Table of Content

10 January 2024, Volume 59 Issue 1

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Special Article

Start a new path with original heart, keep being outstanding with the mission

WU Xinjuan

2024, 59(1):  5-6. 

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Take the road of sustainable development of the journal with the orientation of discipline progress

JIANG Xiaoying

2024, 59(1):  7-9. 

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Special Planning—Pulmonary Rehabilitation Nursing

Expert consensus on postoperative pulmonary rehabilitation nursing for lung transplant patients

Respiratory Nursing Committee of Zhejiang Nursing Association（Writing Committee：ZENG Fei, LAN Meijuan, LIANG Jiangshuyuan, GU Peipei, CAI Lingyun, GUO Luyao）

2024, 59(1):  10-14.  DOI: 10.3761/j.issn.0254-1769.2024.01.001

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Objective To form the expert consensus on postoperative pulmonary rehabilitation nursing for lung transplant patients，standardize the nursing care of pulmonary rehabilitation after lung transplantation in medical institutions，and promote the early postoperative rehabilitation of lung transplant patients. Methods The clinical guideline，expert consensus，systematic review，evidence summary and original research on postoperative pulmonary rehabilitation of lung transplant patients were comprehensively searched in domestic and foreign databases. The time limit for retrieval was from the establishment of databases until February 2023. The draft of the Consensus was formed based on clinical practice experience. From April to June 2023，17 experts were invited to conduct 2 rounds of expert consultation，in order to revise and improve the content of the first draft，and then conduct expert demonstration，and finally form the final draft of the consensus. Results Totally 16 experts responded，and the expert positive coefficient was 94.12%. The effective recovery rates of the 2 rounds of expert consultation were both 100%；the expert authority coefficients were both 0.941；the judgment coefficients were both 0.963；and the familiarity degree were both 0.900. The Kendall coefficients of the 2 rounds of expert consultation were 0.133 and 0.123，respectively，which were statistically significant. The consensus includes 13 themes，involving the formation and management of a pulmonary rehabilitation team, fluid management, mechanical ventilation,sequential assisted ventilation,respiratory function exercise,airway clearance，pain management,exercise management,nutritional support，immunosuppressive management,prevention and control of pulmonary complications,psychological support,and follow-up management. Conclusion The consensus is highly scientific，and can provide references and bases for clinical nursing staff to carry out pulmonary rehabilitation for lung transplant patients.

A qualitative study of the factors of pulmonary rehabilitation behavior of elderly patients with lung cancer in the post-operative transitional period

ZHU Hongxuan, PANG Jianmei, SUN Shengnan, LI Yan

2024, 59(1):  15-21.  DOI: 10.3761/j.issn.0254-1769.2024.01.002

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Objective To understand the factors that affect the pulmonary rehabilitation behavior of elderly patients with lung cancer during the post-operative transitional period，and provide reference bases for formulating the pulmonary rehabilitation plan of elderly patients with lung cancer during the transitional period and improving the compliance of pulmonary rehabilitation. Methods Based on the capability，opportunity，and motivation-behavior model（COM-B model），12 elderly lung cancer patients who underwent surgery at a tertiary A tumor hospital in Tianjin from March to July 2022 were selected for semi-structured interviews using descriptive research methods and purposive sampling method. The data were analyzed using directed content analysis. Results The ability factors （physical strength and postoperative discomfort symptoms of the elderly limit lung rehabilitation exercise，lack of pulmonary rehabilitation knowledge and awareness of the importance of exercise in lung rehabilitation knowledge），opportunity factors（lack of grassroots medical and health services，limiting lung rehabilitation exercise；family and friends are important resources for promoting lung rehabilitation exercise；medical support is a guarantee for promoting lung rehabilitation exercise），motivational factors（high self-efficacy in exercise is the foundation for lung rehabilitation exercise，perception of lung rehabilitation effects increases motivation for lung rehabilitation exercise） and 7 sub themes were extracted. Conclusion There are certain obstacles and promoting factors in the transitional lung rehabilitation process for elderly lung cancer patients after surgery. It is necessary to improve their postoperative discomfort symptoms，increase their knowledge of lung rehabilitation，enhance their awareness of lung rehabilitation，face the social support role of family，friends，and medical staff，improve the infrastructure and lung rehabilitation system，increase community lung rehabilitation support，provide multi-channel high-quality lung rehabilitation resources，and promote the development of smart medical services，constructing a transitional lung rehabilitation strategy for elderly patients with lung cancer.

