Table of Content

10 September 2024, Volume 59 Issue 17

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Special Planning—Pulmonary Rehabilitation Nursing

Construction and application of an advanced pulmonary rehabilitation programme for patients undergoing high-flow nasal cannula oxygen therapy

LÜ Dan, ZHAO Ying, HE Yan, LIU Qing, SONG Fujuan, LI Meng, ZHANG Xinyue, WANG Xiaoping

2024, 59(17):  2053-2061.  DOI: 10.3761/j.issn.0254-1769.2024.17.001

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Objective To explore the application effect of advanced lung rehabilitation programs in patients undergoing high flow nasal cannula oxygen therapy（HFNC）. Methods Convenience sampling method was used to select 40 HFNC patients admitted to the respiratory department，ICU，coronary heart disease monitoring unit，and other departments of a tertiary A comprehensive hospital in Tianjin from January to June 2023 as the experimental group，and 40 HFNC patients admitted from June to December 2022 as the control group. Both groups of patients received HFNC treatment during hospitalization and continued at home，while the experimental group adopts the information-motivation-behavioral skills（IMB） model as the theoretical basis，implements advanced pulmonary rehabilitation during the stable condition period，discharge preparation period，and home rehabilitation period，and implements compliance management of home pulmonary rehabilitation through cloud follow-up，and the control group received routine lung rehabilitation and home follow-up. The degree of respiratory distress，6-minute walking distance，exercise self-efficacy，quality of life were compared between the 2 groups before intervention，2 months and 6 months after intervention，and compliance with home pulmonary rehabilitation was compared between the 2 groups 6 months after intervention. Results The repeated measures analysis of variance showed that there was an interaction effect between time and the 2 groups in terms of difficulty in breathing，6-minute walking distance，exercise self-efficacy，and quality of life（P<0.05）. Simple effect analysis showed that after 2 and 6 months of intervention，the experimental group performed better than the control group in the respiratory distress，6-minute walking distance，exercise self-efficacy，and quality of life（P<0.05）. Within 6 months of intervention，the compliance of home pulmonary rehabilitation in the experimental group was better than that in the control group，and the difference was statistically significant （P<0.05）. Conclusion The application of advanced pulmonary rehabilitation programme based on IMB can improve respiratory symptoms and improve exercise self-efficacy and adherence to pulmonary rehabilitation，enhance activity endurance and improve quality of life.

Application of a pulmonary rehabilitation exercise program based on IMB model in patients with moderate to severe chronic obstructive pulmonary disease

ZHAO Lingyan, WANG Zhengyi, XU Shufen, DU Tiantian

2024, 59(17):  2062-2069.  DOI: 10.3761/j.issn.0254-1769.2024.17.002

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Objective To explore the application and effect of a pulmonary rehabilitation exercise program in patients with moderate to severe COPD based on the Information-Motivation-Behavior Skill（IMB） