Table of Content

20 April 2022, Volume 57 Issue 8

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Research Paper

Construction and application of an early activity program in children with mechanical ventilation

LIU Meihua, PENG Jianxiong, LUO Cui, ZHENG Yan, ZHU Lihui, XIAO Zhenghui, ZHANG Xinping, LI Qingbo, XIONG Liang

2022, 57(8):  901-907.  DOI: 10.3761/j.issn.0254-1769.2022.08.001

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Objective To construct an early activity program for children with mechanical ventilation,and to explore the safety and efficacy of its clinical application. Methods On the basis of literature analysis,the early activity program was constructed. The convenience sampling method was used to select 50 cases of 3~14-year-old children with mechanical ventilation into an experimental group from December 2020 to July 2021 at the pediatric intensive care unit（PICU） of a tertiary children’s hospital in Hunan province. A nurse-led early activity program was implemented on the basis of the routine nursing. 50 children admitted from April 2020 to November 2020 were selected into a control group,and the routine nursing was given. The heart rate,respiration,systolic blood pressure and oxygen saturation of the experimental group were collected 5 mins before the activity,at the 15th min of the activity and 5 mins after the activity,as well as the occurrence of adverse events such as unplanned extubation,falling and bed falling during the activity. Meanwhile,the completion rate of the early activity program was calculated to evaluate the safety and feasibility of the early activity. Muscle strength level,incidence of delirium,duration of mechanical ventilation and duration of PICU were compared between the 2 groups on day 1,day 3 and day 6,and the effect of the early activity program was evaluated. Results There were no statistically significant differences in heart rate,respiration and blood oxygen saturation of the experimental groups at 5 mins before the activity,at the 15th min of the activity and 5 mins after the activity（P>0.05）,while there were statistically significant differences in systolic blood pressure（P<0.001）. There were no unplanned extubation,fall and bed falling during the activity. The overall completion rate of the early activity program was 86.96%. There was no significant difference in muscle strength between the 2 groups on day 1 and day 3 （P>0.05）,and the muscle strength of the experimental group was higher than that of the control group on day 6（P<0.001）. The incidence of delirium in the experimental group was lower than that in the control group,and the time of mechanical ventilation and PICU stay were both shorter than that in the control group,with statistically significant differences（P<0.05）. Conclusion The early activity program for children with mechanical ventilation is safe and feasible,which can improve the muscle strength level of children,reduce the incidence of delirium,shorten the time of mechanical ventilation and PICU stay,and contribute to the early recovery of children.

Qualitative research on the feeling and experience of medical staff on neonatal hospice care

LI Mengting, CHEN Shuohui, CHEN Xiaofei, CHENG Xiaoying, LUO Feixiang, MEI Lingli, ZHOU Jinyan

2022, 57(8):  908-913.  DOI: 10.3761/j.issn.0254-1769.2022.08.002

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Objective To understand the feelings and experiences of medical staff on neonatal hospice care,and to provide a reference for the development of neonatal hospice care. Methods Descriptive research methods were used to conduct semi-structured interviews with 13 neonatal clinicians and clinical nurses,nursing managers,medical social workers,hospice care doctors and nurses,and the data was analyzed using targeted content analysis. Results 5 themes were extracted,including the needs of the dying newborn,the needs of the family of the dying newborn,the communication between doctors and patients,the timing of intervention for hospice care,and the multidisciplinary team of hospice care. Conclusion Medical staff should pay attention to the needs of dying newborns for pain reduction,comfort care,nutritional support,sense of security,and the needs of families to accompany children,emotional support,information support,professional guidance,understanding and respect,when conducting the neonatal hospice care of newborn babies. Effective and good communication between doctors and patients should be promoted. It is needed to consider the timing of intervention and the child’s disease condition and family will. Multidisciplinary collaboration is a good model for the development of neonatal hospice care.