Development and validation of an Exercise Behavior Perception Scale for Lung Cancer Patients

LIN Qi, LIU Yurong, YANG Hui, YANG Fengjuan, WANG Dan, CHEN Ruiyun

2024, 59(1):  22-28.  DOI: 10.3761/j.issn.0254-1769.2024.01.003

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Objective To develop an Exercise Behavior Perception Scale for Lung Cancer Patients in China，and to test its reliability and validity. Methods According to the health belief model，the first draft of the scale was formed through literature review，semi-structured interview，research group discussion，2 rounds of expert correspondence and pre-survey. A total of 842 patients with lung cancer who received treatment in a tertiary A hospital in Zhengzhou City from October 2022 to April 2023 were selected for investigation，and item analysis，validity analysis，and reliability analysis were applied to adjust the items to form a formal scale. Results The Exercise Behavior Perception Scale for Lung Cancer Patients contained 24 items，and exploratory factor analysis generated 6 common factors，including physical rehabilitation benefits，emotional and mental benefits，information disorders，disease symptom disorders，condition disorders，and psychological disorders. The cumulative variance contribution rate reached 73.916%，and the results of confirmatory factor analysis showed that the model fit was good，the χ²/df was 2.371，the root mean square error of approximation was 0.057，the normed fit index was 0.924，and the comparative fit index was 0.954，the scale score was moderately positively correlated with the total score of the Frenchay activities index （r=0.529，P<0.001）. The Cronbach’s α，coefficient，half reliability，and retest reliability of the scale were 0.884，0.741，and 0.889，respectively. Conclusion The Exercise Behavior Perception Scale for Lung Cancer Patients had good reliability and validity，and it can be used to effectively evaluate the exercise behavior perception status of lung cancer patients.

Nursing care of postoperative lung re-expansion in an elderly hemiplegic patient with a massive pulmonary tumor

HUANG Binbin, WANG Hui

2024, 59(1):  29-32.  DOI: 10.3761/j.issn.0254-1769.2024.01.004

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To summarize the nursing experience of postoperative lung re-expansion in an elderly hemiplegic patient with a massive pulmonary tumor. The nursing interventions included the utilization of high-flow therapy with positive pressure ventilation to facilitate early alveolar re-expansion. Guided breathing exercises were implemented to enhance respiratory muscle strength and maintain alveolar expansion. Furthermore，a comprehensive approach to airway clearance techniques was employed to improve the patient’s ability to expectorate sputum effectively. A stepwise nutritional care plan was implemented to reduce complications and ensure a safe transition to oral feeding. Additionally，a discharge preparation service plan was executed to ensure the provision of continuous care after hospital discharge. Through the collaborative efforts of a multidisciplinary team and diligent postoperative nursing care，the patient exhibited a favorable recovery and was discharged after a 20-day hospitalization period.

Summary of best evidence of respiratory muscle training in patients with mechanical ventilation after withdrawal

