Table of Content

10 April 2024, Volume 59 Issue 7

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Research Paper

Construction and application of a graded exercise rehabilitation program for patients with acute exacerbation of chronic obstructive pulmonary disease

YANG Nana, ZENG Hui, FU Dandan, WANG Yan, CHENG Chuanli, LIU Rong, LUO Luwen

2024, 59(7):  773-780.  DOI: 10.3761/j.issn.0254-1769.2024.07.001

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Objective To construct and preliminarily apply a graded exercise rehabilitation program for patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD），and to provide a theoretical basis for the scientific implementation of exercise rehabilitation by medical staff. Methods Based on Triangle model and evidence-based method，the first draft of the graded exercise rehabilitation program was constructed，and the items were revised through 2 rounds of expert consultations from March to October，2023. The graded exercise rehabilitation program was preliminarily applied in 10 patients with AECOPD. Results The effective recovery rates of the 2 rounds of expert consultation questionnaires were 100%；the expert authority coefficients were 0.857 and 0.863；the coefficients of variation were 0-0.285 and 0.052-0.244；the Kendall’s harmony coefficients were 0.167 and 0.145，respectively（all P<0.001）. The final plan includes 4 first-level indicators，13 second-level indicators，and 25 third-level indicators. The scores of 6 min walking test，mMRC and CAT after exercise were improved compared with those before exercise，and the differences were statistically significant（all P<0.05）. Conclusion The graded exercise rehabilitation program for patients with AECOPD constructed in this study has good scientificity and practicability，which can provide references for clinical implementation of exercise rehabilitation.

Evidence-based practice for the prevention and care of ocular complications in ICU patients

WANG Lizhu, CHEN Yuaner, LI Qian, HU Yaling, LU Haifei, XIANG Yan, WANG Ziwei, QI Xuefeng

2024, 59(7):  781-788.  DOI: 10.3761/j.issn.0254-1769.2024.07.002

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Objective To develop an evidence-based practice program for ICU eye care and evaluate its application effect using Stetler model of research utilization. Methods The systematic search was carried out in domestic and foreign guidelines，systematic reviews，evidence summaries，expert consensuses on eye care for ICU patients. The quality of the included literature was evaluated and the evidence was summarized. The evidence based on expert advice，clinical context and stakeholder opinions was screened. According to Stetler model of research utilization，the evidence translation/application was formulated from 3 aspects，including method，level and type of evidence application，and the evidence translation was implemented using a stepwise trial design. Five ICUs in a tertiary hospital in Zhejiang Province were selected，and the order of enrollment of each ICU was determined by computer-generated random numbers from April to september，2022. In the first month，all ICUs were in pre-evidence-based practice period，and in the second month，an ICU was trained and entered the evidence-based practice period. Until the 6th month，all ICUs entered the evidence-based practice period. Then the rate of ocular symptoms and implementation rate of eye care measures were compared before and after EBP. Results A total of 1 540 patients were included. With regard to the implementation rate of eye care measures，the rate of lubricant use and suspected ocular infection management in patients at high risk for ocular complications in evidence-based practice period was significantly higher compared with pre-evidence-based practice period（P<0.001），and no statistically significant difference was found in the rate of eyelid closure. The incidence of conjunctival exposure，subconjunctival hemorrhage，conjunctival congestion，and ocular discharge in non-neurology critical care patients decreased compared with pre-evidence-based practice period（P<0.05），and the incidence of conjunctival edema and conjunctival congestion in NICU patients decreased compared with pre-evidence-based practice period as the intervention continued（P<0.001）. Conclusion Evidence-based practice in eye care for ICU patients using Stetler model of research utilization can standardize the practice of eye care for ICU patients and improve the quality of care.