Special Planning--Urology Care

Expert consensus on perioperative urosepsis nursing of patients with intracavitary surgery for urinary tract calculi

Urology Branch of Guangdong Medical Association, （Writing Committee：SUN Hongling, LIU Lihuan, LIU Chunxiang, MA Xiaoyin, ZHANG Min, ZHANG Suying, HUANG Jingye, ZHONG Wen, LIU Yongda, ZENG Guohua

2022, 57(8):  914-917.  DOI: 10.3761/j.issn.0254-1769.2022.08.003

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Objective To establish a consensus on perioperative urospesis nursing of patients with intracavitary surgery for urinary tract calculi. Methods A consensus developing group was established,and the first edition of the "Expert consensus on perioperative urosepsis nursing of patients with intracavitary surgery for urinary tract calculi"（hereinafter referred to as the "consensus"） was formed after a large amount of literature review and collation,online expert consultation and group discussion. Domestic medical experts from urology,minimally invasive operating rooms and intensive care units were invited to discuss and revise the "consensus" for 2 rounds,and then peer review was conducted,and finally the "consensus" was completed. Results The final version of the "consensus" comprises 3 major sections,namely the preoperative,intraoperative and postoperative,which covers high-risk factors,prevention,identification,condition monitoring and nursing intervention,with a total of 21 items. The positive coefficients for the 2 rounds of consultations were 100%. The coefficients of judgment,familiarity and authority in the 2 rounds of consultations were 0.975,0.960 and 0.968,respectively. In the 2 rounds of expert consultations,the importance assignments of each items were（4.847±0.304） and（4.888±0.212）,and the overall Kendall’s coefficients were 0.232 and 0.287,respectively. Conclusion The "consensus" integrates the suggestions of multidisciplinary experts with a certain degree of practicality,representativeness and scientificity. It can provide guidance for clinical nursing practice of patients with perioperative urosepsis of intracavitary surgery for urinary tract calculi.

The analysis of the financial toxicity and its influencing factors in prostate cancer patients

YUAN Fang, LIN Mengyue, LIU Yongzhen, SHI Linlin, JU Hailing, YANG Bin, YUAN Jing

2022, 57(8):  918-924.  DOI: 10.3761/j.issn.0254-1769.2022.08.004

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Objective The purpose of this study is to investigate the status and influencing factors of financial toxicity（FT） in patients with prostate cancer,and to provide a basic theory for reducing FT levels in prostate cancer patients. Methods With the convenience sampling method,a total of 281 prostate cancer patients were recruited from a hospital in Shanghai from January 2020 to August 2021. A cross-sectional study was conducted by the general data questionnaire,the Comprehensive Scores for Financial Toxicity based on the Patient-Reported Outcome Measures（COST-PROM）,the Medical Coping Modes Questionnaire（MCMQ） and the General Self-Efficacy Scale（GSES）. Besides,multiple linear regression was used to identify predictors of FT in patients with prostate cancer. Results The total score of COST-PROM was 22.0 （17.0,24.0）. Multiple linear regression analysis showed that the factors of the diagnosis of prostate cancer affecting the retirement age,the average income per person in family,the treatment cost in the last 3 months,the dimension of surrender in medical coping style and the level of self-efficacy were the main influencing factors of FT（P<0.001）,which accounted for 45.6% of total variation. Conclusion The FT of patients with prostate cancer is in the middle and low level. Clinical staff should use the effective intervention measures to help patients go back to work,estimate their economic conditions for choosing individualized treatment,help them seek more social supports and resources,and guide them to manage problems in positive ways and enhance the level of self-efficacy,in order to reduce the level of FT and improve the quality of their life.

Meta integration of qualitative research on disease experience in patients with prostate cancer

ZHOU Yao, WANG Wei, CHEN Minna, ZHANG Ruolin, HONG Meirong, GAO Yating, LIN Ying, LOU Yan

