Table of Content

20 May 2023, Volume 58 Issue 10

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Research Paper

Construction and application of a prevention programme for central venous catheter-related thrombosis in critically ill children

ZHAO Xiaoshuang, ZHANG Dan, GUAN Ruixin, ZHANG Baorong, SUN Hairui, WU Hanshu, XING Weijie

2023, 58(10):  1157-1165.  DOI: 10.3761/j.issn.0254-1769.2023.10.001

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Objective To construct a prevention programme of central venous catheter-related thrombosis （CRT） in critically ill children，and to evaluate its clinical effects. Methods Based on the theory of “structure-process-result” quality evaluation model，literature research and evidence summary，2 rounds of expert consultations were conducted to construct a CRT prevention programme for critically ill children from August to September 2021. The critically ill children who received central venous catheterization in the pediatric intensive care unit（PICU） of a tertiary hospital in Jilin Province from January to March 2022 were selected as an experimental group by convenience sampling，those who received central venous catheterization from October to December 2021 as a control group. The experimental group was given the CRT prevention programme，while the control group was given routine precautions. The implementation rate of precautions，incidence of CRT，incidence of adverse events and hospitalization time in PICU were compared between 2 groups. Results The effective recovery rates of 2 rounds of expert consultations were 100%，and the authority coefficient were 0.85，0.90. In the second round，the coefficient of variation of importance score of each item was 0-0.144，and the Kendall’s harmony coefficient was 0.359（P<0.001）；the coefficient of variation of the feasibility score was 0-0.141，and the Kendall’s harmony coefficient was 0.513（P<0.001）. Finally，the CRT prevention programme for critically ill children included 3 first-level items，10 second-level items and 24 third-level items. The application results showed that the utilization rate of deep venous thrombosis risk assessment tool，timing of risk assessment，rate of jugular vein catheterization and the compliance rate of drug prevention in the experimental group were higher than those in the control group，and the incidence of CRT and hospitalization time in PICU were lower than those in the control group（P<0.05）. Conclusion The CRT prevention programme constructed in this study is scientific and practical. The implemented the programme can improve the implementation rate of precautions，decrease the incidence of CRT in critically ill children and shorten the hospitalization time.

Special Planning——Diabetes Care

Design and application of an insulin pump whole process management system led by advanced practice nurses for diabetes mellitus

YAO Huilan, YUAN Hongdi, HUANG Chen, CHENG Lili, WU Lili, PAN Hongying, SHI Wenli

2023, 58(10):  1166-1171.  DOI: 10.3761/j.issn.0254-1769.2023.10.002

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Objective To design an insulin pump whole process management system led by advanced practice nurses（APN） for diabetes，and to explore its application effect. Methods A research group was established and a whole-process insulin pump management system was designed，including the functions of receiving nursing consultation，installation records，daily pump inspection records，pump withdrawal，quality monitoring of documents related to the responsible nurse pump，closed-loop management of insulin pumps，and quality control，and the differences of nursing document quality statistics. Specialty nursing quality indicators（number of adverse events reported to insulin pump and number of hypoglycemia events） and nursing document quality of patients treated with insulin pump in non-endocrinology department were compared before（June to December 2020） and after （June to December 2021） application of the system. In January 2022，a self-designed satisfaction questionnaire was used to investigate 154 nurses’ satisfaction with the system. Results After the application of insulin pump whole process management system，the number of hypoglycemia events decreased（P=0.039）. The quality of nursing documents was significantly better than that before the system application（P<0.001）. The nurse scored 40（36，45） quartile in their satisfaction with the system，with a total score of 45，which was generally satisfactory. Conclusion The insulin pump whole process management system led by diabetes APN can improve the quality of nursing and the safety management of clinical nurses，and improve the satisfaction of nurses，improve the quality of nursing documents.

