Table of Content

10 March 2024, Volume 59 Issue 5

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Hospice Care Practice and Diversification

Construction and preliminary application of a telemedicine-based home care program for hospice patients

GUO Junchen, XU Xianghua, LIU Chaoyi, WANG Ying, LIU Junqingzhao, CHEN Yongyi, ZHU Lihui, XIAO Yazhou, LIU Yang

2024, 59(5):  517-525.  DOI: 10.3761/j.issn.0254-1769.2024.05.001

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Objective To construct a telemedicine-based home care program for hospice patients that will provide a reference for hospice telemedicine-based home care practices. Methods Using the Supportive Care Model as a theoretical guide，a preliminary telemedicine-based home care program for hospice patients was developed based on literature research combined with qualitative interviews. 2 rounds of expert consultation were conducted in March 2023 to solicit their opinions and revise the proposal to form the final draft. In April 2023，9 patients who were about to be discharged from the palliative care ward of a cancer hospital in Hunan Province，were selected for the preliminary application of the program by the convenience sampling method；the number of cases of adverse events and the Telemedicine Satisfaction Questionnaire were used for the effectiveness of the program. Results A total of 16 experts completed 2 rounds of consultation，and the coefficient of expert authority was 0.928. The effective questionnaire recovery rates of the 2 rounds of consultation were 94.12% and 100%；the expert opinion submission rates were 100% and 25.00%；the coefficients of variation of item scores were 0.05~0.18 and 0~0.16. The coefficients of Kendall harmony in 2 rounds were 0.093 and 0.210（P<0.001）. The constructed final program included 4 dimensions of symptom management，daily life care，psycho-spiritual care and social information support，and a total of 17 modules such as pain management，dyspnea management，gastrointestinal symptom management and cough management，which covering 37 specific items. No adverse events occurred during the application and the score of care satisfaction was（60.22±7.41），which indicated a high level of satisfaction. Conclusion The program constructed in this study is scientific，relevant and feasible，and can provide guidance for healthcare professionals in conducting hospice telemedicine-based home care practices.

Disease coping experience of patients with advanced cancer from the perspective of sense of coherence：a qualitative study

HUANG Yongqi, TIAN Xia, WANG Zheng, SUN Mimi, ZHOU Liqun, XIAO Wenli

2024, 59(5):  526-532.  DOI: 10.3761/j.issn.0254-1769.2024.05.002

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Objective To explore the disease coping experience of patients with advanced cancer from the perspective of sense of coherence，in order to provide references for identifying their coping resources and formulating effective coping strategies. Methods A descriptive qualitative research method was used to conduct semi-structured interviews with 18 patients with advanced cancer who were hospitalized in the cancer center of a tertiary A hospital in Guangzhou from March to May 2023 by purposive sampling. The content analysis method was used to summarize and extract the interview results. Results A total of 3 themes were summarized，including comprehending the disease experience（reflecting on health behaviors，facing up to the fact of illness，accepting the law of life），managing disease threats（responding to multiple challenges，mobilizing coping resources），realizing the meaning of disease coping（acknowledging the meaning of disease coping，perceiving the benefits of disease，and making a life plan）. Conclusion Effective coping resources can help patients with advanced cancer cope with multiple challenges in the disease process. Medical staff should strengthen cancer knowledge education，help patients with advanced cancer to explore positive coping resources，and reinforce the meaning of disease coping，thereby enhancing patients’ disease coping ability and promoting their physical and mental health.

Introduction of palliative care for patients with cardiovascular diseases in Japan and its implication for China

PENG Mengyun, HARADA Nahoko, SAITO Shinya

2024, 59(5):  533-539.  DOI: 10.3761/j.issn.0254-1769.2024.05.003

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The WHO calls for global healthcare workers to pay attention to hospice practice for non-cancer patients. Currently，domestic palliative care is mainly focused on cancer patients，and the practice and development in chronic disease populations such as cardiovascular disease is relatively weak. In recent years，palliative care for cardiovascular disease in Japan has been proven to be effective in relieving end-stage symptoms of patients with cardiovascular disease and improving the quality of life of patients and family members. The paper introduces the development history，scale and demand，team members and collaboration，intervention time，assessment and screening，service content and process，quality evaluation and dilemmas of palliative care for patients with cardiovascular disease in Japan，and proposes implications for the implementation of palliative care for patients with cardiovascular disease in China，in order to provide a reference for the development of palliative care for patients with cardiovascular disease.