Special Planning——Promotion and Application of Traditional Chinese Medicine Nursing

Research on the application of Traditional Chinese Medicine’s five-element music therapy in patients with autoimmune liver disease of liver depression and spleen deficiency type

WANG Xuan, HU Jingxian, HAN Shuyu, WANG Ying, WU Xuan, ZHAO Yanchao, LIU Xuejiao

2024, 59(7):  789-795.  DOI: 10.3761/j.issn.0254-1769.2024.07.003

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Objective To explore the effect of Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional counseling intervention in patients with autoimmune liver disease of liver depression and spleen deficiency type. Methods 74 patients with autoimmune liver disease of liver depression and spleen deficiency type who were admitted to the hepatology department of a tertiary hospital from January 2021 to February 2022 were selected as research subjects，and they were divided into an experimental group and a control group by a random number table with 37 cases in each group. The control group was given routine treatment and nursing care，as well as Traditional Chinese Medicine’s emotional nursing. The experimental group received Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional counseling intervention on the basis of routine treatment and nursing care，with an intervention period of 4 weeks. The Generalized Anxiety Disorder Scale （GAD-7），Patient Health Questionnaire Depression Scale （PHQ-9） and Pittsburgh Sleep Quality Index（PSQI） were used to evaluate patients within 24 hours after admission and after 4 weeks of intervention. Results A total of 72 patients completed the study，with 36 in the experimental group and 36 in the control group. Before and after intervention，the scores of GAD-7，PHQ-9，and PSQI in the experimental group were compared，and the differences were statistically significant （P<0.001）. After the intervention，the GAD-7 score in the experimental group was （7.89±3.15），which was lower than （10.14±4.41） in the control group. The PHQ-9 score was （12.33±4.08） in the experimental group，which was lower than （14.64±5.34） in the control group. The PSQI score was （12.39±3.06） points，which was lower than （14.22±3.37） in the control group，and the differences were statistically significant （P<0.05）. Conclusion The application of Traditional Chinese Medicine’s five-element music therapy combined with individualized emotional guidance intervention can effectively improve the sleep quality and help alleviate negative emotions in patients with liver depression and spleen deficiency type of autoimmune liver disease.

Current situation and strategies for improving Traditional Chinese Medicine health education among hemodialysis patients in 7 tertiary TCM hospitals

WANG Chenglong, JIN Ningning, PEI Lisong, TIAN Yuan, WANG Liwei, ZHANG Yi, LI Qingping, ZHANG Cuiqing, WANG Caihong, HAN Yang, GUO Julan, LIU Xiangdi

2024, 59(7):  796-801.  DOI: 10.3761/j.issn.0254-1769.2024.07.004

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Objective To understand the proficiency level and sources of Traditional Chinese Medicine（TCM） health education among hemodialysis patients，in order to provide the basis for promoting the application of TCM nursing in hemodialysis patients. Methods Utilizing a convenience sampling approach，we conducted a survey from April to May 2023 involving hemodialysis patients from 7 tertiary TCM hospitals across Beijing，Hebei Province，Sichuan Province，and other regions. Custom-made questionnaires were utilized，gathering general information，responses concerning the level of mastery on TCM health education，and their primary sources of such knowledge. Results A total of 413 questionnaires were disseminated，and 392 proved valid，yielding a valid response rate of 94.92%. The score of patient’s knowledge on TCM health education averaged（8.25±3.73），and an average score rate of 48.53% was obtained. In the patients undergoing hemodialysis，a relatively larger number of people possess knowledge of TCM health knowledge about relieving symptoms（50.8%~55.9%） and traditional Chinese daily life routines（56.4%~90.1%）. However，fewer people are aware of how to use the five-tone therapy method for emotional inter-vention （40.8%） and principle of taking restorative Traditional Chinese Medicine （24.5%~36.7%），the dietary prin-ciples of “nurturing yang in spring and summer, and nurturing yin in autumn and winter” （14.3%），and theories of TCM kidney functions （9.9%）. Approximately 23.0% of the patients sourced their TCM health education knowledge from new media platforms. Compared with new media method alone，patients who utilized only traditional educational platforms（P=0.020），and those who combined both new media and traditional methods（P=0.018） demonstrated higher proficiency in TCM health education. Conclusion Hemodialysis caregivers are urged to develop a TCM health education framework that emphasizes emotional well-being and traditional wellness concepts，thereby fostering patient-centric TCM health ideologies. Hemodialysis education personnel are encouraged to leverage new media whilst ensuring education quality and effective outcomes.

