Table of Content

10 February 2023, Volume 58 Issue 3

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Research Paper

Construction and application of a diaphragm exercise program in patients with mechanical ventilation in ICU

LIU Xiu, LIU Binbin, QUAN Mingtao, ZHAN Weili, YANG Dengbi, ZHANG Jiaxin

2023, 58(3):  261-267.  DOI: 10.3761/j.issn.0254-1769.2023.03.001

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Objective To construct a diaphragm exercise program for patients with mechanical ventilation in intensive care unit（ICU），and to explore its clinical application effect. Methods Based on literature analysis and expert meeting，a diaphragm exercise program of ICU patients with mechanical ventilation was constructed. A total of 69 adult patients with mechanical ventilation in our comprehensive ICU from October 2020 to October 2021 were randomly divided into an experimental group（35 cases） and a control group（34 cases）. The control group was given ICU routine rehabilitation nursing care and early activities，and the experimental group was given the diaphragm exercise on the basis of the interventions in the control group. End-inspiratory diaphragm thickness （DTei），end-expiratory diaphragm thickness（DTee），diaphragm thickening fraction（DTF） and diaphragmatic excursion（DE） were evaluated by ultrasound before and 24，48，72 and 120 hours after intervention. The success rate of weaning and the incidence of adverse events were compared and analyzed between the 2 groups. Results Repeated measures ANOVA showed that the time effect and interaction effect of DTei between the 2 groups were statistically significant（P<0.05）；the time effect of DTee in the 2 groups was statistically significant（P<0.05）；the time effect and interaction effect of DTF in the 2 groups were statistically significant（P<0.05）；the time effect and interaction effect of DE in the 2 groups were statistically significant（P<0.05）. The DTei of the experimental group was higher than that of the control group at 120 h after intervention；the DTF of the experimental group was higher than that of the control group at 72 h and 120 h after intervention；the DE of the experimental group was higher than that of the control group at 120 h after intervention；the differences were statistically significant（P<0.05）. The weaning success rate of the experimental group was higher than that of the control group，and the difference was statistically significant（P<0.05）. There were no adverse events such as sudden drop of oxygen saturation，tachycardia or musculoskeletal injury occurred in the 2 groups. Conclusion The diaphragm exercise program is safe and feasible for ICU patients with mechanical ventilation，which can improve diaphragm function，increase the success rate of weaning，and promote the rehabilitation of patients.

Special Planning—Stroke Rehabilitation Nursing

Construction and application of a rehabilitation nursing program for elderly patients with cerebral infarction

CUI Xueyan, ZHANG Jinhua, ZHOU Xiaoyan, WANG Chenke, WANG Ruoyu

2023, 58(3):  268-765.  DOI: 10.3761/j.issn.0254-1769.2023.03.002

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Objective To construct a rehabilitation nursing program for elderly patients with cerebral infarction and to evaluate its application effect. Methods The rehabilitation nursing program for elderly patients with cerebral infarction based on 5E rehabilitation model was constructed through literature research and expert correspondence. The program includes 5 first-level indicators of encouragement，education，exercise，employment and evaluation，and 20 second-level indicators. By the convenient sampling method，85 elderly patients with cerebral infarction hospitalized in the Department of Neurology of a tertiary A hospital in Xinxiang City from May to December 2020 were selected as the research subjects. They were divided into an experimental group with 42 cases and a control group with 43 cases randomly by numerical table method. The experimental group was treated with 5E rehabilitation nursing model on the basis of routine nursing care，and the control group was treated with routine nursing care. The intervention time was for 2 months. Before the intervention，a month and 2 months after the intervention，2 groups were evaluated by unarmed muscle strength test，Brunnstrom motor function assessment and hospital anxiety and depression scale. Results The time effect，grouping effect and interaction effect of muscle strength，motor function，anxiety and depression in the 2 groups were statistically significant（P<0.05）. After a month and 2 months of the intervention，the indexes of the experimental group were better than those of the control group（P<0.05）. Conclusion The rehabilitation nursing program for elderly patients with cerebral infarction can improve their muscle strength，motor function，anxiety and depression effectively.

