Table of Content

20 August 2022, Volume 57 Issue 16

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Research Paper

Application of a multi-component exercise intervention based on Wechat applet in the pre-frailty elderly

ZHANG Jie, LIU Xinmei, ZHAO Fang, LI Jing, ZHANG Dandan, YANG Yue, SUN Rui, WU Juan, WANG Haiyan

2022, 57(16):  1925-1930.  DOI: 10.3761/j.issn.0254-1769.2022.16.001

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Objective To investigate the impact of a multi-component exercise program based on Wechat applet on improving exercise adherence and the frailty state. Methods 95 pre-frailty of the elderly in a community in Beijing were randomly divided into 2 groups. On the basis of explanation and demonstration，the Wechat applet group used the multi-component exercise course of Wechat applet. The health education group used the way of explanation and demonstration to carry out multi-component exercise health education. The exercise adherence，frailty state and physical function were compared between the 2 groups. All subjects received 3-month intervention. Results 89 participants completed the study. The implementation of the multi-component exercise programs，the improvement of frailty and the improvement of walking speed in the Wechat applet group were better than those in the health education group（P<0.05），but there was no significant difference on grip strength，SPPB and TUGT between 2 groups（P>0.05）. Conclusion The multi-component exercise intervention based on Wechat applet is helpful to enhance the exercise adherence and improve frailty state of the elderly.

A qualitative research on voiceless experience of patients with voice restoration failure after total laryngectomy

DAI Dandan, LIU Wensheng, KOU Cuimin, WANG Xiaoyan, HOU Zhu, BAI Xiaolu

2022, 57(16):  1931-1936.  DOI: 10.3761/j.issn.0254-1769.2022.16.002

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Objective This research，which focuses on the experience of patients living in voiceless conditions with voice restoration failure after total laryngectomy，aims to provide a basis for nursing and intervention tactics for the patients. Methods The purposive sampling method was used to select 17 patients as the research participants. The patients，who had total laryngectomy in the department of head and neck surgery in a tertiary A cancer hospital in Beijing from June 2019 to March 2021，participated in a training class using esophagus for pronunciation，but failed in voice restoration and the medics by other auxiliary voice aids. The researchers conducted semi-structured interviews with the patients and used Colaizzi 7-step analysis to sort out，summarize and refine the data. Results The patients who lived in voiceless conditions with voice restoration failure after total laryngectomy，have the experience in following 4 aspects，including palpable stigma，eager for medical professional guidance，good family support to benefit patients，and expectations for social understanding and support. Conclusion This population faces many problems and also has many needs. Therefore，it is necessary for the nurses to pay much attention to the psychological changes of the patients，as well as their main concerns and feelings，and to provide targeted nursing guidance and social support.

Standards

Chinese expert consensus on cardiac rehabilitation nursing care

Geriatric Nursing Committee of Chinese Nursing Association, Committee of Cardiac Rehabilitation and Prevention of Chinese Association of Rehabi-litation Medicine, Organ Rehabilitation Committee of Chinese Elder Health Care Association, Writing Committee: SHEN Lin, MENG Xiaoping, CHEN Xiaoming, ZHU Liyue, WANG Mei, CAO Yingjuan

2022, 57(16):  1937-1941.  DOI: 10.3761/j.issn.0254-1769.2022.16.003

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Objective To form the Chinese expert consensus on cardiac rehabilitation nursing care，so as to standardize the work related to cardiac rehabilitation nursing. Methods The first draft was initially formed，based on a comprehensive review of domestic and foreign cardiac rehabilitation guidelines，expert consensuses，systematic reviews，original research and other literature，as well as related disease diagnosis and treatment plans，management consensuses and related literature. Results The draft was thereafter reviewed by a total of 37 experts in related fields. This consensus was finalized after 3 rounds of discussions and modifications. The expert consensus covers the following 4 topics，namely the work goals of cardiac rehabilitation nursing care，the qualifications，training，core competencies and responsibilities of cardiac rehabilitation nursing care，the components of cardiac rehabilitation nursing care，and quality control of cardiac rehabilitation nursing care，and the safety management of cardiac rehabilitation patients. Conclusion The consensus was formed on the basis of comprehensive expert opinions and relevant guidelines，consensuses and clinical research on cardiac rehabilitation，which can provide guidance for medical institutions to carry out cardiac rehabilitation nursing practice.