Development and reliability and validity test of patient admission nursing assessment sheet of integrated Chinese and western medicine ward

ZHOU Fanhua, GAN Lin, MEI Yanli, DU Fen, YAN Ye, XIONG Lijuan

2024, 59(7):  802-807.  DOI: 10.3761/j.issn.0254-1769.2024.07.005

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Objective To design and test the reliability and validity of patient admission nursing assessment sheet of integrated Chinese and western medicine ward. Methods On the basis of literature research，with traditional Chinese medicine "look，hear，ask and pulse-taking" as the basic framework，physical discrimination as the evaluation outcome，combined with the general nursing evaluation points of patients admitted to hospital，we designed the patient admission nursing assessment sheet of integrated Chinese and western medicine ward，and then we adopted the Delphi method to conduct an inquiry on the draft of the admission sheet. In April 2022，3 clinical nurses were selected to evaluate 160 admitted patients from Integrated Traditional Chinese and Western Medicine Department of a tertiary A comprehensive hospital in Hubei Province，and Fleiss’ Kappa coefficient and content validity coefficient were used to test the reliability and validity. Results The recovery rates of the 2 rounds of expert correspondence questionnaires were 95.45% and 100%. The authority coefficients were 0.931 and 0.957；the Kendall harmony coefficients were 0.101 and 0.106（P<0.01）；the importance scores of articles were 4.13~4.82；the coefficient of variation was 0.07~0.19 in 2nd round of expert correspondence. The final nursing assessment list for inpatients in the integrated Chinese and Western medicine ward included 3 parts：general demographic data assessment，four-Chinese medicine diagnosis assessment/physical discrimination，and nursing risk assessment，and there are 32 evaluation contents in the assessment sheet. The Fleiss’ Kappa coefficient of this assessment sheet was 0.602（P<0.001）；the item content validity index was 0.857~1.000，and the overall content validity index was 0.920. Conclusion The admission nursing assessment sheet for inpatients in integrated Chinese and Western medicine wards has good reliability and validity，and it is suitable for the integrated Chinese and Western medicine wards.

Integrative nursing experience of a case with chronic refractory wound formation caused by drug extravasation

ZHANG Yuanyuan, LONG Xiuhong, LÜ Chan, LI Xian, WANG Yi, HUANG Lanying, TU Huiqiong, QIN Huijuan

2024, 59(7):  808-811.  DOI: 10.3761/j.issn.0254-1769.2024.07.006

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To sum up integrative nursing experience of a case with chronic refractory wound formation caused by drug extravasation. The essentials of integrative nursing are：structured nursing intervention of “assessment-management-treatment” based on the Triangle of Wound Assessment；determination of the timing for integrative nursing according to the theory of TCM sores and ulcers；implementation of copper board scraping method to promote circulation of qi and blood；use of Huo-long Comprehensive Moxibustion Therapy to promote muscle regeneration. With the help of the cooperation of the multidisciplinary specialist nursing team，the wound was completely healed after 59 days of integrated traditional Chinese and Western medicine nursing interventions.

Evidence summary of Traditional Chinese Medicine rehabilitation nursing during recovery in patients with stroke limb dysfunction

HUANG Yimin, HUANG Lijun, WENG Danting, ZHUANG Ping, TAN Yibing

2024, 59(7):  812-819.  DOI: 10.3761/j.issn.0254-1769.2024.07.007

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Objective To search and integrate relevant evidence of Traditional Chinese Medicine rehabilitation care during recovery of stroke patients with limb dysfunction，and to provide the evidence for clinical practice. Methods We systematically search domestic and foreign guideline websites，professional association websites，and databases such as Cochrane Library，PubMed，Embase，CNKI，CBM for evidence on Chinese medicine rehabilitation care for limb dysfunction following stroke. The search included guidelines，clinical decisions，evidence summaries，systematic reviews，expert consensuses，and randomized controlled trials，with the search timeframe spanning from the inception of the respective databases to May 2023. The literature was evaluated and rated for quality by 2 researchers independently. Results A total of 17 articles，including 7 guidelines，4 systematic reviews，1 evidence summary and 5 randomized controlled trials were included to summarize 28 pieces of evidence on Traditional Chinese Medicine rehabilitation care for stroke patients with limb dysfunction. The evidence can be categorized into 4 areas，including evaluation，Traditional Chinese Medicine nursing technology，health education and precautions. Conclusion Traditional Chinese Medicine nursing technology for stroke patients with limb dysfunction have various forms and rich contents. Appropriate Traditional Chinese Medicine nursing techniques should be selected according to the actual situation and the willingness of patients to promote the rehabilitation of their limb functions.