Application effect of multi-module rehabilitation nursing model in intelligent follow-up of stroke patients

DUAN Chunmei, WANG Yuanyuan, WANG Lingling

2023, 58(3):  276-281.  DOI: 10.3761/j.issn.0254-1769.2023.03.003

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Objective To develop a multi-module rehabilitation nursing model，and apply it in intelligent follow-up of stroke patients，and evaluate the effect on symptom experience and quality of life of stroke patients. Methods From January 1，2020 to October 31，2021，a total of 316 stroke patients in the Department of Neurology of a tertiary A hospital in Xinjiang Uygur Autonomous Region were selected by convenience sampling. According to the order of admission time，160 patients admitted from January 1，2021 to October 31，2021 were selected as the experimental group. A total of 156 patients admitted from January 1 to October 31，2020 were selected as the control group. The historical control method was used to verify the effect of multi-module rehabilitation nursing model on symptom experience and quality of life of stroke patients during intelligent follow-up. Results The symptom experience of the experimental group was improved compared with that before intervention；the quality of life and self-management behavior were improved；compared with the control group，the differences were statistically significant（P<0.05）. Conclusion The application of multi-module rehabilitation nursing model in intelligent follow-up of stroke patients can reduce or alleviate the symptom experience of stroke patients，and effectively improve their quality of life and self-management behavior.

Effects of repetitive transcranial magnetic stimulation combined with cognitive training in patients with apathy after ischemic stroke

TAN Shaoying, LIN Xiaoli, LIU Zan, WANG Danxin, WU Yao, WANG Tao

2023, 58(3):  282-288.  DOI: 10.3761/j.issn.0254-1769.2023.03.004

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Objective To explore the effects of repetitive transcranial magnetic stimulation（rTMS） combined with cognitive training on apathy symptoms in patients with apathy after ischemic stroke. Methods From January to December 2021，96 patients with ischemic stroke complicated with apathy in a tertiary A Hospital in Haikou City were randomly divided into a control group （n=24），r group （n=24），s group （n=24） and a combined group （n=24）. Using 2×2 factorial experimental design，the control group was given routine treatment，rehabilitation and nursing care. On the basis of interventions in the control group，the r group was treated with rTMS，and the s group was treated with card Stroop paradigm cognitive training，and the combined group was treated with rTMS combined with card Stroop paradigm cognitive training. The intervention cycle was 15 days. The apathy evaluation scale-informant（AES-I） was used to evaluate the improvement of apathy level. Results （1）87 patients completed the intervention，and there was no significant difference in baseline balance among the 4 groups（P>0.05）. （2）rTMS had a main effect on reducing the total score of AES-I and each dimension（P<0.001）. Card-based Stroop paradigm cognitive training had a main effect on reducing the total score of AES-I and the dimensions of interest，cognition and behavior（P<0.05）. Combined application had no interactive effect on improving apathy AES-I and all dimensions（P>0.05）.（3）The improvement of the total score of AES-I in the intervention groups were more effective than that in the control group（P<0.05），and the improvement effect was from large to small in the combined group，r group and s group，and the effect of the combined group was best in interest，cognition and behavior（P<0.05）. Conclusion rTMS combined with cognitive training or single training can reduce the level of apathy in PSA patients. The effect of combined application was most obvious，but there was no interaction between rTMS and cognitive training. The effect of combined application may only be the superposition of the effect of a single measure.

Analysis of status and influencing factors of recurrence risk perception in first-episode ischemic stroke patients

TANG Baoli, LÜ Yuhua, WANG Xianni, XU Ping, CAO Jing, XIE Ming, WANG Liangliang, CHANG Ting

