. Conclusion The specialized nurse team has provided the comprehensive and standard weight management for overweight or obese patients,which helps the patients to lose weight,improve anxiety,depression and metabolism state in the multidisciplinary outpatient care on weight loss.

Investigation and analysis of factors related to dyadic coping among young and middle-aged patients with type 2 diabetes

ZHAO Lu, LI Junling, WANG Junfeng, GU Peipei, LI Yuxue, ZHENG Liping

2022, 57(5):  576-581.  DOI: 10.3761/j.jissn.0254-1769.2022.05.010

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Objective To investigate the status of dyadic coping in young and middle-aged type 2 diabetes patients,and to explore the influencing factors. Methods A total of 411 young and middle-aged type 2 diabetes patients were recruited from 2 tertiary hospitals in Zhengzhou from February to December 2020,and they were investigated with a general information questionnaire,Dyadic Coping Inventory（DCI） and Diabetes Self-efficacy Scale（DSES）. Results The total DCI score was 130.60±11.26 and the total DSES score was 93.11±18.93,showing significantly positive correlation（r=0.323,P<0.05）. Gender,duration of disease,family monthly income and self-efficacy were main factors affecting dyadic coping of patients（P<0.05 for all）. Conclusion The level of dyadic coping in type 2 diabetes patients are average and needs to be further improved. Self-efficacy can be used as the starting point to develop feasible and effective interventions to enhance dyadic coping of patients with type 2 diabetes in clinical nursing.

Development and reliability and validity test of constipation risk scale for patients with severe craniocerebral injury

WANG Zhuangying, WANG Yuanfeng, LIANG Miaomiao, GUO Haiyan, LIAN Ziai, GAO Xiaojuan, CHEN Xiaoli, ZHOU Xiaofeng

2022, 57(5):  582-587.  DOI: 10.3761/j.issn.0254-1769.2022.05.011

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Objective The constipation score scale for patients with severe craniocerebral injury was developed,and its reliability and validity were tested,providing an intuitive,effective and simple tool for assessing the risk degree of constipation in patients with severe craniocerebral injury. Methods Guided by the framework of the theoretical study on the cause of constipation in patients with severe craniocerebral injury,a systematic literature analysis was conducted on this theme. A preliminary comprehensive pool of items was then formed,evaluated and supplemented through Delphi expert reviews. The preliminary investigation was conducted and the ambiguous items were revised. Finally,project analysis and exploratory factor analysis were employed to identify the best potential structure of the scale. The convenience sampling method was adopted to select 108 patients with severe craniocerebral injury admitted to the Department of Neurosurgery of a tertiary hospital in Jinzhong City,Shanxi Province from January to December 2019 as the research subjects,and a questionnaire survey was conducted to evaluate the reliability and validity of the scale. Results A pre-test questionnaire of 27 items was formed according to the results of expert letter consultation. 3 items that did not meet the standard were deleted after item analysis. 5 factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 66.347%. The 5 factors were named as intestinal peristalsis function,neuro-conscious dysfunction,excessive transport of intestinal water molecules,patient factor and medical personnel factor. The Cronbach’s α coefficient of the scoring scale was 0.908;the Cronbach’s α coefficient of each dimension was 0.830-0.957;the retest reliability was 0.879. Conclusion The constipation risk scale for patients with severe craniocerebral injury developed in this study has good reliability and validity. It can be used as an effective tool to evaluate the risk of constipation in patients with severe brain injury.