Summary of evidence on bereavement support for parents of terminally ill children

WEI Shuangshuang, YOU Xuemei, YANG Lijie, LI Fanrong, TANG Rubing

2024, 59(5):  540-546.  DOI: 10.3761/j.issn.0254-1769.2024.05.004

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Objective To search，evaluate and summarize the best evidence on bereavement support for parents of terminally ill children. Methods A systematic search for evidence on parental bereavement support was conducted in UpToDate，BMJ Best Clinical Practice，Joanna Briggs Institute Evidence-Based Health Care Center Database，PubMed，Embase，Cochrane Library，CNKI，Wanfang Date and so on，and the literature includes guidelines，clinical decisions，recommended practices，evidence summaries，systematic reviews and expert consensuses. The time range of retrieval was from the database establishment to February 18，2023. Literature quality evaluation，data extraction and evidence summary were performed by 2 researchers. Results A total of 9 articles were included，consisting of 2 guidelines，1 expert consensus，1 clinical decision and 5 systematic reviews. 24 pieces of evidence were summarized on 6 aspects，covering multidisciplinary team building，assessment，timing of support，pre-death support，end-of-life support，and post-mortem support. Conclusion The study summarizes the best evidence on parental bereavement support and provides clinical practice guidance for bereavement support for parents of terminally ill children. Healthcare professionals should combine China’s clinical reality，fully consider the cultural background of both children and parents，follow the principle of individualization，and prudently apply evidence to clinical practice.

The volunteering experience of palliative care volunteers：a meta-synthesis of qualitative studies

CHENG Lin, LI Yuanyuan, PEI Bei, LI Huan, LIU Jinlong, XU Yulu, FENG Xinyue, LOU Yan

2024, 59(5):  547-555.  DOI: 10.3761/j.issn.0254-1769.2024.05.005

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Objective To systematically evaluate and analyze the qualitative research on the experience of volunteers in palliative care practice，thereby providing health professionals with evidence in training and support to palliative care volunteers. Methods Chinese and English databases including PubMed，Web of Science，Cochrane Library，ProQuest，Scopus，CINAHL，CNKI，Wanfang，VIP and CBM were searched for qualitative studies exploring the true feelings of volunteers in palliative care practice from inception to November 2023. The JBI Critical Appraisal Tool for Qualitative Studies from Australia was used to evaluate the quality of the studies. The results were synthesized using the meta-integration method. Results 14 studies were included in the final review. Totally 49 findings were extracted，leading to the creation of 10 new categories. 4 integrated results were synthesized as follows：① The motivations for palliative care volunteers to participate in volunteering are intricate and varied；②Palliative care volunteers encounter a range of challenges；③ Palliative care volunteers exhibit a positive attitude and utilize diverse approaches to overcome challenges；④Palliative care volunteers recognize dual benefits from their volunteering. Conclusion The experience of volunteering in palliative care is multifaceted and intricate. During the recruitment process，it is advisable for health professionals to evaluate the motivations and mental states of potential volunteers for their participation. Throughout the service tenure，volunteers should be guided to cultivate and sustain positive psychological experiences，mitigate any negative emotions，and concurrently，efforts should be made to bolster the training and support system to enhance their volunteering capabilities.

Application progress of online grief counseling in palliative care

ZHANG Miaomiao, ZHANG Li, YAN Rong, DING Min, MENG Xiangmin, XU Ping

2024, 59(5):  556-561.  DOI: 10.3761/j.issn.0254-1769.2024.05.006

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Grief counseling is one of the main contents of palliative care，which plays an important role in alleviating the grief of terminal patients and bereaved people. As a new platform for grief counseling，the internet has the advantages of cross-time space，anonymity，flexibility and so on. This paper reviews the relevant theoretical models，application carriers，intervention methods，feasibility and effectiveness evaluation tools or indicators of online grief counseling，analyzes the dilemma of using internet to carry out grief counseling，and puts forward clinical practice suggestions，aiming to provide references for domestic medical staff to carry out relevant research and promote the application of online grief counseling in the field of palliative care.