Specialist Practice and Research

Construction and validation of a postoperative lung infection prevention care program for lung cancer patients

ZHENG Pingting, JI Chaona, WANG Yiru, CHEN Xisui

2024, 59(7):  820-827.  DOI: 10.3761/j.issn.0254-1769.2024.07.008

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Objective To construct a postoperative lung infection preventive care program for lung cancer patients and carry out preliminary validation，so as to provide a reference basis that can be used in clinical practice. Methods Literature analysis was carried out to search domestic and international databases，guideline networks，and association websites，with a search timeframe of January 2011 to December 2021，to obtain relevant evidence，to construct a preliminary draft of a preventive care program for postoperative lung infections in patients with lung cancer，and to use the Delphi method of correspondence with experts from Guangdong Province，Henan Province，and Sichuan Province，September-December 2022，to determine the content of the program. Correspondence to determine the content of the program. In November-December 2023，15 thoracic surgery nurses and 15 lung cancer patients in a tertiary hospital in Shantou City were selected for the initial application of the program and evaluated the effectiveness of the program through the nurses’ clinical significance，applicability，feasibility，and patient satisfaction. Results A total of 21 experts completed 2 rounds of correspondence. 95.65% and 95.45% of questionnaires were returned in the 2 rounds of correspondence；the authority coefficients of the experts were 0.941 and 0.948；the Kendall’s harmony coefficients were 0.176 and 0.310；the coefficients of variation for each item in the 2nd round of correspondence were 0.04~0.25. The final draft of the program included 10 aspects and 37 measures，such as teamwork，health education，risk assessment，rehabilitation training，fluid management，oral manage-ment，airway management，nutritional management，pain management，line management，and other 10 areas with 37 measures. After the initial application of the program，100% of the nurses thought that the program was meaningful，87% of the nurses thought that the program was clinically applicable and feasible，and 100% of the patients indicated that they were satisfied with the program，of which 80% were very satisfied. Conclusion The constructed nursing program for preventing postoperative lung infection in lung cancer patients is scientific，relevant and feasible，and can provide references for clinical health care personnel to develop measures for preventing postoperative lung infection in lung cancer patients.

A network analysis and nursing implications of core symptoms and symptom clusters in head and neck cancer patients

LIU Meizi, AN Ran, WU Zitong, GAO Fei, CHEN Wenfeng

2024, 59(7):  828-834.  DOI: 10.3761/j.issn.0254-1769.2024.07.009

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Objective To investigate the prevalence and severity of symptoms and to construct symptom networks in head and neck cancer patients during treatment to identify core symptoms and symptom clusters. Methods 366 patients who were hospitalized in 3 tertiary hospitals in Changsha were selected using convenience sampling from March to October 2022 and asked to complete the M.D. Anderson Symptom Inventory-Head & Neck. Exploratory factors analysis was used to extract the symptom clusters，and R packages were used to construct the symptom severity network and symptom clusters network. The centrality indexes of the networks，including strength，closeness，and betweenness，were analyzed to identify core symptoms and core symptom cluster. Results The most common symptoms in head and neck cancer patients during treatment were dry mouth （93.44%），fatigue（89.07%），loss of appetite（86.34%），and difficulty swallowing or chewing（85.79%），and the most severe symptoms were dry mouth，loss of appetite，oral or pharyngeal mucus，and difficulty swallowing or chewing. 4 symptom clusters were extracted，namely oral-pharyngeal，gastrointestinal，emotional-sleep，and sickness-sensing behavioral，which could explain 67.415% of the total variance. In the symptom severity network，oral or pharyngeal mucus（r_s=9.60） was a symptom with the highest strength. In the symptom clusters network，oral or pharyngeal mucus（r_s=1.20），nausea（r_s=1.00），fatigue（r_s=1.10），and drowsiness（r_s=0.97） were the symptoms with the highest strength across 4 symptom clusters. Conclusion Oral or pharyngeal mucus，nausea，fatigue，and drowsiness are the core symptoms of symptom clusters in head and neck cancer patients during treatment. Oral-pharyngeal symptom cluster is the core symptom cluster. It is recommended that clinical staff should develop interventions based on the core symptoms and symptom cluster to implement precise symptom management and improve symptom management efficiency.