2022, 57(8):  925-931.  DOI: 10.3761/j.issn.0254-1769.2022.08.005

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Objective To systematically review the qualitative research on the disease experience of patients with prostate cancer,and to provide references for improving the mental health of this population and establishing a support system. Methods The databases of PubMed,Web of Science,Cochrane,Embase,Cochrane Library,CNKI,VIP,Wanfang,CBM were retrieved on qualitative research about the disease experience of prostate cancer patients. The retrieval period is from the establishment of the database to April 2021. The quality of the literature was evaluated by JBI Critical Appraisal Tool for qualitative studies. Results A total of 13 studies were included,and 50 clear study results were extracted. Similar study results were summarized into 8 new categories,and 3 integrated results were synthesized：self-perception changes in symptomatic prostate cancer patients accompanied by regression,leading to impaired male self-esteem and alienation in the intimate relationship of couples;differences in coping strategies among patients with different emotional experiences,which are manifested as avoidance of surrender and post-traumatic growth;patients have unmet needs in multiple dimensions,such as poor doctor-patient communication,lack of peer support,and low social attention,and they strive to seek relevant support. Conclusion Prostate cancer patients have many aspects of disease experience in the whole disease process. Healthcare professionals tend to ignore patients’ feelings and experiences,and should pay attention to and evaluate patients’ psychological feelings from multiple perspectives in the future. They should also provide comprehensive physical and mental care from the perspective of positive psychology to improve social support and improve their quality of life.

Research progress of network technology in case management of prostate cancer patients

HU Ziyan, CHEN Yaping, ZHANG Jing, CAI Yibo

2022, 57(8):  932-936.  DOI: 10.3761/j.issn.0254-1769.2022.08.006

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Case management of prostate cancer patients can promote their behavior change and meet the health needs of patients and their families. Network technology has been applied in case management with its advantages of convenience and strong promotion. Case management is a process of conducting dynamic medical collaboration by its steps,including the assessment,planning,implementation,coordination and supervision. Based on the dynamic steps of case management,this paper summarizes advantages and disadvantages of the application form and application effect of the network technology,in order to provide references for the application of network technology in the case management of prostate cancer patients in China.

A specific scale of quality of life in neurogenic bladder patients：Chinese translation,cultural adaptation and test of validation and reliability of the SF-Qualiveen

TANG Rong, ZHOU Liqiong, SONG Wen, ZHAO Dan

2022, 57(8):  937-941.  DOI: 10.3761/j.issn.0254-1769.2022.08.007

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Objective To translate the SF-Qualiveen into Chinese,and to evaluate its reliability and validity in neurogenic bladder patients,to develop a specific quality of life assessment scale for neurogenic bladder patients. Methods After obtaining the authorization of the author of SF-Qualiveen,the scale was translated,back-translated and cross-culturally adjusted according to the Brislin model to form the Chinese version. 96 patients with neurogenic bladder in 5 tertiary comprehensive hospitals in Sichuan Province were investigated by snowball convenience sampling to evaluate the reliability and validity of the scale. Results The Chinese version of SF-Qualiveen included 4 dimensions and a total of 8 items. The decision value（CR） of each item was all>3.000,and the correlation coefficient between each item and the total score of the scale was all>0.400. The Cronbach’s α coefficient of the scale was 0.926,and the Cronbach’s α coefficient of each dimension was 0.908~0.931. The retest correlation coefficient of the scale was 0.971,and the retest correlation coefficient of each dimension was 0.539~0.935. The content validity index of the items（I-CVI） was 0.857~1.000,and the content validity index of the scale（S-CVI） was 0.875. The criterion validity of the scale was 0.891. Conclusion The Chinese version of SF-Qualiveen scale has been proved with good reliability and validity,and it can be used as an evaluation tool for the quality of life of patients with neurogenic bladder in China.

Specialist Practice and Research

Establishment of an evaluation index system for health education among nasopharyngeal carcinoma patients with radio-chemotherapy

LU Jiamei, LI Wei, LIAO Jinlian, HUANG Xiaojun, HU Kai, TANG Qiuming, LIANG Limin, FENG Yan, YANG Guirong, YANG Li