Application of the optimized scheme of continuous intravenous insulin infusion with micro-pump

TIAN Fengmei, TAN Liping, LU Yaqiong, HUANG Hui, ZHAO Lishuang

2023, 58(10):  1172-1177.  DOI: 10.3761/j.issn.0254-1769.2023.10.003

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Objective To optimize the scheme of continuous intravenous insulin infusion with micro-pump based on Portland protocol，to improve blood glucose level in patients with acute myocardial infarction complicated with type 2 diabetes mellitus after percutaneous coronary intervention. Methods 122 patients with acute myocardial infarction complicated with type 2 diabetes undergoing percutaneous coronary intervention were randomly divided into a control group and an experimental group from March 2021 to February 2022. The patients of the control group received measures according to Portland protocol，and patients of the experimental group received the optimized scheme based on Portland protocol. The mean blood glucose，standard deviation of blood glucose，mean amplitude of glycemic excursion，postprandial glucose excursion and time in ranges were used to evaluate effectiveness of the scheme during hospitalization. Results The average blood glucose，standard deviation of blood glucose，mean amplitude of glycemic excursion and time in ranges in the experimental group were lower than those in the control group，and the differences were statistically significant（P<0.05）. The postprandial glucose excursion in the 2 groups was not statistically significant（P=0.154）. Conclusion The optimized scheme can improve blood glucose in patients with acute myocardial infarction complicated with type 2 diabetes after percutaneous coronary intervention，and significantly increase time in range.

Investigation and research of the gap between clinical practice and guidelines of nurse knowledge, attitude and practice on insulin injection

CUI Peirong, ZHOU Yingxia, ZHANG Mingxia, ZHAO Fang, YUAN Li, XIAO Lingfeng, XING Qiuling, WANG Qun, MO Yongzhen

2023, 58(10):  1178-1184.  DOI: 10.3761/j.issn.0254-1769.2023.10.004

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Objective To investigate and analyze the gap between the current clinical practice and guidelines of insulin injection knowledge，attitude and practice，and to provide a basis for further construction of an intervention program for insulin injection knowledge，attitude and practice that conform to the actual situation in China. Methods The stratified random convenience sampling method was used to investigate 5550 nurses from 3 primary，7 secondary and 11 tertiary hospitals from July 28 to August 30，2019，using the general information questionnaire and the questionnaire of nurses’ knowledge，attitude and practice on insulin injection.SPSS26.0 was used for independent sample T test，variance analysis and correlation analysis on the influencing factors of knowledge，attitude and practice，and Mplus8.3 was used to analyze the path of influencing factors of knowledge，attitude and practice. Results The scores of nurse knowledge, attitude and practice on insulin injection were 68.17±15.76，87.22±13.34 and 93.74±7.97，respectively. There was a positive correlation between nurses’ insulin injection knowledge and attitude，knowledge and practice，attitude and practice scores（r=0.321，0.298，0.561，P<0.001）. Gender and professional title were the main influencing factors of nurses’ insulin injection knowledge scores. Knowledge，hospital level，number of beds，professional title，department，and the last time you engaged in insulin injection were the main influencing factors of nurses’ attitude score of insulin injection. Hospital level，education，knowledge and belief were the main influencing factors of nurses’ insulin injection practice score. Attitude played a partially mediating role in knowledge and nurses’ insulin injection practice. The total effect value was 0.299；the indirect effect was 0.163；the intermediary effect accounted for 54.5% of the total effect value. Conclusion There is still a big gap between clinical practice and guidelines of nurse knowledge，attitude and practice on insulin injection. Nursing managers should strengthen the evaluation of hospital nurses’ knowledge，attitude and practice of insulin injection，and take intervention measures according to the characteristics and influencing factors of nurses’ knowledge，attitude and practice of insulin injection to improve their knowledge，attitude and practice.

Construction of a health education program for diabetic retinopathy patients based on protection motivation theory

WANG Zhihui, HAO Shuai, BAI Xiaowen, WANG Mengdi, LIU Chang, REN Yongxia

2023, 58(10):  1185-1191.  DOI: 10.3761/j.issn.0254-1769.2023.10.005

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Objective To construct a health education program for diabetic retinopathy patients based on the theory of protection motivation，and to provide references for the development of health education for diabetic retinopathy patients. Methods Through literature research，theoretical analysis，group discussion and clinical investigation，the health education program of diabetic retinopathy patients was constructed. By Delphi expert consultation method，20 influential senior clinical experts in the field of eye care and diabetic retinopathy were selected as correspondence consultation experts from August to October 2022. 2 rounds of Delphi expert consultation were conducted to preliminatively determine each item of the score table，and the weights and values of each index were determined through the analytic hierarchy process. Finally，the health education program for diabetic retinopathy patients was established. Results The expert authority coefficient of the 2 rounds of consultation was 0.89，and the positive coefficient was 100%. The coefficients of variation were 0.094~0.564 and 0.063~0.186，and the Kendall harmony coefficients were 0.246 and 0.293. Finally，a health education program for patients with diabetic retinopathy was formed，including 2 primary items，7 secondary items and 30 tertiary items. The results of hierarchical analysis show that the CR values of each matrix of the three-level entries are all less than 0.1，which meets the requirements of consistency test. Conclusion The established health education program of diabetic retinopathy patients is highly scientific and targeted，which can provide references for the application.