YIN Jianing, GUAN Xiaomin, JIA Dengshuai, XU Ling, CHEN Lan

2024, 59(1):  33-41.  DOI: 10.3761/j.issn.0254-1769.2024.01.005

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Objective The best evidence of respiratory muscle training for patients with mechanical ventilation in ICU after machine withdrawal was extracted and summarized to provide evidence-based evidence for respiratory muscle training for patients with mechanical ventilation after machine withdrawal. Methods We searched relevant guideline networks and association websites，as well as PubMed，Web of Science，Embase，CINAHL，CNKI，VIP，Wanfang and other databases to collect relevant guidelines，clinical decisions，evidence summaries，expert consensuses，systematic reviews and randomized controlled studies，and the search time limit is from the establishment of the databases to July 30，2023. There were 2 researchers who independently evaluated the literature quality and extracted data. Results A total of 13 articles were included，including 2 guidelines，2 clinical decisions，5 systematic reviews and 4 expert consensuses. There were 24 pieces of evidence being summarized in 7 categories，including training team，training evaluation，training methods，training frequency，training safety，training effect evaluation and health education. Conclusion This study summarizes the best evidence for respiratory muscle training in patients with mechanical ventilation after withdrawal，which can provide references for medical staffs to conduct respiratory muscle training for patients after withdrawal. It is recommended that medical staff should consider the clinical situation when applying the evidence，and selectively apply the best evidence.

Best evidence summary of postoperative pulmonary rehabilitation management in patients with lung cancer complicated with chronic obstructive pulmonary disease

HAN Nafei, FENG Huali, HE Hong, LI Qian, XU Jianfeng, JIN Yaojuan, SHEN Mengya, SUN Jiaye, HUANG Tianhai

2024, 59(1):  42-49.  DOI: 10.3761/j.issn.0254-1769.2024.01.006

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Objective To retrieve，extract，evaluate，and integrate the relevant evidence of postoperative pulmonary rehabilitation management in patients with lung cancer complicated with chronic obstructive pulmonary disease，so as to provide an evidence-based basis for improving the quality of postoperative pulmonary rehabilitation. Methods Relevant literature on postoperative pulmonary rehabilitation of lung cancer complicated with chronic obstructive pulmonary disease were searched by computer from clinical decisions，guideline websites，professional association websites，and comprehensive databases. The types of the literature included clinical decisions，guidelines，expert consensuses，evidence summaries，systematic reviews，meta-analyses，and randomized controlled trials. The retrieval time limit was from the establishment of the database to September 2023. Results A total of 19 articles were included，including 4 clinical decisions，3 guidelines，6 expert consensuses，1 evidence summary，3 systematic reviews，and 2 randomized controlled trials. Through reading，extraction and classification，23 pieces of best evidence were finally formed，including multidisciplinary cooperation，evaluation，pulmonary rehabilitation strategies and health education. Conclusion This study summarizes the best evidence for postoperative lung rehabilitation management in patients with lung cancer and chronic obstructive pulmonary disease. Clinical medical staff can implement practical evidence for postoperative lung rehabilitation based on actual situations，and promote the transformation of evidence-based knowledge into practice.

Specialist Practice and Research

Experience of dietary restriction in patients with inflammatory bowel disease： a qualitative study

ZHU Yuqian, GAO Yanan, JIA Junwan, DU Bing, LEI Lexia, CHEN Yamei

2024, 59(1):  50-56.  DOI: 10.3761/j.issn.0254-1769.2024.01.007

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Objective To analyze the real experiences of patients with inflammatory bowel disease（IBD） during dietary restrictions，providing references for healthcare personnel to guide patients in standardizing dietary restriction behaviors. Methods Purposeful sampling was employed to select 14 patients with IBD who were treated at a tertiary A hospital in Shanghai between October 2022 and February 2023 for semi-structured in-depth interviews. Data were analyzed using the Colaizzi’s 7-step method in phenomenological research. Results 4 themes and 13 sub-themes were extracted. Theme 1：facing multiple physiological challenges（hunger，nutritional imbalance，fatigue and muscle atrophy）. Theme 2：experiencing negative psychological disturbances（craving and struggle for gourmet food，diminished zest for life and increased anxiety，feeling embarrassed during social activities）. Theme 3：adopting various coping strategies（self-adjustment and adaptation to dietary restrictions，satisfying oral desires through various avenues，seeking knowledge and guidance on nutrition）. Theme 4：gaining more growth and support（improved symptom and quality of life，enhanced awareness of dietary health，improved ability to manage diet，receiving support from peers and family）. Conclusion The experience of dietary restrictions in IBD patients is complex and varied. Nursing staff should prioritize nutritional risk screening for IBD patients，pay attention to their mental health，provide patients with scientific and personalized dietary guidance，and strengthen social and family support to assist patients in better self-management of their diet.