2022, 57(8):  942-949.  DOI: 10.3761/j.issn.0254-1769.2022.08.008

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Objective We aimed to establish an evaluation index system for health education among patients with nasopharyngeal carcinoma（NPC） who are undergoing radio-chemotherapy. As a theoretical basis,this system may be applied by the clinical nurses to carry out targeted health education and guidance among NPC patients undergoing radio-chemotherapy and to evaluate the effect of health education. Methods From March to July 2021,we constituted a structured multidisciplinary research team,including oncologists,nurse specialists,nutritionists,et al,based on the theory of Knowledge-Belief-Practice. Literature review,semi-structured interviews,as well as the Delphi method and Multi-dimensional Analytic Hierarchy Process,were used to establish a framework of the evaluation index system and set weighted value for each evaluation index. Results The response rates of the 2 rounds of expert consultations are 85.0% and 100%.The expert authority coefficients are 0.932 and 0.935,respectively.The total Kendall harmony coefficients of the 2 rounds of expert consultations are 0.235~0.326 and 0.302~0.419（P<0.01）.As a result,we built up an evaluation index system of health education which comprised 3 first-level indexes,19 second-level indexes and 73 third-level indexes for NPC patients undergoing radio-chemotherapy. Conclusion The evaluation index system may provide evidence and a practice tool for clinical nurses in conducting a comprehensive and efficient evaluation of health education among NPC patients undergoing radio-chemotherapy.

Construction and evaluation of a risk prediction model of postoperative delirium in patients with Stanford type A aortic dissection

LI Xueping, WANG Lei, ZHANG Huai, XING Aizhen, CHEN Chaohong, YIN Zhiqin

2022, 57(8):  950-957.  DOI: 10.3761/j.issn.0254-1769.2022.08.009

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Objective To construct a risk prediction model of the postoperative delirium for patients with acute type A aortic dissection（ATAAD）,and to verify the prediction effect of the model. Methods A retrospective study was conducted among 245 adult patients undergoing aortic dissection surgery in the cardiac surgery department of a tertiary A hospital in Wenzhou from October 2020 to April 2021. According to the occurrence of postoperative delirium,the patients were divided into a delirium group （n=51） and a non-delirium group （n=194）,and the data of the 2 groups were compared. The risk prediction scoring model was constructed based on the multivariate logistic regression analysis of ATAAD postoperative delirium risk factors. The Hosmer-Lemeshow test was used to determine the model’s goodness of fit of the model,and the receiver operator characteristic curve （ROC） was used to test the model differentiation. The risk prediction model was validated by the prospective study with inclusion of 51 ATAAD patients admitted to the cardiac surgery department from July,2020 to June,2021. Results There were 6 factors included in the risk prediction model of patients with postoperative delirium,namely age over than 55.50 years（1 point）,male（1 point）,preoperative blood lactic acid value more than 1.85 mmol/L（1 point）,hypothermia cycle arrest time more than 36.50 minutes（1 point）,length of stay in CCU（cardiovascular intensive care unit）more than 8.50 days（2 points）,and other postoperative complications（1 point）. The Hosmer-Lemeshow test of the prediction scoring model showed that when P=0.393,the area under the ROC was 0.926. When the patient’s score was ≤4,the incidence of postoperative delirium in patients with ATAAD was≤15.63%;while it was≥5,the incidence was ≥50.00%. The sensitivity,specificity and accuracy of the risk stratification model were 76.47%,93.30% and 89.80%,respectively. The result of model verification shows that when the area under the ROC was 0.896,the Hosmer-Lemeshow test P=0.359. The sensitivity,specificity and accuracy of the risk stratification model were 75.00%,92.31% and 88.24%,respectively. Conclusion This risk prediction model provides an effective prediction effect,and it is simple and convenient to use in clinical application,which could be a reference for medical staff to take preventive treatment and nursing care.

Obstacle factors of the best evidence application for the prevention of deep vein thrombosis after joint replacement

XU Yuan, WU Xinjuan, YANG Xu, WANG Yu, PANG Dong, WANG Xiaojie, LIU Jia, SHANG Gaopeng, JIANG Ying, ZHU Liyun, MA Yufen