Design of combined exercises in patients with type 2 diabetes mellitus in intervention studies：a scoping review

WANG Hui, CHENG Kangyao, ZHU Peimin, LÜ Weibo, WANG Yan, LIU Yingping, YANG Yuanling, MA Rui

2023, 58(10):  1192-1198.  DOI: 10.3761/j.issn.0254-1769.2023.10.006

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Objective To explore the different application types of combined exercises in patients with type 2 diabetes，and to clarify the characteristics of different combined exercises. Methods Guided by the scoping review framework proposed by Arksey et al.，a literature search was performed in the Chinese and English literature Databases. The retrieval period was from the establishment of the database to February 26，2022，and relevant information such as research subjects，sample size and monitoring indicators of the included literature was extracted. Results A total of 18 articles were included. Combined exercises can be divided into different combined types by exercise types（same，different），intensity（high intensity intermittent，moderate-intensity continuous，mixed intensity and different intensities of resistance） and sequence（dual-task，interactive and sequential）. When applied to patients with type 2 diabetes mellitus，combined exercises not only present a single aspect of characteristics，but also intersect with each other. Conclusion The 3 combined exercises have a significant impact in terms of increasing exercise variety，adjusting exercise rhythms and enhancing exercise effects. However，there are still limitations in exercise selection and effect evaluation. Therefore，there is still a need to further explore how to develop normative operational standards，intelligently recommend personalised programmes and identify suitable populations in combined exercises.

Specialist Practice and Research

Construction of a safe and comfortable nursing plan for patients with prone position ventilation

LIU Feiyue, DENG Degui, ZHANG Xinyin, YANG Ye, SONG Yuying, YAO Huiping

2023, 58(10):  1199-1204.  DOI: 10.3761/j.issn.0254-1769.2023.10.007

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Objective To construct a safe and comfortable nursing plan for patients with prone position ventilation to provide guidance for prone position nursing practice. Methods After the review of the relevant literature and the summary of the existing research evidence，a safety and comfortable nursing plan for prone ventilation patients was preliminarily established. 2 rounds of Delphi expert inquiry were adopted，and the program items were modified according to the expert opinions. Results A total of 14 articles were included in the literature review. In the first round，17 experts were consulted，and the effective recovery rate was 94.12%. In the second round，16 experts were consulted，and the effective recovery rate was 93.75%. The 2 rounds of expert authority coefficients were 0.91 and 0.92；the Kendall harmony coefficients were 0.294（P<0.001） and 0.199（P<0.001）；the coefficient of variation of each item was 0 to 0.17；the mean value of importance assignment was 4.40 to 5.00 points. Finally，a safe and comfortable nursing plan for patients with prone ventilation was formed，including 3 first-level indicators，11 second-level indicators and 40 third-level indicators. Conclusion The safe and comfortable nursing plan for patients with prone position ventilation constructed in this study is scientific，feasible and of strong clinical practical value，and can provide guidance for clinical nursing practice.

The status and influencing factors of kinesiophobia in patients undergoing coronary artery bypass grafting