Specialist Practice and Research

Research on influencing factors of usage intention toward internet diagnosis and treatment services among enterostomy patients

GAO Yumeng, ZHAO Hong, LI Xing, WANG Lei, XIE Lunfang

2022, 57(16):  1942-1947.  DOI: 10.3761/j.issn.0254-1769.2022.16.004

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Objective To investigate the influencing factors of enterostomy patients’ usage intention of Internet diagnosis and treatment services within the theoretical framework of Unified Theory of Acceptance and Use of Technology and Dual-Factor Model. Methods Using a convenience sampling method，310 enterostomy patients were recruited from 3 tertiary hospitals in Hefei city from March to September 2021. The general data questionnaire，m-eHEALS Scale and the questionnaire on the usage intention of the Internet diagnosis and treatment services of enterostomy patients were used for investigation. Structural equation model was constructed to analyze the influencing factors. Results The score for usage intention was（3.37±1.31），with the performance expectation of （4.08±0.76），effort expectation of （3.11±1.33），social influence of （3.66±1.02），facilitating conditions of （3.80±1.06），trust of（4.06±0.58），resistance to change of（3.07±1.29），and ehealth literacy of（2.53±1.07）. The results of the structural equation model show that social impact，effort expectation，and ehealth literacy have positive effects on the usage intention，with effect values of 0.251，0.230 and 0.082，respectively. Resistance to changes negatively affects the usage intention，and the effect value was -0.506（P<0.05）. Conclusion The level of usage intention of Internet diagnosis and treatment service of enterostomy patients is in the middle of the upper. Resistance to changes，social influences，effort expectations，and ehealth literacy are the key factors affecting usage intention of enterostomy patients. To enhance patients’ usage intention of Internet diagnosis and treatment.

Establishment of a nomogram model for predicting the risk of deep vein thrombosis in patients with acute stroke

LU Qiufang, YING Yanping, QIN Yanqin, MA Juan, HUANG Biaojin, LIAO Qiuming, WEI Fangsu, XU Mingli, QIN Shuangwen

2022, 57(16):  1948-1955.  DOI: 10.3761/j.issn.0254-1769.2022.16.005

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Objective To construct and verify a risk nomogram prediction model of lower extremity deep venous thrombosis（DVT） in patients with acute stroke. Methods A prospective study design was adopted. 602 patients with acute stroke hospitalized in a tertiary general hospital in Nanning，Guangxi province from January 2020 to April 2021 were selected as the research subjects，of which 415 patients from January 2020 to December 2020 were allocated into the modeling group and 187 patients from January 2021 to April 2021 in the validation group for external validation. Univariate and multivariate logistic regression were used to analyze the risk factors of lower limb DVT in acute stroke，to establish the risk prediction model and draw the nomogram model. Receiver operating characteristic（ROC） and Hosmer lemeshow were used to verify the predictive effect of the model. Results 35 of 415 cases in the modeling group had DVT，with an incidence of 8.4%;19 of 187 cases in the validation group had DVT，with an incidence of 10.2%. The results of univariate analysis in the modeling group showed that age，diagnosis，bed time，state of consciousness，degree of hemiplegia，smoking history，atrial fibrillation history，thrombosis history，use of dehydration drugs，and central venous catheterization，fibrinogen and D-dimer quantification were the influencing factors of DVT in patients with acute stroke. Multivariate logistic regression analysis showed that age，state of consciousness，degree of hemiplegia，the use of dehydrating drugs were independent risk factors for DVT of acute stroke（OR values were 1.901，1.702，1.940 and 3.231，all P<0.05）. The nomogram model was constructed with the above 4 factors;the area under the ROC curve of nomogram model is 0.850;the maximum value of Jordan index is 0.758;the sensitivity is 83%;the specificity is 82%;the best critical value is 0.071. Hosmer-Lemeshow test χ²=2.143，P=0.951;when the area under the ROC curve of the external verification group is 0.893 and the maximum value of Jordan index is 0.746，the sensitivity is 90%，the specificity is 85%，and the best critical value is 0.084. Conclusion The nomogram model can predict the risk DVT of acute stroke，and help to formulate personalized intervention measures.