2022, 57(8):  958-963.  DOI: 10.3761/j.issn.0254-1769.2022.08.010

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Objective To explore the barriers in the clinical use of evidence-based deep vein thrombosis prevention after joint replacement,and to provide bases for clinical measures. Methods The interview outline was developed based on the Theoretical Domains Framework（TDF） from July to August 2020. Totally 16 nurses working in the department of orthopedic at a tertiary A hospital in Beijing were selected for semi-structured interviews by convenient sampling,and the content analysis was conducted based on the results. The content of the transcribed text is analyzed,and specific topics and codes are classified according to the relevant fields of TDF. Results In clinical practice,the department has used the HIS system to assess DVT risks,but the nurses do not have a good grasp of the assessment scale,and the case information need to be retrieved,which has caused certain obstacles to the development of the assessment work. Nurses have the awareness to carry out health education and nursing prevention,but due to the lack of auxiliary tools,it is difficult to attract patients’ attention,and thus they lose the will to act,and hold doubts about the prevention effects. Nurses master health education related content and can implement physical and drug prevention,and the department has carried out prevention effect evaluation. However,due to the lack of relevant procedures,there are differences in behaviors among nurses. Combined with TDF,the above obstacles are classified into 5 domains：knowledge,environmental factor,motivation and target,result expectation,and code of conduct. Conclusion There is a variety of obstacles that affect the prevention of deep vein thrombosis after joint replacement in clinical application. It is necessary for the department to carry out the reform of evidence-based nursing practice on the basis of obstacles and promote the clinical application of the best evidence for the prevention of deep vein thrombosis after joint replacement.

Development of the Medical Adhesive Related Skin Injury Risk Assessment Scale in Cancer Patients and the test of its reliability and validity

YUE Lan, XU Yan, LI Zhen, YANG Changyong, GU Yujun, WANG Meng, LI Leilei

2022, 57(8):  964-969.  DOI: 10.3761/j.issn.0254-1769.2022.08.011

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Objective To develop a Medical Adhesive Related Skin Injury Risk Assessment Scale in Cancer Patients,and to test its reliability and validity. Methods The scale was compiled on the basis of literature analysis,group discussion and 2 rounds of expert consultations. Using the convenient sampling method,a total of 306 patients in departments of oncology of 3 tertiary A hospitals in Henan Province from March to July 2021 were selected for questionnaire survey to test the reliability and validity of the scale. Results The scale includes 7 dimensions,including patient factors,disease history,laboratory examination,skin status,adhesive properties,treatment cycle and catheter maintenance factors,with a total of 25 items. 7 common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 77.52%;the load values of each item in its common factor were 0.63~0.96;the content validity index at the scale level was 0.91,and the content validity index at the item level was 0.81~1.00. The area under the operating characteristic curve of the scale for predicting the risk of medical adhesive related skin injury in cancer patients was 0.87（P<0.001,95%CI ：0.72~0.83）;the cut-off value was 27.50 points. The Cronbach’s α coefficient was 0.81 and the half reliability was 0.55. Conclusion The risk assessment scale constructed by this study has good reliability and validity,and it can be used to assess the risk of medical adhesive related skin injury in cancer patients.

TCM Nursing

Clinical study of elevating Yang moxibustion therapy in elderly female patients with stress urinary incontinence of kidney-Yang deficiency

YANG Danhua, FANG Guizhen, SUN Min, WANG Yan

2022, 57(8):  970-976.  DOI: 10.3761/j.issn.0254-1769.2022.08.012

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Objective To evaluate the application effect of elevating Yang moxibustion therapy in elderly female patients with stress urinary incontinence of kidney-Yang deficiency. Methods The elderly female patients with stress urinary incontinence in kidney-Yang deficiency were enrolled from a tertiary A hospital in Hangzhou between September 2019 and May 2021. By the random number table,they were divided into an experimental group（n=40） and a control group（n=40）. The control group took pelvic floor muscle and bladder function training,the experimental group took the elevating Yang moxibustion on the basis of the control group for a course of 12 weeks,followed up to the 16th week. The daily urinary incontinence frequencies,1-hour urine leakage from pad test,ICI-Q-SF score and TCM syndrome score of stress urinary incontinence in kidney-Yang deficiency were compared between the 2 groups. Results At the 12th week of treatment,the difference in the number of daily incontinence between the 2 groups was statistically significant（t=-3.794,P<0.001）;the decrease of urine leakage in 1-hour pad test in the experimental group was greater than that in the control group （Z=5.270,P<0.001）;the ICI-Q-SF score（t=-3.297,P=0.001） and TCM syndrome score（t=-2.035,P<0.05） were compared between the 2 groups; the differences were statistically significant. At the 16th week of treatment,there were statistically significant differences in the number of daily urinary incontinence,ICI-Q-SF score and TCM syndrome score between the 2 groups. There were statistically significant differences in the number of daily urinary incontinence,ICI-Q-SF score and TCM syndrome score between the 2 groups at each time point（P<0.05）. Conclusion Moxibustion with elevating Yang method can reduce the daily frequencies of urinary incontinence and the urine leakage amount of 1-hour pad test in elderly female stress urinary incontinence patients with kidney-Yang deficiency,reduce the score of ICI-Q-SF and TCM syndrome score,thus improving the symptoms of urinary incontinence,and the quality of life of elderly female patients.