ZHANG Jing, DING Jianling, ZHANG Jiashuai, TAO Xiuxiu, BEN Yanli

2023, 58(10):  1205-1211.  DOI: 10.3761/j.issn.0254-1769.2023.10.008

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Objective To investigate the level of kinesiophobia in patients undergoing coronary artery bypass grafting（CABG） and analyze the influencing factors，so as to provide references for rehabilitation exercise intervention in patients with CABG. Methods A convenient sampling method was used to select 249 patients with CABG hospitalized in 3 tertiary hospitals in Urumqi，Xinjiang from January 2022 to August 2022. A month after the CABG，the general information questionnaire，the Tampa Scale for Kinesiophobia Heart（TSK-SV Heart），Multidimensional Fatigue Symptom Inventory-Short Form（MFSI-SF-C） and Exercise Self-Efficacy Scale（PSE） were conducted for investigation. Latent class analysis（LCA） was used to explore the potential categories of kinesiophobia among patients with CABG. Single factor analysis and logistic regression analysis were used to identify the factors associated with the potential categories of kinesiophobia. Results A total of 249 patients were included. Based on the analysis of potential categories，the kinesiophobia of patients with CABG was divided into 2 potential categories，namely high fear-kinesiophobia group（59.4%） and low fear-exercise avoidance group（40.6%）. The results of logistic regression analysis showed that gender，body mass index（BMI），MFSI-SF-C score and PSE score were important factors of the potential categories of kinesiophobia in CABG patients. Conclusion The kinesiophobia of patients with CABG can be divided into 2 latent classes. Patients with the gender of female，body mass index≥24.0，a high MFSI-SF-C score and a low PSE score were more likely to be classified into the high fear-kinesiophobia group. Healthcare providers should identify the characteristics and influencing factors of different latent classes of CABG patients，and carry out individualized intervention strategies，in order to reduce the kinesiophobia.

Latent profile analysis and nursing decision-making of psychological resilience among patients with inflam-matory bowel disease

XU Guangyi, LIU Ting, XU Yanhong, JIANG Yunxia

2023, 58(10):  1212-1218.  DOI: 10.3761/j.issn.0254-1769.2023.10.009

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Objective To explore the characteristics of latent profiles of psychological resilience among patients with inflammatory bowel disease，and to analyze the differences of the latent profiles of psychological resilience in sociodemographic information as well as the impacts of the profiles on patients’ psychosocial adaptability，and to propose nursing decisions. Methods From June to October 2022，a total of 230 outpatients with inflammatory bowel disease in a tertiary hospital in Shandong Province were selected as the survey subjects by cross-sectional survey method. The General Information Questionnaire，Resilience Scale for Inflammatory Bowel Disease and Psychosocial Adaptation Questionnaire for Inflammatory Bowel Disease were used for investigation. The latent profile analysis was conducted with the 6 dimensions of psychological resilience in patients with inflammatory bowel disease as the explicit indicators. Univariate analysis was used to explore the differences in potential profiles of psychological resilience，and regression mixture model was used to analyze the impacts of different profiles on psychosocial adaptation of patients. Results 222 valid questionnaires were collected，with the effective recovery rate of 96.5%. The status of psychological resilience of 222 patients with inflammatory bowel disease was divided into 3 profiles，including low resilience and low efficiency in active coping with difficulties group（9.00%），moderate resilience and moderate efficiency in active coping with difficulties group（41.90%），and high resilience and high efficiency in active coping with difficulties group（49.10%）. Housing arrangement was the influencing factor of the 3 profiles. The high resilience and high efficiency in active coping with difficulties group had the highest total score of psychosocial adaptation. Conclusion The psychological resilience of patients with inflammatory bowel disease was significantly heterogeneous，and there were significant differences in psychosocial adaptation among the profiles. Nursing personnel should formulate personalized intervention strategies based on the classification characteristics of psychological resilience of inflammatory bowel disease patients to improve their psychosocial adaptation.

Trajectory of oral sucking function of premature infants

LÜ Tianchan, Akhbarzadeh Saeed, HU Xiaojing, ZHANG Yuxia, LI Liling, CAO Yun, GU Ying