Specialist Practice and Research

Construction and validation of structural equation modeling of factors influencing treatment adherence in maintenance hemodialysis patients

CHE Xu, QIAO Dongge, WANG Hongxia, CAO Qizheng, CUI Rongrong, CAO Ning

2024, 59(5):  562-568.  DOI: 10.3761/j.issn.0254-1769.2024.05.007

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Objective To construct the structural equation of the influencing factors of the treatment compliance of maintenance hemodialysis patients based on the information-motivation-behavioral skill model，verify its internal pathway，and provide scientific bases for the intervention study under the guidance of the optimized model. Methods From July to November 2022，283 patients with maintenance hemodialysis were selected by convenience sampling method from 2 tertiary A hospitals in Henan Province. The hemodialysis patients’ knowledge level questionnaire，social support rating scale，chronic disease self-efficacy scale，maintenance hemodialysis patients’ self-management scale，dialysis treatment compliance scale of end-stage renal disease patients were investigated. SPSS25.0 was used to statistically describe the scores of patients’ treatment compliance；correlation analysis of each scale was carried out；structural equation model was established by AMOS 24.0 software. Results 267 valid questionnaires were collected，and the effective recovery rate was 94.3%. Structural equation model showed that disease knowledge had no effect on self-management and treatment compliance（P>0.05）；self-efficacy had a positive effect on treatment compliance（total effect 0.382，direct effect 0.183，indirect effect 0.199，P<0.05）；social support had a positive effect on treatment compliance（total effect 0.699，direct effect 0.300，indirect effect 0.399，P<0.05）；self-management had a positive effect on treatment compliance（total effect 0.183，direct effect 0.183，P<0.05）. Conclusion When developing intervention strategies under the guidance of information-motivation-behavioral skill model，the emphasis should be placed on the promoting effect of motivation and behavioral skill factors on treatment compliance，especially the important pathway role of social motivation in the model，so as to improve the overall level of treatment compliance and quality of life of patients.

Qualitative research on emotional experience of mild cognitive impairment patients participating in cognitive intervention based on virtual reality technology

TIAN Siying, LI Suai, LIU Mengrao, LI Peipei, ZHANG Xinyue, CHANG Hong

2024, 59(5):  569-575.  DOI: 10.3761/j.issn.0254-1769.2024.05.008

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Objective To explore the emotional experience of mild cognitive impairment patients participating in cognitive intervention based on virtual reality technology，so as to provide references for medical personnel to carry out cognitive intervention. Methods With the method of objective sampling，10 patients with mild cognitive impairment who participated in cognitive intervention based on virtual reality technology in a tertiary A hospital in Beijing from July 2021 to September 2021 were selected as the research subjects for semi-structured interviews，and the data were analyzed with Colaizzi’s 7-step analysis method in phenomenological research. Results The emotional experience of mild cognitive impairment patients participating in cognitive intervention can be summarized into 4 themes，including the overall perception of virtual reality technology cognitive intervention（perception task characteristics，perception task skills，perception training mentality），the driving factors of cognitive intervention based on virtual reality technology （internal driving factors，external driving factors）；changes in outcomes of cognitive intervention based on virtual reality technology（changes in cognitive and speech functions；changes in motor function and behavioral patterns）；emotional awareness based on virtual reality technology cognitive training（continuously self-close before training；gradually focus on external objects during training；searching for the value of life after training）. Conclusion The medical staff should improve the diversity of cognitive intervention methods for patients with mild cognitive impairment，give play to the internal and external driving factors that promote patients to participate in training，improve training compliance，pay attention to their spiritual world，provide medical support，family support and social support，help them regain the value of life，strengthen psychological intervention at the same time of cognitive intervention，promote their cognitive improvement，delay the progress of cognitive deterioration，and improve their quality of life.

A qualitative study of disease communication experiences in couples with stroke

LIU Zhiwei, MEI Yongxia, ZHANG Zhenxiang, LIN Beilei, CHEN Suyan, ZHANG Dudu, XUE Lihong, YUAN Yan, ZHANG Weihong

2024, 59(5):  576-581.  DOI: 10.3761/j.issn.0254-1769.2024.05.009

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Objective To gain insight into the experience of disease communication among couples with stroke. Methods A descriptive phenomenological approach was conducted and a purposive sampling method was used to select 19 couples with stroke from August 2022 to March 2023 in the Department of Neurology of a tertiary hospital in Henan Province for semi-structured interviews. Data were analyzed by the Colaizzi method. Results A total of 2 themes and 8 sub-themes were extracted. Constructive disease communication included open communication of treatment information，timely communication of changes in symptoms，active communication of secondary prevention，and proactive communication of negative emotions. Negative disease communication included avoidance of communication，communication conflict，ineffective communication，and communication concealment. Conclusion Couples with stroke experienced both constructive and negative disease communication. Healthcare professionals should develop targeted interventions to improve disease communication，enhance the ability of couples to make decisions together，and reduce their negative emotions.