2023, 58(3):  289-295.  DOI: 10.3761/j.issn.0254-1769.2023.03.005

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Objective To investigate the status of recurrence risk perception in first-episode ischemic stroke patients，and to analyze the influencing factors. Methods Based on the theory of triadic influence，a convenience sampling method was used to select 236 patients with first-episode ischemic stroke who were reexamined in neurology outpatient clinics of 2 tertiary general hospitals in Xi’an and Xianyang，Shaanxi Province from December 2021 to April 2022 as the research subjects. General Information Questionnaire，Recurrence Risk Perception Scale for Patients with Stroke，Health Literacy Scale for Stroke Patients，Patient Communication Pattern Scale and Measure of Stroke Environment were used to investigate the patients. Results The total score of Recurrence Risk Perception Scale for Patients with Stroke in 236 patients with first-episode ischemic stroke was（31.89±7.66） points. Multiple linear regression analysis showed that educational level，time of diagnosis，number of risk factors for ischemic stroke recurrence，family history of ischemic stroke，health literacy，doctor（nurse）-patient communication pattern，and environmental experience were the influencing factors of recurrence risk perception in first-episode ischemic stroke patients（P<0.05）. Conclusion The ability to perceive recurrence risk in first-episode ischemic stroke patients is at a moderately low level. Individualized interventions can be carried out for patients with different characteristics to promote the patients’ ability to perceive recurrence risk and the formation of preventive behaviors.

Effects of virtual reality-based language training for people with post-stroke aphasia：a meta-analysis

ZHANG Yuanxing, HE Lei, JIN Qiansheng, HU Yufan, JI Cuiling, CHEN Lu

2023, 58(3):  296-303.  DOI: 10.3761/j.issn.0254-1769.2023.03.006

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Objective To evaluate the effect of virtual reality（VR） technology on the rehabilitation of language function in patients with post-stroke aphasia（PSA） and to compare the effect differences between this method and conventional measures，in order to provide evidence for a more standardized and effective clinical application of VR technology. Methods 9 electronic databases，such as PubMed，CINAHL etc.，and clinical trials registry platforms were searched for randomized controlled trials about VR-based language training for PSA from inception until March 2022. There were 2 researchers who independently screened the literature，evaluated the quality and extracted information. Meta-analysis was implemented with Review Manager 5.4 software. Grades of recommendations assessment，development and evaluation（GRADE） were used for evidence quality rating. Results 9 studies involving 311 patients were included. Meta-analysis showed as following.（1）VR-based language training could increase spontaneous speech[SMD=0.88，95%CI（0.57，1.20），P<0.001]，naming[SMD=0.60，95%CI（0.30，0.90），P=0.001]，listening comprehension[SMD=0.81，95%CI（0.40，1.22），P=0.001]，retelling [SMD=0.55，95%CI（0.30，0.80），P<0.001] and the effectiveness of treatment[RR=1.43，95%CI（1.06，1.95），P=0.020] of PSA patients. （2）The effect of VR-based language training on aphasia severity is unclear[SMD=0.70，95%CI（0.01，1.39），P=0.050]. Conclusion The VR-based language training can provide positive influences on language function in patients with PSA，with significant improvement effects on spontaneous speech，naming，listening comprehension，and retelling. VR-based language training can improve the effectiveness of treatment，but the intervention effect on aphasia severity is unclear. Due to limited quantity and heterogeneity of the results，high quality randomized controlled trials are still needed to further verify the effect of VR-based language training on language function in patients with PSA.

Ecological momentary assessment in stroke patients：a scoping review

SANG Yuhuan, YAN Zhongting, YUAN Yuan, GAO Yunfei, JU Mei

2023, 58(3):  304-310.  DOI: 10.3761/j.issn.0254-1769.2023.03.007

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Objective To provide an overview of the available studies that applied ecological momentary assessment（EMA） among patients with stroke，so as to provide references for future related research and application. Methods This scoping review was conducted under the Joanna Briggs Institute guidelines. A literature search was performed in the Web of Science，PubMed，CINAHL，Embase，Cochrane Library，PsycINFO，CBM，CNKI，and Wanfang from inception to May 2022. The included studies were summarized and analyzed. Results 14 papers were included，summarized and analyzed from 4 aspects，including study design characteristics （study aim，sample characteristics，outcome indicators），data collection methods（application methods，input format，schedule characteristics and data sampling method），response-related results（participation rate，response rate，turnover rate，incentives） and main findings. Conclusion The application of EMA in stroke patients is feasible and valid，contributing to assessing symptoms，behavior，and emotional responses in the natural environment，and exploring post-stroke symptom experience and management. In the future，EMA should continue to develop in a scientific，replicable and sustainable manner，exerting its great potential in promoting individualized rehabilitation interventions for stroke patients.