Multicenter survey on feeding of very low birth weight infants with different types of dairy products in the Yangtze River Delta

WANG Li, LÜ Tianchan, LI Liling, JIN Yumei, WANG Yan, TANG Yunfei, MA Yuelan, DOU Yalan, LIU Chan, CAO Yun, HUAN Xia, ZHANG Li, CAO Suzhen, HUANG Guoying, HU Xiaojing

2022, 57(16):  1956-1961.  DOI: 10.3761/j.issn.0254-1769.2022.16.006

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Objective To analyze the application status of different dairy products for very and extremely low birth weight infants in Yangtze River Delta，so as to provide evidence for making better feeding choices in clinic Practice. Methods From January 2019 to December 2019，the self-made “form of feeding situation in very low birth weight infants（VLBW） in neonatal intensive care unit（NICU）” was used to collect data and uploaded to the database，and the clinical data of VLBW infants with gestational age ≤35 weeks and admitted to the NICU within 24 hours after birth in 5 tertiary hospitals in the Yangtze River Delta were retrospectively analyzed，and the composition ratio of different dairy types was obtained. At the same time，the clinical outcomes related to feeding in the exclusive breastfeeding group and the formula supplement group were compared. Results 830 cases of VLBW infants were admitted to the NICUs of 5 hospitals，among which 667 cases met the inclusion criteria. Among them，82（12.3%） received exclusive maternal breast milk;5（0.8%） received exclusive donated breast milk;65（9.8%） received both maternal and donated breast milk，the above three feeding types were collectively referred to as exclusive breastfeeding, a total of 152（22.9%） cases. 34（5.1%） received both donated breast milk and formula;75（11.2%） received exclusive formula;333（49.9%） received both maternal breast milk and formula;73（10.9%） received formula，maternal and donated breast milk. The number of days of parenteral nutrition in the donor breast milk supplement group was less than that in the formula supplement group，and the incidence of necrotizing enterocolitis and septicemia was lower than that in the formula supplement group，with statistical significance（P<0.05）. Conclusion The exclusive breastfeeding rate of VLBW infants in various institutions in the Yangtze River Delta region is not optimistic. When the mother’s breast milk is insufficient，formula supplement feeding is still not as effective as exclusive breastfeeding.

Construction of a breastfeeding follow-up checklist for discharged newborns

KE Songlin, LENG Hongyao, TANG Yuman, ZHENG Xianlan

2022, 57(16):  1962-1968.  DOI: 10.3761/j.issn.0254-1769.2022.16.007

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Objective To develop a follow-up checklist for breastfeeding of discharged newborns，standardize the contents of breastfeeding follow-up visits after the discharge of hospitalized newborns，and to promptly identify and solve feeding problems encountered by newborns and mothers. Methods The first draft of the follow-up checklist was developed through the literature review and semi-structured interviews，and 2 rounds of correspondence were conducted with 15 experts from Chongqing，Sichuan，Yunnan，Guizhou，Guangdong，Hunan，and Hubei provinces from December 2021 to February 2022. A follow-up checklist for breastfeeding of discharged neonates was initially applied and then revised again to form the final draft. Results The positive coefficients of experts in both rounds of correspondence were 100%;the authority coefficients of experts were 0.945 and 0.956，respectively;and the Kendall harmony coefficients were 0.296 and 0.241，respectively（P<0.001）. The final list of breastfeeding follow-up for discharged newborns contained 6 primary indicators，11 secondary indicators，and 37 tertiary indicators，including newborn feeding status，newborn physical status，mother’s feeding perception，mother’s physical and mental status，family social support，and health education. Conclusion The follow-up checklist constructed in this study is more comprehensive and can provide a reference for the follow-up of breastfeeding after the discharge of hospitalized newborns.

The influence of family management adjustment and the trajectory of transition readiness in adolescents with chronic diseases and caregivers on their quality of life