Enteral and Parenteral Nutrition

The effect of reducing frequency of gastric residual volume monitoring on enteral nutrition in ICU patients

YU Kunrong, LI Fan, HOU Qingmin, XU Yingzhen, LI Xiaorong, MA Jun, CHEN Yan, GUAN Yuxia

2024, 59(5):  582-587.  DOI: 10.3761/j.issn.0254-1769.2024.05.010

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Objective To evaluate the effect of reducing frequency of gastric residual volume monitoring on enteral feeding-related complication and caloric intake in ICU patients. Methods Patients who admitted to medical ICU，respiratory ICU and emergency ICU of a tertiary A teaching hospital in Beijing during October 2020 to January 2023 and undergoing mechanical ventilation and continuous enteral feeding via nasogastric tube in 24~48 hours were enrolled. According to the random number table method，they were divided into a control group and an intervention group，with 52 cases in each group. Gastric residual volume was monitored daily 12h after enteral nutrition initiation in the intervention group，and every 4 hours in the control group. The enteral feeding-related complication and caloric intake of the 2 groups were recorded after enteral nutrition initiated and until 7th day in ICU. Results 52 cases completed the study in each group respectively. During the first 7 days，the incidence of vomiting and the maximum of gastric residual volume in the experimental group were higher than those in the control group，with no statistically significant differences. No nasogastric tube occlusion was observed in any patients in either group. Compared to the control group，both the caloric intake of 7th day in ICU and the proportion of patients achieving calorie target on 7th day in ICU were significantly higher in the experimental group，with statistically significant differences. Conclusion Reducing the frequency of gastric residual volume monitoring to once a day could significantly increase caloric intake of patients without an increase in enteral feeding-related complication.

Nursing Management

The level and influencing factors of spare time planning of clinical nurses

SHENG Zhiqiong, YAN Xingyu, LIU Yuwen, LI Shuhuan, DING Yanjie, CHEN Shanshan, YE Minghui, SUN Caixia

2024, 59(5):  588-593.  DOI: 10.3761/j.issn.0254-1769.2024.05.011

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Objective To investigate the current situation of spare time planning among nurses，and to analyze the influencing factors to provide a reference for managers to design interventions to improve nurses’ leisure crafting. Methods From February to May 2023，271 clinical nurses from 2 tertiary general hospitals were selected by convenience sampling method in Wenzhou City. Questionnaire surveys were conducted through the general information questionnaire，the Leisure Crafting Scale，the Self-Identity Scale，and the Perceived Organizational Support Scale. Results A total of 257 valid questionnaires were collected，and the nurses’ leisure crafting score was 18~25（26.93± 8.08）. Multiple linear regression analysis showed that self-identity and perceived organizational support of nurses were the main influencing factors on nurses’ leisure crafting （P<0.01）. Conclusion The score of nurses’ spare time planning is in the middle level. Nursing managers can provide targeted training for nurses with different professional titles，set reasonable goals for spare time planning，and improve nurses’ sense of organizational support by giving them positions and increasing opportunities for further training，so as to help nurses to adjust their role cognition and improve their social status to improve their self-identity and ultimately promote their level of spare time planning.

Investigation on the knowledge and influencing factors of vessel catheter-associated infection among clinical nurses

ZHANG Jinghui, XU Ran, ZHONG Ping, HOU Jianmei, MA Guiyuan, PENG Sha, SHI Zeya, HUANG Xin, WANG Jiaan