Specialist Practice and Research

Effect of prone ventilation in children with acute lung injury after congenital heart disease surgery

XU Yulu, GU Ying, ZHU Mengxin, REN Yuehong, CHEN Yan, GONG Weijuan, WANG Huimei, MI Yaping, JIA Bing

2023, 58(3):  311-317.  DOI: 10.3761/j.issn.0254-1769.2023.03.008

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Objective To investigate the feasibility and effectiveness of the prone position ventilation technique for the pulmonary protection strategies of pulmonary injury in children with congenital heart disease（CHD） received cardiac surgery. Methods 68 children hospitalized in the CICU of Children’s Hospital of Fudan University from April 2020 to December 2021 were selected as the study participants by convenience sampling. A block randomization method was employed to assign these children into a study group and a control group. The study group received routine nursing care and prone position ventilation for 8 h，while the control group only received routine nursing care after CHD surgery. The respiratory mechanic indexes“percutaneous oxygen saturation（SpO₂），oxygenation index （OI），dynamic pulmonary compliance” and hemodynamic indexes“HR，SBP，DBP and blood lactic acid” at 4 h，8 h and 16 h were compared between 2 groups；mechanical ventilation duration and CICU duration were compared；unplanned extubation，insufficient wound healing，pressure-related injury，Braden Q pressure-related injury risk score，surgical incision classification and healing grade between 2 groups were also be compared after mechanical ventilation was finished. Results None of a case dropped out. There were interactive effects on groups and times for respiratory mechanic indicators and blood lactic acid（P<0.05）. Simple effect analysis results showed that the SpO₂，dynamic pulmonary compliance and OI in the study group were higher than those in the control group at 4 h，8 h and 16 h，and the differences have statistical significance（P<0.001）. Blood lactic acid in the study group were lower than it in the control group，and the difference have statistical differences（P<0.05）. The mechanical ventilation duration and ICU days in the study group were lower than it in the control group，and the differences have statistical significance（P<0.05）. No pressure-related injury，unplanned intubation and insufficient wound healing occurred during the process. The Braden Q pressure-related injury score have no statistical difference between 2 groups（P=0.907）. All the surgical incision sites were type I incision and class A healing. Conclusion Prone position ventilation is a suitable ventilation strategy for clinical application in CHD children who received cardiac surgery with a postoperative acute pulmonary injury. It was beneficial to improve the respiratory and circulation function of patients with good safety and feasibility.

Development of a risk prediction model for intraoperative abnormal blood glucose in elderly patients without diabetes

WANG Lin, WANG Ran, LIU Ting, CAO Peng, ZHAO Lei

2023, 58(3):  318-324.  DOI: 10.3761/j.issn.0254-1769.2023.03.009

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To analysis the risk factors of intraoperative blood glucose abnormalities（dysglycemia） in elderly patients without diabetes，and to develop a nomogram risk prediction model. Methods Convenience sampling was conducted in elderly patients aged ≥ 65 years without diabetes who received surgical treatment. Univariate analysis and binary logistic regression analysis were used to determine the risk factors of intraoperative blood glucose abnormalities，establish a risk prediction model and draw a nomogram. Receiver Operating Characteristic（ROC） and Hosmer-Lemeshow tests were used to verify the predictive effect of the model，and Bootstrap method was used for internal validation. Results The logistic regression analysis showed that type of anesthesia，duration of surgery，baseline operating room blood glucose level，and age were independent predictors of intraoperative dysglycemia. The predictive formula for intraoperative dysglycemia was established as follows：Logit P=-12.810+0.066 × age +1.966 × baseline operating room blood glucose level +0.008 × duration of surgery -2.778 × type of anesthesia. The area under the ROC curve was 0.815，and the optimal critical value boundary was 0.765. The sensitivity and specificity were 83.00% and 67.00%，respectively. The result of Hosmer-Lemeshow test was χ²=5.557（P=0.697）. The prediction curve fit well with the ideal curve，suggesting that the model has good predictive ability. External validation showed that the sensitivity of the model was 77.01%，the specificity was 75.36%，and the overall accuracy was 76.56%. Conclusion The prediction model constructed in this study has a good effect，which can provide a reference for clinical evaluation of the risk of abnormal blood glucose in elderly patients without diabetes.