TCM Nursing

Application of acupoint application therapy combined with seed embedding in ear acupoints at selected time in patients with constipation after endoscopic retrograde cholangiopancreatography

HUANG Xiaoyan, CAI Lan, QU Huazhen, LI Xiaoting, ZHU Mengying, LU Jiaojiao, WANG Jie

2022, 57(5):  588-593.  DOI: 10.3761/j.issn.0254-1769.2022.05.012

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Objective To explore the application effect of acupoint application therapy combined with seed embedding in ear acupoints at selected time in patients with constipation（Heat syndrome） after endoscopic retrograde cholangiopancreatography（ERCP）. Methods A total of 90 patients with constipation（Heat syndrome） after ERCP in a tertiary A hospital of traditional Chinese medicine in Suzhou from July 2019 to June 2021 were selected as the research subjects by convenience sampling method. They were randomly divided into an experimental group（n=45） and a control group（n=45）.The experimental group was provided acupoint application therapy combined with seed embedding in ear acupoints at selected time intervention on the basis of routine care,and the control group was given acupoint application therapy intervention on the basis of routine care. The TCM syndrome points,efficacy index and first defecation time after intervention were compared between the 2 groups. Results The TCM syndrome points of （2.41±1.23） in the experimental group was lower than that of （4.17±1.56） in the control group （P<0.001）. The efficacy index of （97.44%） in the experimental group was higher than that of （41.46%） in the control group（P<0.05）.The time of first defecation after intervention in the experimental group was（10.03±3.98） h,which was shorter than （22.51±6.36） h in the control group（P<0.001）. Conclusion Compared with single usage of acupoint application therapy,acupoint application therapy combined with seed embedding in ear acupoints at selected time can effectively improve the constipation （Heat syndrome） after ERCP by decreasing the TCM syndrome points,enhancing the efficacy index and shortening the first defecation time.

Nursing Management

Investigation and analysis of the status of insulin injection management in hospitals at all levels in 31 provinces and autonomous regions

ZHANG Mingxia, ZHAO Fang, YUAN Li, XIAO Lingfeng, XING Qiuling, WANG Qun, ZHOU Yingxia, MO Yongzhen, LI Caihong, HUANG Jin

2022, 57(5):  594-601.  DOI: 10.3761/j.issn.0254-1769.2022.05.013

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Objective To investigate the status of insulin injection management in hospitals at all levels in 31 provinces and autonomous regions,so as to provide references for promoting standardized and homogenized management of insulin injection in hospitals. Methods Nursing managers in 1 075 hospitals in 31 provinces,municipalities and autonomous regions were surveyed by stratified random cluster sampling from January to February 2019 with a self-designed questionnaire. Results A total of 1 075 valid questionnaires for nursing managers from nursing departments,and 1 5794 valid questionnaires for nursing managers from clinical departments were collected. 976（90.79%） surveyed hospitals manage insulin as a high-risk drug. More than 80% surveyed hospitals formulated insulin injection specifications at the hospital level or department level,provided regular training and assessment,and organized insulin injection training for new nurses. 828 hospitals（77.02%） regularly carried out insulin management quality control. More than 80% of the departments are equipped with multiple types of cardinal insulin and placed in special places,stored insulin in use in special places,stored opened insulin at room temperature. 90.53% of the doctors in the department prescribed injection orders for patients with self-provided insulin;insulin management institution and insulin management status of departments in different levels of hospitals,and insulin management status in different departments showed statistically significant differences （P<0.001）. Insulin management was more standardized in hospitals with regular quality control of insulin management（P<0.001）. Conclusion Insulin management institution in hospitals at different levels in China needs to be improved,and the quality of insulin management in departments needs to be improved. Insulin management in different hospitals and departments needs to be homogenized. It is necessary to strengthen the insulin injection management in primary hospitals and non-endocrinology departments. Relevant academic organizations should issue the standard of insulin injection management in hospital to promote the standardized management of insulin injection in hospitals.

The current situation and influencing factors of nutritional care competence for clinical nurses from 4 general hospitals in Anhui Province