2024, 59(5):  594-600.  DOI: 10.3761/j.issn.0254-1769.2024.05.012

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Objective To investigate the current situation of clinical nurses’ knowledge of vessel catheter-associated infection（VCAI） and analyze its influencing factors，so as to provide a basis for homogenizing training on prevention and control strategies of VCAI. Methods A total of 1 450 nurses were selected from 15 hospitals in East，West，Central，South and North area of China from April 9 to June 9 2022 by multi-stage random sampling method. They were investigated by general data questionnaire and VCAI knowledge questionnaire. The questionnaire included 7 dimensions，covering definition，clinical manifestations，diagnosis methods，risk factors，prevention measures，treatment measures and management system. Results A total of 1 424 valid questionnaires were collected，with an effective recovery rate of 98.21%. Nurses’ knowledge of VCAI was 50.97±19.20. There were 442 qualified nurses （30.9%），169 good nurses（11.8%），and 50 excellent nurses（3.5%）. Multiple linear regression analysis showed that the main influencing factors of clinical nurses’ knowledge score on VCAI were age，hospital grade，job post，educational background，and whether or not they were intravenous therapy specialist nurses（P<0.05）. Conclusion Nurses in county-level and prefecture-level hospitals who participated in the survey had a lower knowledge of VCAI than nurses in provincial or minister-level hospitals. Nursing managers should conduct homogenized training on VCAI knowledge for nurses in county-level and prefecture-level hospitals，so as to change the prevention and treatment behavior of nurses in county-level and prefecture-level hospitals，and reduce the incidence of VCAI.

Intractable Diseases Care

Nursing care of a patient with infection of hypervirulent Klebsiella pneumoniae：a case report

ZHAO Qiaomei, HUANG Bingying, XU Hongxia, CAI Lingyun, ZHOU Donger, ZHU Huanbing, DING Chao

2024, 59(5):  601-605.  DOI: 10.3761/j.issn.0254-1769.2024.05.013

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To summarize the nursing of a diabetic patient with gas-forming retroperitoneal abscess and invasive hypervirulent Klebsiella pneumoniae syndrome. Key points of nursing：rescue of ketoacidosis complicated with septic shock；observation and nursing of gas-forming retroperitoneal abscess；nursing of subcutaneous emphysema and cellulitis；stepwise nutritional support and blood glucose management；rehabilitation nursing of ICU-acquired weakness；precaution against pulmonary embolism. After treatment and nursing，the patient’s condition improved after 68 days of hospitalization，and was transferred to a rehabilitation hospital. The patient was reexamined and recovered well 1 month after discharge.

Perinatal care of a case of Klippel-Trenaunay syndrome complicated with intrahepatic cholestasis of pregnancy

CHEN Jianhong, ZHANG Yan, ZHANG Lili, YE Juan

2024, 59(5):  606-609.  DOI: 10.3761/j.issn.0254-1769.2024.05.014

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To summarize the perinatal nursing of a case of Klippel-Trenaunay syndrome complicated with intrahepatic cholestasis of pregnancy. The key points of nursing include personalized prenatal guidance and emergency cesarean section for fetal distress；maintaining intraoperative fluid balance during delivery and assisting in rescuing newborns with asphyxia；postpartum maintenance of dynamic balance of bleeding and thrombosis，and separation of mother and infant care. After careful perinatal treatment and nursing，the mother and baby were discharged from the hospital in a stable condition. The prognosis of the mother and baby was good after 1 month follow-up after discharge.

Evidence Synthesis Research

Best evidence summary of non-pharmacological interventions in post-burn itch

YAN Xueqin, BAI Suping, LIU Qiaoyan, ZHOU Fangfang, YAN Lei, CAO Yun, BAO Lei, GAO Ting, ZHU Mengxue

2024, 59(5):  610-617.  DOI: 10.3761/j.issn.0254-1769.2024.05.015

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Objective To retrieve，evaluate and summarize the best evidence of non-pharmacological interventions for post-burn itch. Methods All evidence on non-pharmacological interventions in post-burn itch was retrieved from databases and websites including UpToDate，BMJ Best Practice，JBI，NICE，RNAO，GIN，Yimaitong，Cochrane Library，PubMed，CNKI，Wanfang，ISBI，EBA，ABA，Wounds International and Chinese Burn Association. The retrieved evidence included clinical decisions，guidelines，evidence summaries，systematic reviews，expert consensuses. The retrieval period was from the establishment of the databases to December 1，2022. The guideline literature was evaluated by 4 researchers，and the other literature was evaluated by 2 researchers of the project，and the literature content was extracted and summarized according to the topic. Results A total of 10 pieces of literature were included，including 4 clinical decisions，3 guidelines，3 evidence summaries. A total of 22 pieces of best evidence were summarized in 7 aspects，including assessment，moisturizing，massage，pressure therapy，skin cooling，other interventions and health education. Conclusion This study summarized the best evidence of non-pharmacological interventions in PBI，providing evidence-based basis for clinical application. Medical staff can follow the clinical context，wound healing situation and patients’ wishes，rationally apply the evidence，formulate intervention plans，reduce the itching symptoms of patients，and improve the quality of nursing.