Enteral and Parenteral Nutrition

Development of a Nursing Knowledge-Attitude-Practice Assessment Questionnaire for the Investigation of Enteral Nutrition Refeeding Syndrome and the test of its reliability and validity

WU Taiqin, GAN Xiuni, GAO Yan, ZHOU Wen

2024, 59(7):  835-841.  DOI: 10.3761/j.issn.0254-1769.2024.07.010

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Objective To develop a Nursing Knowledge-Attitude-Practice Assessment Questionnaire for the Investigation of Enteral Nutrition Refeeding Syndrome and to test its reliability and validity. Methods Based on the theory of knowledge-attitude-practice，an initial questionnaire was developed through literature review，Delphi and pre-survey. 350 ICU nurses from 2 tertiary A hospitals in Chongqing were investigated for item analysis，reliability analysis and exploratory factor analysis in August 2023；another 546 ICU nurses were selected for confirmatory factor analysis from 5 tertiary A hospitals. Results The final questionnaire included 3 dimensions and 45 items. The total Cronbach’s α coefficient，split-half reliability，test-retest reliability and the questionnaire level content validity index were 0.970，0.878，0.873，and 0.940，respectively. Exploratory factor analysis extracted 3 common factors；the factor load of each item ranged from 0.535 to 0.878；the cumulative variance contribution rate was 68.683%. Confirmatory factor analysis showed that the model fit well and the questionnaire’s factor structure was stable. Conclusion The Nursing Knowledge-Attitude-Practice Assessment Questionnaire for the Investigation of Enteral Nutrition Refeeding Syndrome has good reliability and validity，which can be used as a survey tool to evaluate enteral nutrition refeeding syndrome cognitive level of ICU nurses.

Nursing Management

Construction and practice of multilevel and inter-disciplinary management scheme for specialist nurses

HUO Xiaopeng, ZHANG Hongmei, LAI Xiaoxing, ZHENG Danping, YE Yawen, ZHANG Xinyue, ZHAO Yafang, WU Xinjuan

2024, 59(7):  842-847.  DOI: 10.3761/j.issn.0254-1769.2024.07.011

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Objectives To explore the establishment and effects of a multilevel and inter-disciplinary management scheme for specialist nurses. Methods The multilevel and inter-disciplinary management scheme included establishing the pyramid hierarchical training model，exploring superimposed training mechanism for specialist nurses with horizontal expansion，vertical extension，and deep development，and constructing stereoscopic clinical evaluation and quantitative assessment system. Four hundred-forty two specialized nurses have been recruited to join the multilevel and inter-disciplinary management scheme from July 2021 to August 2023. The core competencies of specialized nurses were compared before and after the implementation of management scheme. Results The quality development of specialized nursing have been improved，and the total scores and the scores of 3 dimensions （research innovation，management，and professional development） in core competencies of specialized nurses after the intervention of multilevel and inter-disciplinary management scheme were higher than those before（P<0.05）. Conclusion The multilevel and inter-disciplinary management scheme can effectively improve the core competencies of specialized nurses，and promote the high-quality development of specialized nursing.

The current status and influencing factors of thriving at work among junior nurses

DUAN Siyu, HOU Ming, DING Min, SUN Yao, LI Ping

2024, 59(7):  848-853.  DOI: 10.3761/j.issn.0254-1769.2024.07.012

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Objective To investigate the status of thriving at work among junior nurses，and to analyze the influencing factors，so as to provide theoretical bases for promoting the job growth of junior nurses and improving the level of thriving at work. Methods From January to March 2023，431 junior nurses from 3 tertiary hospitals in Xinjiang Uygur Autonomous Region were selected as the research subjects. Questionnaire survey were conducted through the General Information Questionnaire，the Thriving at Work Scale，and the Job Crafting Scale. The univariate analysis and multiple linear regression were used to analyze the influencing factors of thriving at work among junior nurses. Results A total of 431 nurses with low seniority completed the survey.The total score of thriving at work is（35.46±6.74） score. Multiple linear regression analysis showed that age，education level and job remodeling score were the factors affecting the job prosperity of junior nurses（P<0.05）. Conclusion The thriving at work of junior nurses was at a moderate level. Nursing managers should strengthen the benign guidance of junior nurses，provide sufficient resource support，improve the level of job remodeling to promote the thriving at work of junior nurses and maintain the stability of organizational development.