Construction of key nursing technology system for hospital treatment of patients with nuclear radiation exposure

HU Xianjing, YAN Yan, WANG Jing, ZHANG Heli, CHEN Yamei, MA Li, GENG Rongmei, LI Baohua

2024, 59(1):  57-63.  DOI: 10.3761/j.issn.0254-1769.2024.01.008

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Objective To construct a key nursing technology system for the treatment of patients exposed to nuclear radiation in hospitals，and provide technical guidance and support for emergency nursing rescue in hospitals of nuclear radiation accidents. Methods A research group was composed of a team with rich experience in nuclear radiation accidents. Based on 4 scenarios of nuclear radiation accidents（including external irradiation，internal irradiation，external contamination，internal contamination），the literature search was conducted to form the first draft of the system. Delphi method was used to complete 2 rounds of expert letter consultation，and the final draft of the key nursing technology system for hospital treatment of patients with nuclear radiation exposure was constructed according to the revised opinions of experts. Results A total of 16 experts completed 2 rounds of correspondence. The effective recovery rates were 100% and 80%；the recommendation rates were 65% and 50%；the authority coefficients（Cr） were 0.778 and 0.797；the coefficient of variation（CV） of the 2 rounds of expert letter consultation was≤0.25. Finally，a key nursing technology system for in-hospital treatment of patients with nuclear radiation exposure was formed，including 5 first-level indicators，26 second-level indicators and 74 third-level indicators. Conclusion The constructed key nursing technology system for hospital treatment of patients with nuclear radiation exposure is highly practical and scientific，and it is conducive to the formation of standardized nuclear radiation exposure treatment procedures，and provides a theoretical basis for the training and evaluation of nursing staff related to nuclear radiation exposure.

Construction and evaluation of a risk prediction model for hypoglycemia in colonoscopy patients

LI Min, LU Xueping, BING Weiwei, ZHENG Taohua, WEI Lili

2024, 59(1):  64-69.  DOI: 10.3761/j.issn.0254-1769.2024.01.009

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Objective To analyze the influencing factors of hypoglycemia in patients undergoing colonoscopy and to construct a risk prediction model and evaluate the model. Methods A total of 528 patients who underwent colonoscopy were selected by the convenience sampling method from the gastroenterology department of a tertiary A hospital in Qingdao from March 2022 to August 2022. Their general information，laboratory indicators and operation-related data were collected. Multivariate Logistic regression was used to analyze the risk factors of hypoglycemia in patients with colonoscopy for risk prediction model construction，and its prediction effect was evaluated by drawing a nomogram. Results Hypoglycemia occurred in 66 of 528 patients，with an incidence of 12.50%. The risk factors finally in the risk prediction model in Logistic regression were drinking history，long fasting time after operation，polyethylene glycol（PEG）-electrolyte solutions>3 L，low quality of bowel preparation. The model passed Hosmer-Lemeshow goodness of fit test χ²=10.158（P=0.200）. The area under the ROC curve was 0.829，while the cut-off was 0.575，with sensitivity of 92.90% and specificity of 64.60%. Conclusion Patients undergoing colonoscopy have a higher risk of hypoglycemia. Patients with a history of drinking，longer fasting after surgery，more than 3 L of PEG-electrolyte solutions，and low quality of bowel preparation were more likely to develop hypoglycemia. The established risk prediction model has a good effect，providing the reference for screening high-risk group of hypoglycemia and taking preventive and protective measures.