2023, 58(10):  1219-1224.  DOI: 10.3761/j.issn.0254-1769.2023.10.010

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Objective To explore the trajectory of oral sucking function of premature infants with gestational age and its relationship with oral feeding progression. Methods From April 2018 to April 2019，we conveniently selected premature infants from a tertiary children’s hospital in Shanghai，and used a self-developed oral sucking evaluation tool to measure the oral sucking function of premature infants when their corrected gestational age was 32~36 weeks. The measurement parameters included average sucking negative pressure peak，average sucking positive pressure peak，average sucking peak interval of negative pressure，average sucking peak interval of positive pressure，average sucking peak interval of positive pressure to negative pressure，number of sucking negative pressure，number of sucking positive pressure. At the same time，the time for premature infants to start and complete oral feeding was recorded，and the correlation between oral sucking function and corrected gestational age at 32 weeks was analyzed. Results A total of 132 premature infants completed the evaluation of oral sucking function and were finally included. The results showed that with the increase of gestational age，the amplitude and number of positive and negative sucking pressure of premature infants increased significantly（P<0.001），and the interval duration decreased significantly（P<0.001）. At the same time，the positive sucking pressure amplitude at the time of correcting the gestational age of 32w was negatively correlated with the gestational age of starting oral feeding（r=-0.217，P=0.040），and the negative sucking pressure duration at the time of correcting the gestational age of 32w was positively correlated with the gestational age of complete oral feeding（r=0.334，P=0.002）. Conclusion The positive sucking pressure and negative sucking pressure of premature infants showed the same trend with the increase of gestational age. The average sucking peak of negative pressure at 32 weeks of gestational age was negatively correlated with the time to start oral feeding，and the average sucking negative pressure peak interval was positively correlated with full oral feeding. Caregivers should pay attention to the peak of positive sucking pressure at the beginning of oral feeding readiness assessment and its effect on sucking frequency when performing oral motor interventions to promote full oral feeding.

Case Study

Nursing of a patient combined with acute antibody-mediated rejection after kidney transplantation

MA Zhengzheng, NIU Mei’e, QIAN Chunya, WU Lifen, WANG Lili, ZHOU Zheng

2023, 58(10):  1225-1229.  DOI: 10.3761/j.issn.0254-1769.2023.10.011

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To summarize the nursing experience of a patient with recurrent upper gastrointestinal bleeding combined with acute antibody-mediated rejection after kidney transplantation. Nursing points：early identification of upper gastrointestinal bleeding，active prevention of hypovolemic shock；close observation of complications after blood transfusion；prevention of deep vein thrombosis and internal jugular vein thrombosis；providing staged nutritional support to maintain the stability of internal environment；early identification of acute antibody-mediated rejection and initiation of emergency plan；management of plasma exchange；precision nursing of immunosuppressive drugs；the whole process of psychological counseling was given to relieve the negative emotions of patients. After 81 days of active treatment and intensive care，the patient recovered and was discharged from the hospital.

Nursing care of a patient with secondary acquired thrombotic thrombocytopenic purpura after secondary heart valve replacement

HU Yaling, WANG Ziwei, HUANG Lingxiao, SONG Jianping, HUANG Jinying, DONG Shuang

2023, 58(10):  1230-1233.  DOI: 10.3761/j.issn.0254-1769.2023.10.012

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To summarize the clinical nursing experience of a patient with thrombotic thrombocytopenic purpura after secondary heart valve replacement. Nursing key points：dynamic monitoring of hemodynamic indexes，the refinement of fluid management；sequential anticoagulant therapy to reduce bleeding risk；closely monitoring blood calcium concentration to avoid citric acid accumulation reaction；strengthening the breathing training and shortening the mechanical ventilation time；early enteral nutrition support to reduce gastrointestinal stress response. After careful treatment and nursing care，the symptoms and signs of patients improved significantly 26 days after surgery. The respiratory support of patients was changed from invasive ventilator assisted ventilation to venturi mask oxygenation，and he was transferred to the general ward for further treatment.

Nursing of a patient with systemic lupus erythematosus complicated with acute respiratory distress syndrome

SHEN Chen, LI Xuezhu, LI Xiaoqing, MA Rong

2023, 58(10):  1234-1237.  DOI: 10.3761/j.issn.0254-1769.2023.10.013

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To summarize the nursing experience of a patient with systemic lupus erythematosus combined with acute respiratory distress syndrome. The key points of care included：noninvasive mechanical ventilation and transnasal high-flow oxygen therapy combined with prone ventilation to improve hypoxemia，prevention of nosocomial infections in immunodeficient patients，integrated progressive early rehabilitation exercises，psychological intervention to alleviate negative emotions. After 19 days of treatment and care，the patient improved and was transferred to the rheumatology department for continued treatment.