Intractable Diseases Care

Nursing care of a case of Sheehan syndrome with infection and combined with diabetic ketoacidosis

ZENG Lirong, ZHANG Xing, CHEN Haoying

2024, 59(7):  854-858.  DOI: 10.3761/j.issn.0254-1769.2024.07.013

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The nursing care of a case of Sheehan syndrome with infection and combined with diabetic ketoacidosis was summarized. To improve prognosis of the disease and guarantee patient’s safety，key points of nursing care are as following：sufficient early liquid resuscitation and target-oriented management of blood glucose to correct internal environment disorder；dynamic monitoring of condition，implementing hormone replacement therapy by stages to prevent pituitary crises；to measure the mental state and implement cluster intervention measures to prevent infection worsening；regular follow-up and disease education to improve patients’ disease self-management ability. After positive treatment and careful nursing care，no serious complications occurred，blood glucose was controlled well，and the case was in stable conditions and was discharged.

Rescue and nursing care of a neonate with severe laryngomalacia complicated with breath-holding attack

CUI Shangqing, GUO Hongqing, WU Jinhua, HUO Qiugui

2024, 59(7):  859-864.  DOI: 10.3761/j.issn.0254-1769.2024.07.014

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To summarize the rescue and care of a case of breath-holding attack caused by congenital contractures of limbs and face，hypotonia，and developmental delay（CLIFAHDD） syndrome. Key points of nursing：early identification and intervention of breath-holding attack in CLIFAHDD syndrome，and implementation of rapid reactive rescue；implementing individualized developmental care measures to avoid stimuli that induce breath-holding attack；paying attention to the assessment of oral feeding ability，strengthening the exercise of oral feeding ability and nutrition management；strengthening perioperative diversified airway management to prevent postoperative complications；the monitoring of early neurological and motor system development，and early start of rehabilitation care；doing a good job in health education for caregivers to help them master the first aid treatment and growth and development assessment methods in the event of a breath-holding attack. After 53 days of hospitalization，the patient was discharged. After being discharged from the hospital for more than 1 month，the patient had breath-holding attack 2~4 times a day. After being discharged from the hospital for more than 2 months，the patient had no breath-holding attack，and only had occasional convulsive seizures during sleep，which could be relieved spontaneously.

Evidence Synthesis Research

Meta-synthesis of qualitative research on the experience of self-management behavior changes for cancer patients

LIN Wenwen, XU Mei, XIA Yun, JIANG Ning, MO Yuwei, WANG Li, NING Li

2024, 59(7):  865-872.  DOI: 10.3761/j.issn.0254-1769.2024.07.015

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Objective To systematically evaluate the self-management behavior transformation experience of cancer patients，providing a basis for the subsequent development of targeted self-management intervention measures. Methods Qualitative studies related to self-management behavior transformation experience of cancer patients from Cochrane Library，CINAHL，Embase，PubMed，Web of science，PsycINFO，and China National Knowledge Infras-tructure，VIP Database，Wanfang Database，and China Biomedical Literature Database were searched by computer，with a search deadline of July 2023. The literature quality evaluation was conducted using the qualitative research quality evaluation standards of the Evidence Based Health Care Center at the Joanna Briggs Institute in Australia，and the results were integrated using a pooled integration method. Results A total of 12 articles were included，and 50 research results were extracted and summarized into 14 new categories. 4 integrated results were synthesized，including the forms of self-management behavior transformation，the characteristics of self-management behavior transformation，the driving factors of self-management behavior transformation，and the obstacles to self-management behavior transformation. Conclusion Medical staff should pay attention to the real experience of cancer patients’ self-management behavior transformation. Targeted ability cultivation and psychological intervention can be carried out based on the characteristics and influencing factors of cancer patients’ self-management behavior transformation，promoting their smooth transformation of self-management behavior.