GONG Geyan, MA Jiali, GAO Wenying, ZHANG Ying

2022, 57(16):  1969-1975.  DOI: 10.3761/j.issn.0254-1769.2022.16.008

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Objective To explore the change of transition readiness from perspective of adolescents with chronic diseases and their caregivers，and to identify its long-term effect on their quality of life，and to clarify the regulating role of family management adjustment. Methods A prospective study was conducted among 201 pairs of adolescents with chronic diseases and their caregivers hospitalized in the wards of nephrology，rheumatology，and endocrinology of 2 children’s hospitals in Shanghai from March to September 2019. Data were collected at hospitalization（T1），1 year after discharge（T2） and 2 years after discharge（T3） using a demographic questionnaire，Chinese version of Family Management Measure，Chinese version of Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire，Pediatric Quality of Life Inventory 4.0 and Pediatric Quality of Life Inventory Family Impact Model. The longitudinal actor-partner interdependence model was used to analyze the impact of transition readiness on quality of life. Results The results of ANOVA showed that transition readiness from perspective of adolescents and their caregivers increased year by year（P<0.001）. The results of correlation analysis showed that there was a significant positive correlation between transition readiness and quality of life at T3（P<0.001）. The analysis results of actor-partner interdependence model showed that adolescents’ perspective of transition readiness had a positive actor effect on their own quality of life（P<0.05）;caregivers’ perspective of transition readiness had positive actor and partner effects on their own quality of life and adolescents’ quality of life（P<0.05）;family management adjustment had significant positive impacts on transition readiness. Conclusion In the context of family management，transition readiness could positively predict quality of life of adolescents with chronic diseases and their caregivers. Medical staff should carry out targeted family interventions at different stages，improve self-management level of adolescents，and thus enhance quality of life of the whole family.

Community Care

Development of evidence-based popular works of swallowing safety for home-dwelling disabled elderly

XU Wenxin, HUANG Huanhuan, WANG Jun, CAO Songmei, TANG Xumeng, XIAO Mingzhao, ZHAO Qinghua

2022, 57(16):  1976-1982.  DOI: 10.3761/j.issn.0254-1769.2022.16.009

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Objective To design and make popular works of swallowing safety for the home-dwelling disabled elderly. Methods The evidence-based nursing and Delphi method were used to form the best evidence summary through literature retrieval and appraisal, evidence extraction and evidence level evaluation. The swallowing safety education system was constructed through 2 rounds of expert consultations. Based on this system, the content was refined and transformed into popular works, and then the popular works were designed and developed by multidisciplinary teams. Results 31 pieces of evidence were summarized from 8 aspects, such as safety education objective，identification of dysphagia，swallowing function exercise，oral management，etc. 2 rounds of consultations showed good initiative，authority and coordination，and the final system included 4 primary indicators，11 secondary indicators and 21 tertiary indicators. The popular works of swallowing safety included manuals，videos and audios，which were easy to understand，vivid and point-prominent. Conclusion The development method of popular works of swallowing safety for home-dwelling disabled elderly is scientific and feasible. It is suggested that creators should strengthen the scientificity，people-orientation and originality of popular works. This study can provide methodological references for other scholars to develop health popular works.

Clinical Practice

Nursing care of a premature infant infected by group B streptococcus

WU Luping, HU Xiaoli, WANG Yupeng, FENG Suwen

2022, 57(16):  1983-1986.  DOI: 10.3761/j.issn.0254-1769.2022.16.010

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To summarize the nursing experience of a premature infant infected by late onset group B streptococcus. Nursing points include:using intrapartum antibiotic prophylaxis administration to reduce the incidence of early-onset infections;establishing a high-risk alert for early-onset group B streptococcal infection;improving the ability to identify early signs of disease to increase the success rate of treatment and rescue;strengthening basic nursing to prevent ventilator-related complications;providing personalized breastfeeding guidance to avoid recurrent group B streptococcal infection;providing targeted health education to reduce the maternal and child hazards related to group B streptococcus disease. The newborn was discharged after 40 days’ active treatment and careful nursing care. Followed up to 6 months of corrected age，the newborn grows well with no recurrent group B streptococcal infection.

Evidence Synthesis Research

The best evidence summary for the prevention of catheter related skin injuries in cancer patients with PICC

LIU Jing, LIU Chunfang, LI Xiuchuan, ZHANG Qi, YANG Xuening, LI Xueer, FANG Ziyan, ZHANG Jing