Evidence Synthesis Research

The effects of resistance exercise on health outcomes of older patients with osteoporotic fractures：a Meta-analysis

TANG Yuxuan, LIANG Xiaoqin, YU Mingming

2023, 58(10):  1238-1244.  DOI: 10.3761/j.issn.0254-1769.2023.10.014

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Objective To systematically assess the effects of resistance exercise on different health outcomes of older patients with osteoporotic fractures. Methods Databases，including Pubmed，Embase，Cochrane Library，Web of Science，CINAHL Plus，CNKI，Wanfang，were systematically searched for studies with randomized controlled trial research design from their inception to september 1，2022. Quality assessment of the included articles was performed by RoB2（Version 2 of the Cochrane tool for assessing risk of bias in randomized trial）. The meta-analysis was conducted using the Comprehensive Meta Analysis V3 software. Results 15 studies involving 1055 patients were finally included in this study.Meta analysis showed that resistance exercise could effectively improve muscle strength[SMD=0.746，95%CI（0.152，1.339），P=0.014]，balance ability[SMD=0.439，95%CI（0.086，0.792）. P=0.015] and mobile ability[SMD=0.240，95%CI（0.074，0.407），P=0.005] in older patients with osteoporotic fractures；however，there were no statistically significant differences in the improvement of walking speed[SMD=0.203，95%CI（-0.008，0.415），P=0.059]. Conclusion Resistance exercise can effectively improve pain，muscle strength，balance ability and mobility in older patients with osteoporotic fractures. During the resistance training，nurses should give patients scientific and efficient suggestions on resistance exercise rehabilitation according to the specific physical conditions of patients，and guide them to complete the exercise plan，so as to ensure the safety of patients and improve the physical function of patients.

Best evidence summary for safety management of inter-hospital transport of patients on extracorporeal membrane oxygenation

YU Anqi, DENG Juan, ZHOU Xinyu, YAN Li, HUANG Sufang, ZHANG Meng, WANG Yi, XIONG Jie

2023, 58(10):  1245-1252.  DOI: 10.3761/j.issn.0254-1769.2023.10.015

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Objective To retrieve，evaluate and summarize relevant evidence of safety management of inter-hospital transport in patients on extracorporeal membrane oxygenation（ECMO），so as to provide references for clinical practice. Methods We searched BMJ Best Practice，UpToDate，Joanna Briggs Institute，Guidelines International Network，Agency for Healthcare Research and Quality，Canadian Medical Association CPG Infobase，Cochrane Library，Yimaitong，Extracorporeal Life Support Organization Website，PubMed，Web of Science，CINAHL，Embase，MEDLINE，CNKI，Wanfang database and VIP database on all evidence related to the management of inter-hospital transport in patients on ECMO，including clinical decisions，guidelines，evidence summaries，best practices，expert consensuses，systematic reviews and meta-analysis. The retrieval time limit is from the establishment to September 2022. There were 4 investigators who independently assessed the quality of the literature，and also extracted，integrated and graded the evidence from the included literature. Results Totally 13 articles were included，involving 2 guidelines，8 expert consensuses and 3 systematic reviews. Finally，37 pieces of best evidence were summarized from 4 dimensions，namely team composition，response and preparation，transportation practice，management and quality control. Conclusion This study summarized the best evidence which can provide a basis for the implementation of inter-hospital transport supported by ECMO to promote patient safety during inter-hospital transport.

Summary of the best evidence for non-pharmacological airway clearance techniques in patients with chronic respiratory diseases

ZHENG Jiang, HAN Ruijuan, WANG Yan, ZHANG Hongxia, CHAI Meimei, QI Wanjun, LI Yulan

2023, 58(10):  1253-1260.  DOI: 10.3761/j.issn.0254-1769.2023.10.016

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Objective To summarize the best evidence for non-pharmacological airway clearance techniques in patients with chronic respiratory diseases. Methods We searched domestic and international databases，guideline networks，clinical decision support systems and websites of respiratory professional associations. The types of the literature include guidelines，expert-consensuses，clinical decision-making，recommended practices and systematic re-views. The retrieval time is from the establishment of the databases to May 2022. There were 2 investigators who evaluated the quality of the literature and pooled evidence. Results A total of 16 publications were included，in-volving 6 guidelines，6 expert consensus articles，1 recommended practice，and 3 systematic reviews. A summary of the best evidence for the overall requirements of 20 airway clearance techniques in 6 areas，namely pre-treatment assessment，interventions，precautions，frequency and duration，assessment of efficacy and health education. 8 com-monly used airway clearance techniques were also summarized，with 32 pieces of evidence for the principles of use，including effective cough or huffing，maneuver-assisted cough，active cycle of breathing techniques，autogenous drainage，manual techniques，postural drainage，high-frequency chest wall oscillatory，and positive expiratory pressure or oscillating positive expiratory pressure. Conclusion In the clinical application of non-pharmacological airway clearance techniques，medical staff should carefully formulate airway clearance techniques plan according to the individual situation of patients，so as to maximize the benefits of patients.