The illness experience and demands of patients with poststroke aphasia during rehabilitation：a qualitative meta-synthesis

WANG Huan, LI Shengjuan, LI Chen, HE Yuanyuan, XIE Yuyao, ZHENG Dongxiang

2024, 59(7):  873-881.  DOI: 10.3761/j.issn.0254-1769.2024.07.016

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Objective To systematically evaluate and integrate qualitative studies on the disease experience and demands of stroke aphasic patients during rehabilitation，and to provide references for the development of a rehabilitation care strategy oriented to the needs of poststroke aphasia patients. Methods Computer search of PubMed，Web of Science，Embase，Cochrane Library，CINAHL，China Knowledge Network，Wanfang database，and VIP Chinese biomedical journals was conducted for qualitative research on the illness experience and demands of poststroke aphasia patients during rehabilitation from the time of database construction to May 2023. The literature was evaluated using the Australian JBI Quality Evaluation Criteria for Qualitative Research in Evidence-based Health Care Centers （2016），and the results were consolidated using an aggregative integration approach. Results A total of 18 studies were included，and a total of 1 theoretical model and 70 themes were extracted and grouped to form 7 categories，which were combined into 3 integrated outcomes：poststroke aphasia is a traumatic life event；poststroke aphasia patients actively rebuild their lives；the demands of poststroke aphasia patients during rehabilitation. Conclusion Poststroke aphasia patients during rehabilitation face difficulties in life；medical professionals should stimulate patients’ positive feelings，strive to promote patients’ social integration and self-management，meet patients’ multidimensional and diverse rehabilitation demands，and ultimately construct personalized rehabilitation management programs oriented to patients’ demands with poststroke aphasia.

Review

A scoping review of virtual reality on the effects on patients of cancer-related cognitive impairment

YE Lei, XIA Guanghui, CHEN Fangmei, TIAN Yuyan, QI Wei

2024, 59(7):  882-889.  DOI: 10.3761/j.issn.0254-1769.2024.07.017

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Objective To conduct a scoping review of studies on the use of virtual reality（VR） in cancer-related cognitive impairment（CRCI），and to generalize and summarize the current state of the art of VR use in CRCI. Methods The computerized retrieval of PubMed，Embase，Web of Science，the Cochrane Library，WanFang Data，CNKI and VIP databases was carried out. Studies were collected from the database establishment to July 2023. 3 researchers independently screened the literature，extracted data，and evaluated the risk of bias in the included studies. Results A total of 9 studies were included. VR was used for CRCI assessment and intervention. The assessment included visual and auditory memory，executive function and verbal fluency. The intervention content involved common cognitive impairment dimensions of CRCI，including memory，executive ability，attention，information processing speed and language fluency. The intervention frequency ranged from 3 to 5 times/week，15 to 60 min/time，and the duration was 2 to 8 weeks. The intervention frequency and intensity were dynamically adjusted based on the patient performance，game type and complexity. VR has shown good validity and benefits in CRCI assessments and interventions，while improving patients’ sleep quality and ability to perform daily living，with higher patient acceptance and no VR related adverse events being reported，but its role in improving mental health remains controversial. Conclusion VR shows good validity and benefits in CRCI assessment and intervention，and has good safety and high acceptance. In the future，it is still necessary to conduct large-sample，randomized controlled studies，attach importance to the role of patient needs in the formulation of VR cognitive intervention programs，and increase CRCI-related objective indicators to further verify the effect of VR intervention on CRCI. At the same time，longitudinal evaluation and follow-up programs may be considered to determine progressive changes in CRCI from VR interventions

Research progress on rehabilitation motivation assessment tools for stroke patients

XIONG Tao, TAN Xuemei, LUO Jing, LI Yang, ZHENG Yuxi, LI Fengling, WEI Xuemei, CUI Lijun, LUO Lanjun

2024, 59(7):  890-896.  DOI: 10.3761/j.issn.0254-1769.2024.07.018

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The rehabilitation compliance of stroke patients is generally low. Evaluating the rehabilitation motivation of patients is helpful to promote the rehabilitation management of patients，enhance the rehabilitation enthusiasm and compliance of patients，and improve the rehabilitation outcome. This paper reviews the existing stroke patients rehabilitation motivation assessment tools，and expounds the main contents，application status，characteristics and limitations of stroke patients rehabilitation motivation assessment tools，in order to provide references for the appropriate selection of clinical assessment tools，the rehabilitation management of stroke patients and the development of domestic localized stroke rehabilitation motivation assessment tools.