Nursing Management

Analysis of influencing factors and impact path of compassion fatigue in nurses from maternity hospitals in Jiangsu

CONG Shengnan, ZHANG Aixia, LIU Ying, ZENG Lihua, FAN Xuemei, WANG Rui, SHA Lijuan, ZHU Zhu, ZHOU Hui, ZHAN Jie

2022, 57(8):  977-984.  DOI: 10.3761/j.issn.0254-1769.2022.08.013

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Objective To investigate the influencing factors of compassion fatigue（CF） among nurses in maternity hospitals,and then to further explore the impact path of factors. Methods 715 nurses in maternity hospitals from Jiangsu were investigated by the cross-sectional survey. A self-developed questionnaire,the Five-Factor Inventory,the Social Support Rate Scale,the Psychological Capital Questionnaire-Revision,and the Compassion Fatigue Scale were adopted to collect data. Results The number of children,personality of neuroticism and agreeableness,social support,and psychological capital are the influencing factors of CF（P<0.05）,while professional titles,length of services,labor relations,personality of extraversion and openness,social support and psychological capital influence compassion satisfaction（CS）（P<0.05）. In structural equation model,the indirect effects of neuroticism on CF or CS existed（ES=0.062,-0.420）. Social support and psychological capital play a partially mediating role in neuroticism and CF（ES=0.017）,accounting for 27.42% of the total indirect effects. They also play a completely mediating role in neuroticism and CS（ES=-0.112）,accounting for 26.67%. Positive personality had a significant indirect effect on CF or CS（ES=-0.158,0.623）,and social support and psychological capital serve as a completely mediating role between them （ES=-0.028,0.102）,accounting for 17.72% or 16.37% of the total indirect effects. Conclusion Nursing managers should take effective measures tailored to personality traits to help nurses meet high levels of social support and psychological capital,so as to promote CS and reduce CF.

Community Care

The relationship between health literacy,empowerment and quality of life in disabled elderly and their spouses based on the theory of “dyadic coping”

LIN Xiaolu, ZHOU Chunlan, XIAO Xiuying, TAO Yanling, SUN Meihua, WU Yanni, YANG Lingli, ZHANG Mi, WANG Run, YANG Lixiao, YE Xiaoling, ZHAO Huihui

2022, 57(8):  985-991.  DOI: 10.3761/j.issn.0254-1769.2022.08.014

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Objective To explore the relationship between health literacy （HL）,empowerment and quality of life （QOL） in disabled elderly and their spouses based on the theory of “dyadic coping”. Methods From December 2020 to June 2021,498 disabled elderly and their spouses in Guangzhou,Zhuhai and Shenzhen of Guangdong province were surveyed by sociological data questionnaire,Katz Index ADL Scale,Health literacy Scale for chronic disease patients,Chinese Elders Health Empowerment Scale and Chinese Short Form-36 Health Survey. Spearman correlation analysis and structural equation model were used to analyze the data. Results The median scores of HL,empowerment and QOL of the disabled elderly were 86.00,30.00 and 391.39,respectively. The median scores of HL,empowerment and QOL of the spouses were 93.00,32.00 and 617.28,respectively. Correlation analysis showed that there were positive correlations between all variables（r=0.156~0.657,P<0.05）,except correlation between spouses’ empowerment and QOL of the disabled elders（P=0.91）. The structural equation model showed that the HL of the disabled elderly could affect the QOL directly or indirectly through empowerment （path coefficients were 0.30 and 0.23,P<0.001）,and the model fitted well（GFI=0.811,AGFI=0.788,RMSEA=0.057）. The HL of the disabled elders and their spouses had a positive interaction（path coefficient was 0.47,P<0.001）. The QOL of the disabled elders was positively correlated with the QOL of their spouses（path coefficient was 0.18,P=0.004）. Conclusion The interaction of HL and QOL between the disabled elders and their spouses suggests that the disabled elders and their spouses should not be considered separately under the pressure of disability,which verifies the rationality of the application of “dyadic coping” theory. The disabled elders and their spouses should be educated and empowered together to improve their QOL.