2022, 57(16):  1987-1994.  DOI: 10.3761/j.issn.0254-1769.2022.16.011

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Objective To retrieve，evaluate，integrate the evidence of catheter related skin injuries prevention practices in cancer patients with PICC from home and abroad，and then summarize the relevant best evidence to provide evidence-based practice for clinical standardized management of catheter related skin injuries. Methods Evidence on prevention of catheter related skin injuries in cancer patients with PICC was systemically retrieved in the websites and databases，namely the BMJ Best Practice，UpToDate，Guidelines International Network，National Guideline Clearinghouse，National Institute for Health and Care Excellence，Scottish Intercollegiate Guidelines Network，Registered Nurses Association of Ontario，Intravenous Nurses Society，National Comprehensive Cancer Network，Oncology Nursing Society，medlive，Cochrane Library，Joanna Briggs Institute，PubMed，Embase，CINAHL，Taiwan academic literature database，CNKI，WanFang，VIP，SinoMed，including clinical decision-making，guidelines，evidence summaries，best practice，recommended practice，systematic reviews，expert consensuses，and government documents. The literature retrieval period was from the database construction to September 12，2021. The guidelines were individually evaluated by 4 experts，and the remaining literature was independently evaluated by 2 researchers. The literature that met the criteria was extracted and graded. Finally，the expert group integrated the evidence and summarized the evidence topics. Results A total of 12 articles were involved，including 1 government document，3 guidelines，4 evidence summaries，3 expert consensuses，and 1 systematic review. Finally，7 evidence topics and 26 pieces of best evidence were formed，including assessment，skin cleaning and antisepsis，dressing selection，operation and securement techniques，skin protection at PICC insertion site，patient education，supervision and training. Conclusion The best evidence of catheter related skin injuries in cancer patients with PICC can provide resources preparation for clinical transformation and offer nurses clinical decision-making for scientific and effective nursing practice. Specialist nurses should reasonably choose the best evidence for localized application，and constantly update the best evidence，standardize nursing practice，and ensure the safety of patients.

Evidence summary for oral intake management during labor

ZHU Zhu, ZHOU Chunxiu, CONG Shengnan, YAO Yuqin, ZHANG Jingjing, ZHOU Yingfeng, FAN Xuemei

2022, 57(16):  1995-2002.  DOI: 10.3761/j.issn.0254-1769.2022.16.012

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Objective To search，evaluate and summarize the best evidence of oral intake management during labor and to provide references for clinical practice. Methods According to the “6S” model of evidence resources，clinical decision support，best practice recommendations，guidelines，evidence summaries，expert consensuses and systematic reviews related to oral intake management published in computer decision support systems，guideline websites，association official websites and databases were searched from the establishment of databases to December 2021. A supplementary search was performed for randomized controlled trials published between January 2018 and December 2021. 2 researchers evaluated the methodological quality of the literature，extracted and summarized evidence according to the subject. Results A total of 12 articles were included，including 1 clinical decision support，5 guidelines，1 evidence summary，3 expert consensuses and 2 randomized controlled trials，and 19 pieces of best evidence were summarized from 4 aspects of health education，dynamic evaluation during labor，recommended schemes of oral intake during labor and systematic support. Conclusion This study summarized the best evidence of oral intake management during labor，which can provide a basis for clinical evidence-based practice. Healthcare professionals should combine the best evidence with clinical situation，expert judgment and maternal wishes to develop personalized oral intake management programs during labor for different groups，so as to ensure energy supply，improve maternal and child delivery outcomes，while improving maternal food satisfaction and relieving emotional stress.

Nurses’ experiences of participating in robotic surgery：a qualitative meta-synthesis

YANG Wantong, ZHANG Qiuwen, MU Li, LI Xuesong, WANG Jing, PANG Dong

2022, 57(16):  2003-2009.  DOI: 10.3761/j.issn.0254-1769.2022.16.013

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Objective To systematically review and synthesize the experience of nurses participating in robotic surgery，so as to provide recommendations for clinical practice. Methods The computer retrieval was performed in PubMed，CINAHL（EBSCO），Embase，Web of Science，Scopus，ProQuest Dissertations and Theses，SinoMed，CNKI，Wanfang Data and VIP database from January 1，2000 to November 26，2021，to collect qualitative studies in the experience of nurses participating in robotic surgery. This qualitative systematic review was conducted under the Joanna Briggs Institute guideline. This paper was written according to the enhancing transparency in reporting the synthesis of qualitative research（ENTREQ）. Results A total of 6 qualitative studies were included，and 39 findings were extracted，which were summarized into 8 categories and integrated into 3 synthesized findings. Findings included that nurses play a coordinating role in teamwork and gain a sense of achievement;nurses face multiple challenges and pressures in their work;nurses lack professional knowledge and need technical support and team training. Conclusion The communication and cooperation among members of the robotic surgical team should be strengthened;the management of operation time，operating room space，equipment failure and patient safety should be strengthened;the operation process should be standardized;the legal responsibilities of nurses should be clarified;professional team training and technical support should be provided for nurses.