Enteral and Parenteral Nutrition

Application of electromagnetic-guided placement of nasoenteral feeding tubes among aged bedridden patients

MA Xiao, SHI Haiyan, WANG Xiang, WANG Jun, HAN Zhongyan, ZHANG Huaguo

2024, 59(1):  70-76.  DOI: 10.3761/j.issn.0254-1769.2024.01.010

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Objective To investigate the application effect of electromagnetic navigation bedside nasoenteral intubation technology in elderly bedridden patients. Methods A total of 92 elderly patients with tube feeding in bed in a tertiary A hospital in Beijing from June 2021 to December 2022 were selected by convenience sampling method，and they were divided into an experimental group and a control group with 46 patients in each group by random number table method. The experimental group adopted the electromagnetic navigation bedside nasoenteral catheterization technique and the control group adopted the blind catheterization method. The total success rate of catheterization，the success rate of the first catheterization，the time taken for catheterization，the proportion of catheter tip reaching jejunum，and the incidence of catheter-related complications were compared between the 2 groups. Results There were no shedding cases in both groups. The success rate of total catheterization was 95.7% in the experimental group and 80.4% in the control group. The success rate of first catheterization was 95.7% in the experimental group and 71.7% in the control group. The time taken for catheterization was（12.37±4.19） min in the experimental group and（19.22±5.48） min in the control group. The proportion of catheter tip reaching the jejunum was 60.9% in the experimental group and 28.3% in the control group. The above data were compared between the 2 groups，and the differences were statistically significant（P<0.05）. In terms of the incidence of catheter-related complications，the incidence of epistaxis in the experimental group was 6.5% and it was 21.7% in the control group，and the difference was statistically significant（P=0.036）. The positive rate of fecal occult blood test was 2.2% in the experimental group and 17.4% in the control group，and the difference was statistically significant（P=0.030）. There was no significant difference in the incidence of nausea，vomiting and abdominal distension between the 2 groups（P>0.05）. No serious complications such as catheter ectopic placement，pneumothorax and perforation occurred in the 2 groups. Conclusion The application of electromagnetic navigation bedside nasoenteral intubation technology for elderly bedridden patients has a high success rate and takes a short time，which can improve the proportion of catheter tip reaching the jejunum and reduce the incidence of epistaxis and fecal occult blood test.

Nursing Management

Construction and preliminary application of a training program of operating room nurses for returning to work after delivery based on work adaptation theory

BAI Ping, WEI Yongting, SUN Zhichao, DONG Xiaofan, WANG Jianhua, WANG Feng, YAO Qi

2024, 59(1):  77-84.  DOI: 10.3761/j.issn.0254-1769.2024.01.011

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Objective To construct a training program for returning to work after delivery based on Morrison’s job adaptation theory in operating room nurses and to explore its application effect. Methods On the basis of literature research and Delphi expert consultation method，a training program of postpartum return of operating room nurses was constructed. From August 2021 to December 2022，the preliminary application of this research program was carried out，with 6 cases in an experimental group and 5 cases in a control group. The differences between the 2 groups were compared by Job Adaptation Scale，Psychological Resilience Scale and satisfaction evaluation，and the application effect was evaluated. Results After 2 rounds of correspondence，a training program for postpartum return of operating room nurses was formed，which included 4 first-level indicators（role adaptation，task adaptation，environment adaptation and cultural adaptation），and 32 second-level indicators. The authority coefficients of the 2 rounds of correspondence consultation were 0.908 and 0.917，and the Kendall W coefficients were 0.224 and 0.206，respectively（both P<0.001）. The preliminary application results showed that there were statistically significant differences in job adaptation and satisfaction evaluation between the 2 groups（both P<0.05）. There was no significant difference in psychological resilience score between groups（P>0.05）. Conclusion The postpartum return training program for operating room nurses established in this study is scientific and practical to a certain extent. In the future，samples can be expanded and multi-center studies can be carried out to further test the practicability and effectiveness of the program.