LI Haiqun, ZHU Xinyi, ZHAO Mei, YU Ningning, CHEN Jing, SUN Wanxiao

2022, 57(5):  602-607.  DOI: 10.3761/j.issn.0254-1769.2022.05.014

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Objective To investigate the status quo of clinical nurses’ nutritional care competence in Anhui Province and to analyze its influencing factors. Methods A total of 863 clinical nurses were recruited from 4 general hospitals in northern,central and southern Anhui Province by convenience sampling method. They were investigated by a general information questionnaire and a nutritional care competence scale for clinical nurse. The influencing factors of clinical nurses’ nutritional care competence were analyzed through multiple linear regression. Results Totally 762 valid questionnaires were collected. The score of clinical nurses’ nutritional care competence was（235.16±44.02）;the average score of the total items was（3.73±0.70）. The scores of nutritional professional knowledge dimension and clinical nutrition assessment competence dimension were lower. Multiple liner regression showed that the working years,clinical departments,regular supervision from managers,nutrition courses during school,experience of attending nutrition classes and regular nutrition learning in nursing work were the influencing factors of the clinical nurses’ nutritional care competence（P<0.05）. Conclusion The nutritional care competence of clinical nurses needs to be improved. Nursing managers should pay attention to nutrition-related education and training,strengthen the training of nutritional professional knowledge and clinical nutrition assessment competence,perfect the regular inspection and assessment mechanism to improve the nutritional care competence of clinical nurses.

Evidence Synthesis Research

Qualitative studies on experience of home hospice caregivers：a meta-synthesis

MIAO Miao, YAO Lan, YAO Qianqian, ZHANG Guimei, WU Ruojia, LU Siyue

2022, 57(5):  608-616.  DOI: 10.3761/j.issn.0254-1769.2022.05.015

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Objective To systematically evaluate the qualitative research on the care experience of home hospice caregivers,in order to provide references for paying attention to the care quality of home caregivers and building a home hospice care support system. Methods Qualitative studies on the nursing experience of home hospice caregivers were searched in electronic databases,including the Cochrane Library,JBI,Embase,PubMed,PsycINFO,Web of Science,CINAHL,CNKI,WanFang,CBM Database. The search time was from inception to June 31,2021. Quality of the literature were evaluated according to JBI Critical Appraisal Checklist for Qualitative Research and then the meta-synthesis was performed. Results Totally 19 studies were included and 80 research results were extracted. Finally 7 categories and 3 integrated results were formed. Integrated result：①Caregivers have strong negative experience;②Caregivers actively respond to negative experiences and gain personal growth;③Caregivers seek multifaceted support. Conclusion Home hospice caregivers have heavy care burden and great physical and mental pressure,and are eager for multi-party support. It is suggested to pay attention to the inner experience and needs of family caregivers,and build a regional homogeneous linkage support system of home hospice,so as to improve the nursing quality of home hospice.

Positive psychological experience of stroke patients：a qualitative meta-synthesis

ZHANG Ao, ZHAO Peiyu, HU Nannan, GUAN Weiwei, LI Li, GONG Shaohua, CHEN Shanshan, GUO Hong

2022, 57(5):  617-624.  DOI: 10.3761/j.issn.0254-1769.2022.05.016

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Objective To analyze and evaluate the positive psychological experience of stroke patients to provide reliable bases for their psychological nursing. Methods Chinese and English databases,such as PubMed,Web of Science,Embase,CINAHL,PsycINFO,CNKI,Wanfang Database,VIP,and CBM,were searched,and the literature on the qualitative research on the inner positive psychological experience of stroke patients was retrieved. The time limit of the retrieval was from the establishment to April 2021. The literature quality was evaluated using the 2016 Australian JBI Evidence-Based Health Care Center Quality Evaluation Criteria for Qualitative Research,and the results were consolidated using meta integration method. Results A total of 14 studies were included,and 65 results were extracted and summarized into 12 new categories,which were combined into 3 integrated results. （1）Positive coping attitude and psychology：accepting and adapting to stroke,feeling lucky and grateful,optimistic and positive to face the situation,strong spiritual strength,goals and hope for the future;（2）Positive changes after stroke：increasing health awareness,more intimate and harmonious interpersonal relationships,personal growth,new thinking about the philosophy of life;（3）Support factors of positive psychology;positive coping strategies at the individual level,social support from family,friends and peers,social support from the medical system. Conclusion Existing evidence suggests that patients with cerebral apoplexy after stroke will have a positive psychological experience and change. Nursing staff should pay more attention to the patient’s psychological state and the support of the positive psychology factors,meet their psychological needs,help patients strengthen social support system,and maintain a positive mental state,in order to promote patients to recover and improve the quality of life.