Clinical Practice

Hospice care for a child with acute leukemia in the end-of-life stage：a case study

SUN Li, HU Chengwen, LIU Qunhui, FANG Min, GU Daoqin, XU Baohui

2022, 57(8):  992-995.  DOI: 10.3761/j.issn.0254-1769.2022.08.015

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This article reported hospice care for a child with acute leukemia in the end-of-life stage,including the practical experience of using the concepts knowledge and skills of hospice care and nursing care for the child and his family members. The main points of nursing care include：conducting nursing care for symptoms of breathing difficulties and fever;carrying out family-participated painting therapy interventions,and children’s death education;holding a family meeting;using music,aromatherapy,and auricular acupoint therapy to relieve the insomnia symptoms of the children’s family members;using psychosocial therapy,family mourning,family dignity intervention,and writing letters that travel through time and space to relieve the complex grief of the children’s family members. The score of the Anticipatory Grief Scale dropped from 116 points to 76 points 6 months after the death,which achieved satisfactory results.

Nursing care of a child with Pneumocystis Carinii infection and intracranial hemorrhage after liver transplantation

FU Laijian, LU Fangyan

2022, 57(8):  996-1000.  DOI: 10.3761/j.issn.0254-1769.2022.08.016

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This paper summarizes the nursing experience of a child with lung infection complicated with intracranial hemorrhage after the parental liver transplantation. Nursing points：early identification of changes in the condition and improvement of risk prediction ability;treatment of intracranial hemorrhage and closely observing the occurrence of vascular complications;restarting anticoagulation treatment to prevent secondary bleeding;implementing cluster intervention measures to prevent infection worsening;taking various forms of psychological nursing care for children and their families based on music therapy and narrative nursing;developing an individualized discharge follow-up plan to establish a long-term follow-up program. After active treatment and care,the patient was in stable condition and safely discharged. Followed up for 6 months,the child was in fair condition.

Evidence Synthesis Research

Quality evaluation and content analysis of guidelines of airway extubation for adult patients in ICU

REN Xuanlin, FAN Luo, TIAN Jinhui, ZHU Wei, HAO Yaru

2022, 57(8):  1001-1007.  DOI: 10.3761/j.issn.0254-1769.2022.08.017

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Objective To evaluate the quality and analyze the content of existing guidelines related to airway extubation in adult ICU patients,in order to provide evidence-based bases for the formulation of domestic guidelines. Methods Electronic resources,including websites of international guidelines,related organization websites and biomedical databases,were retrieved from inception to August 31st 2021. 2 reviewers independently evaluated the quality of the included guidelines by the appraisal of guidelines for research & evaluation Ⅱ reporting checklist （AGREE Ⅱ）,and then analyzed and summarized the contents of the recommendations of each guideline. Results A total of 8 guidelines were included,4 of which were rated level A and the rest 4 were rated level B. Recommendations involved 7 aspects,namely pre-extubation evaluation,making plans,pre-extubation preparation,implementation of extubation,post-extubation treatment,adverse reaction reduction and the treatment of special groups. Conclusion The overall quality of the included guidelines is high. However,there is a lack of guidelines specifically for ICU patients,and some recommendations are controversial. Local evidence-based guidelines in China should be developed to guide the implementation of airway extubation in adult ICU patients.