Nursing Management

Establishment of a comprehensive evaluation indicator system for outpatient specialized nursing studios

LUO Jinkai, GONG Wentao, DONG Sixin, XIE Changqing

2023, 58(3):  325-333.  DOI: 10.3761/j.issn.0254-1769.2023.03.010

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Objective To develop a comprehensive quality evaluation indicator system for outpatient specialized nursing studios，and to provide a professional quantitative reference for the operation and evaluation of outpatient specialist nursing studios. Methods Based on the framework of the three-dimensional “structure-process-outcome” quality model，this study was carried out from May 2021 to February 2022. Cross-sectional survey，literature review，Delphi method and analytic hierarchy process（AHP） were used to determine the content of the system，and the weight of each index. Results 2 rounds of professional consultations resulted in an excellent recovery rate of 100%；the expert authority coefficients were 0.938 and 0.947，respectively；the variation coefficients of each item ranged from 0.05 to 0.29 and from 0.02 to 0.23. The Kendall harmony coefficients were 0.216 and 0.210. As a result，we developed a thorough assessment indicator system for outpatient specialized nursing studios which comprised 3 first-level indicators，13 second-level indicators，29 third-level indicators and 87 evaluation rules. Conclusion The comprehensive evaluation indicator system for outpatient specialized nursing studios was scientific and practical，which has important implications for the long-term operation and high-quality development.

Evidence Synthesis Research

The effect of early oral feeding in patients with acute non-variceal upper gastrointestinal bleeding：a systematic review and Meta-analysis

ZHU Rui, WANG Zhuzhu, ZHANG Qiaoxian, ZHUANG Jiayuan

2023, 58(3):  334-341.  DOI: 10.3761/j.issn.0254-1769.2023.03.011

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Objective The purpose of this meta-analysis was to systematically evaluate the safety and effectiveness of early oral feeding（received oral diet from day 1 after hemostasis） on patients with acute non-variceal upper gastrointestinal bleeding（ANVUGIB），and provide evidence references for clinical practice. Methods 8 electronic databases including SinoMed，China National Knowledge Infrastructure（CNKI），Wanfang data，VIP data，PubMed，the Cochrane Library，CINAHL，and Embase were searched for English and Chinese articles published on or before September，2022. There were 2 reviewers who retrieved articles，evaluated quality and extracted data independently. Review manager（RevMan） version 5.4 and Stata version 13.0 were then used to perform Meta-analysis. Results 4 RCTs and 1 cohort study with 803 cases of ANUGUIB were enrolled. Early oral feeding did not increase the rate of re-bleeding[RR=0.87，95%CI（0.47，1.64），P=0.670] or mortality[RR=0.46，95%CI（0.19，1.08），P=0.080]；while the length of hospital stay was shortened[MD=-2.40，95%CI（-2.43，-0.12），P=0.030]. However，the hospitalization costs[SMD=-1.50，95%CI（-3.03，0.03），P=0.050] in the early oral feeding group were not signifi-cantly different from those in the conventional feeding group. Conclusion The existing evidence shows that early oral feeding in patients with ANVUGIB does not increase the risk of poor prognosis and mortality，but also it can shorten the length of hospital stay，with no significant effect on reducing the hospital costs of patients. The included studies are few；the sample size is small；the specific implementation of early oral feeding is different. Therefore，high-quality，large-sample，multicenter original studies are still needed to further verify the application effect of early oral feeding.