Construction and application of a management scheme for nursing assistants in unaccompanied hospitals

FAN Weiying, CHEN Yuan, LIN Yuanyuan

2024, 59(1):  85-92.  DOI: 10.3761/j.issn.0254-1769.2024.01.012

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Objective To construct a management scheme of nursing assistants in unaccompanied hospitals and explore its application effect. Methods The management team of nursing assistants in unaccompanied hospitals was set up. On the basis of investigating the current situation of nursing assistants’ team management，the management scheme of nursing assistants was constructed by ORTCC management model for references，including 5 parts：determining management objectives，perfecting rules system，building hierarchical training system，checking and assessing，and shaping cultural system. Convenience sampling method was used to select 92 nursing assistants in an unaccompanied hospital in Xiamen，Fujian Province from June 2021 to June 2022 as application subjects. The post competence of nursing assistants and the satisfaction of patients and nurses to nursing assistants were compared before the application of the management scheme（June-December 2021） and after the application（January 2022-June 2022）. Results After the application of ORTCC management model，the total score of post competency of medical nursing assistants increased from[65（64，67）] to [91（90，92）]；the excellent rate of post competency level increased from 1.09% to 67.39%；the satisfaction of patients with nursing assistants increased from 61.99% to 88.62%；the scores of nurses’ satisfaction with nursing assistants in all dimensions were significantly higher than before（all P<0.05），and the overall evaluation was improved from 92.73% to 99.24%. Conclusion The use of the ORTCC management model for nursing assistants can effectively improve their post competence，improve the satisfaction of patients and nurses，and help to further stabilize and develop the medical nursing assistants staff.

Study on the current situation and latent profile analysis of nurses’ voice behavior

XIAO Jingfang, XIA Ruinan, WANG Rui, DAI Meifen, ZOU Xiaofang

2024, 59(1):  93-99.  DOI: 10.3761/j.issn.0254-1769.2024.01.013

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Objective To analyze the current situation and latent profiles of nurses’ voice behavior in nurses，and explore the influencing factors of different types. Methods Through convenience sampling，812 nurses who worked in tertiary hospitals from 5 cities in Guangdong Province during April 2022 to June 2022 were recruited. The demographic questionnaire，the Voice Behavior Scale，the Humble Leadership Scale，and the Team Psychological Safety Climate Scale were used for investigation. Latent profile analysis was used to explore the latent profiles of nurses’ voice behavior. The influencing factors of latent profiles were identified by multivariate Logistic regression. Results The total score of the voice behavior in 812 nurses is（37.04±5.88）. Voice behaviors in nurses is divided into 3 latent classes，namely “conservation group”（27.83%），“balanced-risky group”（61.95%），and “the challenge group”（10.22%）. The influencing factors include recruitment type，whether to assist in department management，humble leadership，team psychological safety climate（all P<0.05）. Conclusion The level of nurses’ voice behavior is upper medium with heterogeneity，which can be divided into 3 latent profiles. Nurses managers should focus on nurses with conservation group and balanced-risky group and conduct early targeted prevention and care according to characteristics and influencing factors of different latent profile.

Evidence Synthesis Research

Summary of the best evidence for physical activity in patients with venous leg ulcer

XU Zhiwei, WANG Xian, MU Wenfang, WANG Yan, WANG Anzi

2024, 59(1):  100-107.  DOI: 10.3761/j.issn.0254-1769.2024.01.014

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Objective To retrieve，evaluate and summarize the best evidence of physical activity in patients with venous leg ulcer（VLU），and to provide the evidence for clinical practice of physical activity intervention for patients with VLU. Methods We systematically searched all relevant literature on the physical activity of patients with VLU，including clinical practice guidelines，clinical decision-making，systematic reviews，evidence summaries，expert consensuses，and original studies，from the guideline websites，databases，and professional association websites，with the search period from the database establishment to May 19，2023. 2 researchers independently evaluated the quality of the literature，and included and extracted and integrated evidence based on the judgment of professionals. Results A total of 18 articles were included，consisting of 6 guidelines，2 clinical decisions，6 systematic reviews，3 expert consensuses and 1 original study. Finally，26 pieces of best evidence were summarized，categorizing into 8 aspects which include timing of physical activity，patient assessment before physical activity，mode of physical activity，time and frequency of physical activity，intensity of physical activity，effect evaluation of physical activity，quality control and tips. Conclusion This study summarizes the best evidence of physical activity in patients with VLU. It is recommended that health care professionals should formulate individualized physical activity programs based on the practical conditions and clinical situation，and fully consider the evaluation results of patients.