Summary of best evidence for prevention and management of medical adhesive-related skin injury in neonates

ZHANG Juan, HE Jiao, LUO Li, ZHANG Lan, HAN Yanhong

2022, 57(8):  1008-1012.  DOI: 10.3761/j.issn.0254-1769.2022.08.018

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Objective To retrieve and obtain relevant evidence on the prevention and management of medical adhesive-related skin injury（MARSI） in neonates to guide clinical practice. Methods We searched UpToDate,BMJ Best Practice,Guidelines International Network（GIN）,National Guideline Clearinghouse（NGC）,Registered Nurses Association of Ontario （RNAO）,Medlive,Joanna Briggs Institute （JBI）,Cochrane Library,Embase,PubMed,Science Direct,CNKI to collect relevant guidelines,recommended practice,evidence summaries,systematic reviews and expert consensuses published form January 1,2011 to February 18,2021. There were 2 researchers who evaluated the quality of the literature and extracted evidence according to the Australian JBI Centre for Evidence-Based Health Care’s literature evaluation criteria and evidence grading system. Results A total of 10 articles were included,including 2 guidelines,2 evidence summaries,2 systematic reviews,4 expert consensuses. A total of 18 pieces of best evidence were collected,mainly involving 5 aspects of skin assessment,skin protection,employment choices,operation methods,management and training. Conclusion This study summarized the best evidence for the prevention and management of MARSI in neonates. It suggests that the nursing administrators should take the actual situation into consideration to formulate relevant nursing measures in clinical practice. We should solve the problem of MARSI in neonates in a scientific way,which can reduce the occurrence of skin injury and improve nursing quality.

Review

Application of behavioral cue-based oral feeding in the change of preterm infants’ feeding concept in NICU

ZHAO Lihua, WAN Xingli, ZHU Youju, PU Qianting, HU Yanling, SHI Zeyao, LIU Yulan, CHEN Xiaojuan, FU Li

2022, 57(8):  1013-1018.  DOI: 10.3761/j.issn.0254-1769.2022.08.019

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Behavioral cue-based oral feeding pattern means that feeders make decisions and provide different oral feeding strategies through continuous and dynamic evaluation of the behavioral cues presented by premature infants. This paper reviewed the development background,development situation,theoretical basis,influencing factors and oral feeding readiness assessment,sucking quality evaluation,supporting strategy implementation method of behavioral cue-based oral feeding pattern for preterm infants in NICU. It aimed to provide the references to carry out the behavioral cue-based oral feeding pattern of premature infants at domestic NICU.

Overseas K nowledge

Sinicization of the Supportive Needs of Breastfeeding Scale during hospitalization and the test of its reliability and validity

JIANG Xin, JIANG Hui

2022, 57(8):  1019-1024.  DOI: 10.3761/j.issn.0254-1769.2022.08.020

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Objective To translate the English version of the Supportive Needs of Breastfeeding Scale（SNB） during hospitalization into Chinese,and to verify its reliability and validity. Methods The original scale was translated,back-translated,culturally adapted using the Brislin translation model to form the Chinese version of the scale. A convenience sampling method was used to survey 360 mothers in a tertiary specialized hospital in Shanghai from March to July 2021,in order to analyze the reliability and validity of the scale. Results The Chinese version of the scale included 4 dimensions of emotional needs,skill needs,informational needs and appraisal needs,with a total of 18 items. The content validity of the scale I-CVI content validity index ranged from 0.830 to 1.000,and the S-CVI mean content validity index was 0.930. Exploratory factor analysis used principal component analysis to extract 4 common factors with a cumulative variance contribution rate of 76.152%. After confirmatory factor analysis, χ²/df was 2.568;RMSEA was 0.023;the equations fit well. The Chinese version of the Breastfeeding Self-Efficacy Scale Short-Form was used as the calibration standard,and the calibration standard correlation validity was 0.714. The Cronbach’s alpha coefficient of the scale was 0.947;the split-half reliability was 0.953,and the test-retest reliability was 0.912. Conclusion The scale has good reliability and validity,and it can be used as an assessment tool for breastfeeding support needs during hospitalization.