Risk factors of subjective cognitive decline of the elder adults in communities：a Meta-analysis

ZHANG Xian, MA Qiuping, CAO Ruru, HUANG Xiudan, MING Zhouyan, LIU Yujun

2023, 58(3):  342-348.  DOI: 10.3761/j.issn.0254-1769.2023.03.012

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Objective To clarify the risk factors of subjective cognitive decline of the elder adults in communities by Meta-analysis. Methods The cohort studies and case-control studies on the risk factors of subjective cognitive decline of the elder adults in communities were searched by computer in CNKI，VIP，WanFang data，CBM，PubMed，Cochrane Library，EMbase，CINAHL，PsycInfo，and Web of Science. The search time was from the inception of databases until September 2022. After literature screening，data extraction，and quality evaluation，RevMan 5.4 software was used for Meta-analysis. Results A total of 20 articles were involved，including 28 risk factors. The risk factors with statistical significance were female（OR=1.66），advanced age（OR=1.05），low education （OR=1.08），lack of physical exercise（OR=1.32），depression（OR=1.20），and poor sleep quality（OR=1.91），hearing loss（OR=2.01），hypertension（OR=1.79） and low level of social support（OR=1.51）. Conclusion The elderly in communities who are female with advanced age，low education，lack of physical exercise，depression，poor sleep quality，hearing loss，hypertension and low level of social support are more likely to have subjective cognitive decline. Nurses can formulate nursing measures according to the risk factors to reduce the incidence of subjective cognitive decline of the elder adults in communities.

Evidence summary for non-pharmacological interventions of breast cancer-related lymphedema

LI Jiaqian, QIANG Wanmin, WEI Tingting, ZHU Mingyu, LI Miaomiao, SHEN Aomei, WU Peipei, WANG Ying

2023, 58(3):  349-356.  DOI: 10.3761/j.issn.0254-1769.2023.03.013

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Objective To integrate the best evidence of non-pharmacological interventions for breast cancer-related lymphedema with evidence-based methods，and to provide evidence-based bases for standardized evaluation and management of lymphedema for clinical medical staff. Methods The best evidence about the prevention and management of lymphedema in breast cancer patients were searched systematically，such as relevant guidelines，expert consensuses，systematic reviews and so on. The retrieval period was from January 2016 to January 2022. Results A total of 25 pieces of the literature were included，including 6 guidelines，4 expert consensuses and 15 systematic evaluations，and 33 pieces of best evidences were integrated from 2 aspects，namely the preventive intervention and therapeutic intervention. Conclusion The summarized evidence can be used for the prevention and treatment of breast cancer lymphedema，and medical staff should provide specific health guidance for patients with lymphedema based on cultural background，clinical situation，and patients’ opinions.

Meta integration of qualitative research on home care needs of patients with enterostomy

HU Jiaojiao, WANG Jianning, ZHAN Mengmei, HUANG Qiuxia, GONG Cuiying, LIANG Hui

2023, 58(3):  357-365.  DOI: 10.3761/j.issn.0254-1769.2023.03.014

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Objective To integrate the qualitative research on the home care needs of enterostomy patients，so as to provide references for formulating the demand-oriented health management plan and intervention strategies of enterostomy patients. Methods The computer was employed to search PubMed，Embase，Web of Science，Cochrane Library，EBSCO，CINAHL，CNKI，Wanfang database，VIP database and China biomedical literature database for the qualitative research on the home care needs of enterostomy patients. The retrieval time limit is from the establishment of the databases to March 2022. The “quality evaluation standard for qualitative research of evidence-based health care center of Joanna Briggs Institute in Australia（2016）” was used to evaluate the literature quality，and the Meta integration method was used to integrate the results. Results A total of 18 studies were included；66 research results were extracted；11 new categories were summarized；4 results were finally integrated，including breaking the state of daily life and longing for healthy life guidance；suffering from a variety of psychological stress，accompanied by physical and mental health damage，strong emotional and social support needs；facing the dilemma of stoma self-management，and it is urgent to obtain information and professional support through a variety of convenient channels；self adjustment，role change and life remodeling. Conclusion There are various forms of home care needs for stoma patients. Medical staff should pay attention to the physical and mental health of stoma patients，explore the challenges and obstacles encountered in the process of home care，constantly seek the best solutions，and provide emotional，social and other support for them，so as to promote the patients’ self-management ability and ultimately improve the overall quality of life.