Experiences of people living with HIV participating in peer support：a qualitative meta-synthesis

CHANG Keyi, WU Yangfeng, SHAN Sikai, HAN Shuyu, QUAN Xiaoli, HAN Jianing, WU Dongxia, ZHANG Lili

2024, 59(1):  108-116.  DOI: 10.3761/j.issn.0254-1769.2024.01.015

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Objective To systematically evaluate and integrate the experiences of people living with HIV in peer support，and to provide references and suggestions for improving peer support for HIV patients in clinical practice. Methods The computer retrieval was performed in PubMed，CINAHL（EBSCO），Web of Science，ProQuest，CNKI and Wanfang Data from January 1，1996 to September 30，2022，to collect qualitative studies in the experience of people living with HIV participating in peer support. 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 7 qualitative studies were included，and 26 findings were extracted，which were summarized into 12 categories and integrated into 4 synthesized findings. Findings included that peer support provides patients with information and help them establish and maintain a healthy lifestyle；patients receive emotional support in peer support；patients receive instrumental support in peer support；the objective requirements and scenarios of peer support. Conclusion AIDS peer support has a positive effect on AIDS prevention and treatment，and it is important to address the practical needs of people living with HIV/AIDS. The practice of HIV peer support needs further theoretical support and scientific guidance. Building an HIV peer support model，providing systematic training and professional guidance to HIV peers is conducive to improving the accuracy of HIV peer support behaviors，the development of HIV peer support activities，and optimizing the effectiveness and sustainability of peer support for people living with HIV/AIDS.

Review

Research progress of symptom cluster in patients with acute coronary syndrome

CHEN Xiaoyan, HUANG Lihua

2024, 59(1):  117-123.  DOI: 10.3761/j.issn.0254-1769.2024.01.016

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Acute coronary syndrome（ACS） is a common type of acute and critical disease in Coronary Heart Disease（CHD）. It is characterized by multiple and severe symptoms and rapid progression of the disease，which seriously threatens the life safety of patients. In this paper，the relevant studies on symptom cluster of patients with ACS were systematically searched at home and abroad，and the composition of symptom cluster，symptom assessment tools，symptom cluster establishment methods，influencing factors and intervention methods were reviewed，in order to provide references for nurses to manage ACS symptom cluster.

A concept analysis of reflective practice in nurses

DONG Yanyan, PAN Jingda, HE Jiaxin, LIN Suiyi, YU Hongjing, LING Donglan

2024, 59(1):  124-129.  DOI: 10.3761/j.issn.0254-1769.2024.01.017

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Objective To clarify and analyze the concept and connotation of the reflective practice in nurses. Methods CNKI，Wanfang，CBM，PubMed，Embase，Scopus，CIHNAL database were searched in relation to reflective practice in nurses. The retrieval period was from the inception to Dec.2022. Walker and Avant’s concept analysis method was used to analyze the connotation. Results A total of 43 articles were retrieved. 6 attributes of reflective practice in nurses were identified，including active engagement，critical thinking，openness and acceptance，making connections with previous knowledge or experiences，external support，dynamic and continuity. Antecedents included internal and external drivers. The reflective practice in nurses ultimately had a vital impact on themselves，patients and organizations. In recent years Reflective Practice Questionnaire has been one of the most commonly used data collection tools to measure the reflective practice in nurses. Conclusion The concept attributes of reflective practice in nurses were identified by concept analysis method，which provides references for nursing educators to cultivate reflective practice ability of nurses. In future research，researchers can combine the connotations of reflective practice for nurses to develop specific assessment tools for testing the level of reflective practice of nurses and construct the local reflective practice intervention scheme for nurses，so as to promote the development of reflective practice in nursing field in China.