Review

Exercise rehabilitation in patients with acute decompensated heart failure：a review

LIANG Qian, LIU Jing, LIU Hongjuan, LUAN Xiaorong

2022, 57(5):  625-630.  DOI: 10.3761/j.issn.0254-1769.2022.05.017

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Exercise rehabilitation is an important mean to promote early rehabilitation of patients with acute decompensated heart failure（ADHF） during hospitalization. This paper reviews the related research on exercise rehabilitation of patients with ADHF,summarizes the exercise styles,exercise methods,influencing factors and intervention effects,and enriches the intervention content for early rehabilitation of patients with ADHF.

Nursing Instruments Innovation

Improvement and application of fixed device of gastric lavage pipeline

ZHANG Boquan, ZHAO Shuang

2022, 57(5):  631-634.  DOI: 10.3761/j.issn.0254-1769.2022.05.018

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Objective To explore the application effect of gastric lavage fixed device in gastric lavage operation of emergency poisoning patients. Methods The improved device includes spiral mother bolt,buccal fixation belt,anti-suction side mouth,lip and tooth protective layer and the main body of the bite device,so as to solve the problems,such as gastric cleaning pipeline is difficult to be properly fixed,gastric reflux retention in the mouth,and lip skin damage. A total of 98 patients with poisoning and gastric lavage in the emergency department of a tertiary A hospital in Shenyang from December 2019 to December 2020 were enrolled as the research subjects. The patients were divided into an experimental group and a control group by random number table method,with 49 patients in each group. In the control group,the traditional mouthpiece device and human-assisted fixation method were used for gastric lavage,while in the experimental group,the improved fixed device of gastric lavage and lavage pipeline were used for gastric lavage. The number of displacement,extubation,tube bite,the time of gastric lavage and complications during gastric lavage were compared between the 2 groups. Results The number of displacement,extubation,tube bite,the time of gastric lavage and complications during gastric lavage in the experimental group were significantly lower than those in the control group,and the differences between the 2 groups were statistically significant（P<0.05）. Conclusion The fixed device of gastric lavage pipeline can effectively shorten gastric lavage time,save human resources,improve gastric lavage efficiency,reduce gastric lavage risks and reduce complications in gastric lavage operation of emergency poisoning patients.

Overseas Knowledge

Translation and test of validation and reliability of Inflammatory Bowel Diseases Disk Scale

LIU Jinfeng, JIANG Qiuxia, LIU Alan, LIU Juan, BAN Chunjing

2022, 57(5):  635-640.  DOI: 10.3761/j.issn.0254-1769.2022.05.019

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Objective To sinicize the Inflammatory Bowel Diseases Disk （IBD-disk） Scale into Chinese,and to test the reliability and validity of the scale. Methods Through literal translation,back translation,expert discussion and evaluation and cross-cultural debugging of the scale in English,2 researchers finally formed the IBD-disk Scale in Chinese. 315 patients with inflammatory bowel disease who were followed up in the outpatient department of a tertiary A general hospital in Anhui province from June 2021 to August 2021 were selected as the research subjects. 4 weeks later,48 patients were selected by a random number table method for retesting. Results The Chinese scale contains 10 items,and the correlation coefficients between the scores of each item and the total score of the scale were 0.630~0.816（P<0.001）. The CR values of 10 items were 4.79~30.93 with statistically significant differences（P<0.001）;exploratory and confirmatory factor analysis supported the one-dimensional nature of the scale,and the fit was good. The internal consistency coefficient was 0.895,and the retest reliability was 0.861,which indicated that the data reliability and quality was good. There was a positive correlation between IBD-Disk Scale and IBD Burden of Disease Scale（r=-0.513,P<0.001）. Conclusion The Chinese version of IBD-Disk Scale has good reliability and validity,and it can be used as a tool to evaluate the degree of disability in patients with inflammatory bowel disease.