Review

Indicators to evaluate nursing staff allocation：a scoping review

DU Meichen, WANG Hui, LIU Yu, ZENG Tieying, WANG Ying, LI Miqi, WANG Ying

2023, 58(3):  366-373.  DOI: 10.3761/j.issn.0254-1769.2023.03.015

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Objective The scope of the literature related to nursing staff allocation was reviewed，so as to clarify the evaluation categories，connotations，applicable scenarios，application effects，evaluation tools，and contents of nursing staff allocation，as well as the differences between domestic and overseas evaluation indicators. Methods Guided by the methodological framework of the scope review，we systematically searched domestic and foreign databases and guideline libraries such as CNKI，Wanfang，PubMed，CINAHL，Web of Science，and International Guideline Collaboration Network. The search period was from February 14，2012 to February 14，2022. The included studies were summarized and analyzed. Results 371 papers were included. The indicators appeared 632 times in total，including 338 patient-related indicators，181 nurse-related indicators and 113 organization-related indicators. The top 10 indicators of occurrence frequency were equity，mortality，job satisfaction，quality of care and patient safety evaluation，patient satisfaction，hospital stay，infection，pressure injury，falls and bed fall，and the lack of nursing care. Foreign countries pay more attention to indicators such as infection，mortality，length of stay，readmission rate，and the lack of nursing care，while more emphasis were on fairness and satisfaction in our country. Conclusion At present，the construction of indicators underlying nursing staff allocation needs to be improved. It is necessary to standardize the names，connotations，evaluation methods and weights of indicators，and to build a set of indicator systems with strong guidance and high sensitivity.

Overseas Knowledge

Sinicization of the Cancer Peer Support Scale and the test of its reliability and validity

LI Lijun, DUAN Yinglong, LIU Xiangyu, CHENG Qinqin, XIE Jianfei, Andy SK Cheng

2023, 58(3):  374-379.  DOI: 10.3761/j.issn.0254-1769.2023.03.016

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Objective To sinicize the Cancer Peer Support Scale and evaluate its validity and reliability among adolescent and young adult（AYA） cancer patients. Methods The Chinese version of the Cancer Peer Support Scale was developed by forward translation，back translation，cultural adjustment and pre-survey. From March 2021 to June 2021，128 AYA cancer patients in 2 tertiary hospitals in Changsha were selected for a questionnaire survey to analyze the reliability and validity of the scale. A questionnaire survey of 241 patients recruited from 2 tertiary hospitals in Changsha，and was selected for validated factor analysis from July 2021 to March 2022. Results The Chinese version of the Cancer Peer Support Scale included 3 dimensions and 11 entries. The content validity at the scale level was 0.948，and the content validity at the entry level ranged from 0.714 to 1.000. The exploratory factor analysis extracted 3 common factors with factor loadings of 0.535~0.872 for each entry，and the cumulative variance contribution rate was 69.64%，and the equations were well fitted. The Cronbach’s alpha coefficient for this scale was 0.923，and the fold-half reliability was 0.860. The results of the validation factor analysis showed a good model fit. Conclusion The Chinese version of Cancer Peer Support Scale has good reliability and validity，and it is suitable for assessing the level of peer support of AYA cancer patients.

Introduction of self-supporting care in Japan and its enlightenment to the nursing care of disabled elderly in China

WANG Erjiao, BAI Xi, XIAO Shuqin, LIU Congcong, LIU Xue

2023, 58(3):  380-384.  DOI: 10.3761/j.issn.0254-1769.2023.03.017

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With the deepening of China’s aging society，the number of disabled elderly people is increasing，and the burden on family and social care for the elderly is also increasing. The self-supporting care model derived from Japanese can improve the ability of disabled elderly people to take care of themselves，improve their quality of life，reduce the use of care service resources，and relieve the pressure of the elderly in society. This paper presents an overview of self-supporting care，implementation methods and training，and evaluation of its effectiveness，and then proposes implications for the care of disabled elderly in China to provide a reference for the care of disabled elderly in China.