A systematic Meta-synthesis of qualitative research on life experience of patients with left ventricular assist device implantation

LI Wanhui, YUE Wenjing, WANG Zihan, KANG Xiaofeng, ZHANG Chen

2023, 58(10):  1261-1268.  DOI: 10.3761/j.issn.0254-1769.2023.10.017

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Objective To systematically evaluate and integrate the life experience of patients with left ventricular assist device（LVAD） implantation，so as to provide a reference for helping these patients adapt to life coexisting with LVAD and establishing a support system. Methods Web of Science，PubMed，Embase，Cochrane Library，CINAHL，CNKI，Wanfang data，VIP，CBM were searched for qualitative research on life experience of patients with LVAD implantation. The search time was from January 2008 to July 2022. The literature quality evaluation was carried out by the quality evaluation standard of qualitative research of Joanna Briggs Institute，Australia（2016 edition），and the research results were summarized and integrated by the convergent integration method. Results A total of 15 English studies were included；69 themes were extracted；14 categories were summarized and 4 synthesis results were obtained，namely the health benefits，difficulties and challenges，self-adjustment，and the importance of external support after LVAD implantation to promote recovery and adaptation. Conclusion Patients with LVAD have obvious health benefits，but also face a series of complications and life，psychological and social burdens. In the future，a multi-dimensional support system should be established from medical treatment，family and society to help such patients self-adjust and return to society as soon as possible.

Review

Research progress and nursing enlightenment on sleep quality among obese children

YU Jiaxin, GUAN Ji, YAN Min, ZHOU Hongju, JU Xuemei

2023, 58(10):  1269-1274.  DOI: 10.3761/j.issn.0254-1769.2023.10.018

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The sleep quality of obese children is generally poor due to various sleep problems，which causes great adverse effect on their physical and psychological health. This article reviews the current status，assessment tools，influencing factors and nursing strategies of obese children’s sleep quality，aiming to promote domestic nursing staff to pay attention to the sleep quality of obese children and provide references for them to formulate targeted interventions.

Overseas Knowledge

The translation and validation of Bariatric Surgery Self-management Questionnaire

QIN Jingjing, XIAO Rijiao, LI Xueting, MA Shuang, PAN Yingli

2023, 58(10):  1275-1281.  DOI: 10.3761/j.issn.0254-1769.2023.10.019

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Objective To translate Bariatric Surgery Self-management Questionnaire（BSSQ） into Chinese，and to test its reliability and validity. Methods After obtaining the authorization of the author of the original questionnaire，the original questionnaire was first forward translated，synthesized and translated back，and then the Chinese version of the BSSQ was formed after the cultural adjustment（2 rounds of expert consultations and the pre-test）. From May to August 2022，a convenience sample of 227 patients undergoing metabolic bariatric surgery who were followed up in the outpatient department of metabolic bariatric surgery of a tertiary A general hospital in Shenyang as the study subjects were investigated，and 30 patients were conveniently selected for retest after 14 days to evaluate the reliability and validity of the questionnaire. Results The Chinese version of BSSQ includes 9 dimensions with a total of 32 items. The content validity index of each item is between 0.833 and 1，and the content validity index of the total scale is 0.970. Exploratory factor analysis resulted in a 9-factor structure，explaining 60.314% of the total variance. The score of Chinese version of BSSQ was positively correlated with GSES score（r=0.329，P<0.001） and negatively correlated with PHQ-9 score（r=-0.141，P=0.034）. The Cronbach’s α coefficient for the total BSSQ score was 0.867，and 0.420~0.813 for each factor. The retest reliability for the total BSSQ score was 0.885，and 0.766~0.982 for each factor. Conclusion The Chinese version of BSSQ has good reliability and validity，and it can be used as a tool to evaluate self-management ability of patients undergoing metabolic bariatric surgery in China.