Effect of prone ventilation in patients with hypoxemia after cardiopulmonary bypass surgery:a meta-analysis

JIANG Hui, BAI Xiaoling, CHENG Zhongsha, WEI Qing, ZHANG Jiaxing, JIANG Xue

2022, 57(16):  2010-2017.  DOI: 10.3761/j.issn.0254-1769.2022.16.014

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Objective To systematically evaluate the application effect of prone ventilation in patients with hypoxemia after cardiopulmonary bypass surgery，so as to provide a reference for further discussing the effective mechanical ventilation position of such patients. Methods Pubmed，Web of Science，Embase，Cochrane Library，CENTRAL，CBM，CNKI，Wanfang Data and VIP database were searched from the establishment of databases until September，2021. All the published randomized controlled trials（RCTs） about the effects of prone position ventilation on patients with hypoxemia after cardiac surgery were confirmed by the literature reference citation retrieval. Inclusion and exclusion criteria were used to review and rank the literature. After the evaluation of the quality of included studies，the data was extracted from RCTs and a meta-analysis was conducted by RevMen 5.4. Results 9 RCTs with 456 cases were included. The results of meta-analysis showed that in oxygenation index，the oxygenation index of prone ventilation was higher than that of supine ventilation when the ventilation time（T1） in prone position≥12 h，and the start time（T2） was 6 hours after surgery and the intermittent prone ventilation，and the difference was statistically significant [MD=57.31，95%CI（35.84，78.77），P<0.001]，[MD=71.98，95%CI（64.34，79.61），P<0.001]，[MD=37.97，95%CI（18.36，57.58），P=0.001]. In oxygen partial pressure，when the oxygen concentration（FiO₂） of prone ventilation was lower than that of supine ventilation，the oxygenation index of prone ventilation was higher than that of supine ventilation，and the difference was statistically significant[MD=5.70，95%CI（0.46，10.94），P=0.03]. In clinical outcome，the mechanical ventilation time[MD=-56.47，95%CI（-72.62，-40.33），P<0.001]，ICU stay time[MD=-60.82，95%CI（-76.82，-44.81），P<0.001] and hospital stay time[MD=-44.36，95%CI（-63.10，-25.62），P<0.001] in prone ventilation group were lower than those in supine ventilation group，and the differences were statistically significant. Conclusion The prone position ventilation is effective to improve PaO₂/FiO₂，duration of mechanical ventilation，duration of ICU care，and hospital stays in patients with hypoxemia after cardiac surgery，while it could not effectively improve PaO₂. Despite subgroup analysis of the main indicators，the optimal duration and initiation of prone ventilation remained unclear. Due to the limitations of the quality of included studies，randomized controlled trials with large sample size are needed in the future to evaluate the effects of prone position ventilation on neonatal respiratory distress syndrome.

Review

The application of enhanced recovery after surgery in the perioperative period of lung transplantation:a scoping review

ZHENG Xiaomin, CAI Yinghua, ZHOU Haiqin, WAN Xia

2022, 57(16):  2018-2024.  DOI: 10.3761/j.issn.0254-1769.2022.16.015

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Research progress on palliative care for lung transplant patients

WANG Ruiting, SUN Jing, PENG Fucong, WEI Changyun, YANG Luo, LIU Hongxia

2022, 57(16):  2025-2029.  DOI: 10.3761/j.issn.0254-1769.2022.16.016

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To fully understand the research progress of palliative care in lung transplant patients，this paper introduces the concept，necessity，development status，effect，obstacles and promotion strategies of palliative care for lung transplant patients，which is to provide references for the development of palliative care for lung transplant patients in China，so as to improve the quality of life of lung transplant patients.