Meta-integration of qualitative research on couple intimacy in breast cancer patients

GAO Wenjuan, ZHANG Qian, HAN Jing

2024, 59(5):  618-625.  DOI: 10.3761/j.issn.0254-1769.2024.05.016

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Objective Systematic integration of qualitative research on couple intimacy in breast cancer patients was conducted to provide a foundation for psychosocial interventions involving breast cancer patients and their spouses. Methods For the qualitative studies of couple intimacy in breast cancer patients，a computer search was carried out on PubMed，Web of Science，CINHAL，Embase，the Cochrane Library，Joanna Briggs Institute（JBI），CNKI，Wanfang Database，VIP Database，and CBM. The retrieval time was from the establishment of the databases to October 2022. The quality of the literature was evaluated by the 2017 JBI Evidence-Based Health Care Center Quality Evaluation Criteria，and the results were integrated using the convergent integration method. Results 13 studies were included，and 55 results were extracted into 14 categories. 3 outcomes were combined，including conflict and harmed intimacy，modified and adjusted intimacy，and balanced and sublimated intimacy. Conclusion Patients who have breast cancer may experience numerous changes in their intimate relationships. Medical professionals should promptly understand the emotions of breast cancer patients and their spouses. Then，they should make targeted，effective interventions and support to encourage the growth of stable intimacy，which will help the couple cope with cancer better.

Review

A scoping review of kinesiophobia research in elderly orthopedic postoperative patients

XU Rongjing, HE Xuyan, JIA Shoumei

2024, 59(5):  626-633.  DOI: 10.3761/j.issn.0254-1769.2024.05.017

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Objective This review aims to examine the literature on postoperative exercise-related fear in geriatric orthopedic patients，elucidating current trends，risk factors，adverse effect，evaluative instruments and interventions to aid their rehabilitation. Methods Employing the scoping review framework of Arksey and O’Malley，a systematic electronic search was performed across databases including CNKI，Wanfang Database，China Biomedical Literature Database，Web of Science，PubMed，CINAHL，and the Cochrane Library of Evidence-Based Medicine，up to June 17，2023. Literature screening，summarization，and analysis were collaboratively conducted by 2 researchers. Results Finally，19 relevant publications were included. Evidence indicates a prevalence of exercise-related fear after orthopedic surgery in the elderly ranging from 27.27% to 67.98%，contributing to significant negative health outcomes. 2 assessment tools were identified，including Tampa Scale for Kinesiophobia（TSK-17）（the most commonly used） and Tampa Scale for Kinesiophobia（TSK-11）. Key determinants of exercise fear encompass demographic elements，sleep quality，socio-psychological aspects，pain intensity，and exercise self-efficacy. Interventions currently included cognitive-behavioral therapy，functional exercise，health education，and multifaceted intervention strategies. Conclusion The high incidence of postoperative exercise-related fear in the geriatric orthopedic cohort is influenced by various factors，and it is necessary to promote the development of culturally adapted evaluative tools. Immediate identification and intervention for this fear in such patients are crucial. To date，cognitive-behavioral therapy is the predominant intervention，typically administered in hospital settings. Future strategies should extend to home and community environments，embrace longitudinal studies，and integrate digital technology for comprehensive management.

Research progress of presenteeism behavior in nurses

WANG Siqi, FAN Ling

2024, 59(5):  634-640.  DOI: 10.3761/j.issn.0254-1769.2024.05.018

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Presenteeism behavior occurs frequently in nursing groups with a wide and negative impact on nurses，patients and organizations. This paper reviews the concept，current situation，theoretical models，measurement tools and influencing factors of presenteeism behavior of nurses，and on the basis of this，further explores interventions to reduce nurses’ presenteeism behavior，in order to attract the attention of nursing managers to presenteeism behavior for nurses and to provide a reference basis for the research on presenteeism behavior of nurses in China.