Research progress on sense of coherence in cancer patients

QI Yuhan, FU Jiana, ZHAO Hui

2022, 57(16):  2030-2036.  DOI: 10.3761/j.issn.0254-1769.2022.16.017

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Sense of coherence refers to a universal，lasting and dynamic confidence held by individuals in the face of internal and external environmental stimuli. A high level of sense of coherence can promote the physical and mental health of cancer patients. However，the sense of coherence of most cancer patients is at a low level，which seriously affects the quality of life of cancer patients. This paper reviews the current situation，evaluation tools，influencing factors and intervention measures of sense of coherence of cancer patients，in order to provide references for the research and development of sense of coherence nursing care of cancer patients in China.

Research progress of emergency triage in patients with acute chest pain

ZHOU Xuan, ZHENG Ruofei, JIAN Gangren, WANG Shengfang, YE Chengdong, LIN Lijuan

2022, 57(16):  2036-2041.  DOI: 10.3761/j.issn.0254-1769.2022.16.018

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Acute high-risk chest pain can lead to disease changes and even death in a short period of time. Triage，which can rapidly assess and prioritize patients，is a critical point in risk assessment for patients with acute chest pain. This paper expounds the triage scales，evaluation methods and tools of emergency triage in patients with acute chest pain，analyzes its related influencing factors，and puts forward prospects，aiming to provide a reference for the management of chest pain in emergency triage.

Nursing Instruments Innovation

Design of a birthing chair and its application

ZHOU Lin, ZHANG Shuixian, LIANG Yan, LEI Xia, GUO Ronghuang, LI Yimin

2022, 57(16):  2042-2045.  DOI: 10.3761/j.issn.0254-1769.2022.16.019

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Objective To design a birthing chair to support women with standing position during labor，and to evaluate its effectiveness on correcting occipital posterior position. Methods The birthing chair is composed of 7 components，such as the back of the chair，holding components，seat，standing pedal，et al. 100 women were selected from a hospital in Hangzhou between August and December 2020. They were randomly divided into an experimental group（n=50） and a control group（n=50）. Women in the experimental group were given the birthing chair and it was used to correct the occipital posterior position with the instruction of midwives，while women in the control group were applied the traditional position change method （lateral position + lateral prone position） to correct occipital posterior position. Indicators include the correction rate of occipital posterior position，mode of delivery and incidence of adverse events. Results The correction rate of occipital posterior position in the experimental group （86%） was significantly higher than that in the control group（56%），and the difference between 2 groups was statistically significant（P=0.001）. The rate of natural birth（88%） in the experimental group was higher than that in the control group（66%），while the rate of vaginal assisted delivery（4%） was lower than that in the control group （16%），and the rate of cesarean section（8%） was lower than that in the control group（18%）. The difference between 2 groups was statistically significant（P=0.009）. Conclusion The birthing chair to support women with standing position during labor can effectively correct the occipital posterior position，and increase natural birth rate. It is a convenient and safe birthing tool，which can improve women’s childbirth experience.

Design and application of a sealed negative pressure stool collector for children

JIANG Qiaoping, HE Zhenhua, ZHANG Linjia

2022, 57(16):  2046-2048.  DOI: 10.3761/j.issn.0254-1769.2022.16.020

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Objective To design and investigate the application of a sealed negative pressure stool collector for children with diarrhea. Methods Sealed negative pressure excrement collector is composed of negative pressure ball，sample tube，limiter，casing sheath and so on. 159 children with diarrhea admitted to the emergency department of our hospital（a tertiary A children’s hospital in Hangzhou） from January to December 2021 were convenience sampled as the research subjects and divided into an experimental group with 88 cases and a control group with 71 cases by random number table method. A sealed negative pressure stool collector was used to collect stool samples in the experimental group，and an ordinary anal swab was used in the control group. The success rate of fecal specimen collection，fecal spatter rate，intestinal mucosal injury rate，fecal specimen collection time，and satisfaction with the sampler were compared between the 2 groups. Results Compared with the control group，the experimental group was significantly higher in the success rate of fecal specimen collection and satisfaction with the sampler（all P<0.05）;the fecal spatter rate and intestinal mucosal injury rate in the experimental group were significantly lower than those in the control group（all P<0.05）;there was no significant difference in the fecal specimen collection time（P=0.069）. Conclusion The use of the sealed negative pressure stool collector to collect stool specimens for children with diarrhea can improve the success rate of fecal specimen collection，reduce fecal spatter rate and intestinal mucosal injury rate，and the staff for the sampler has a high degree of satisfaction.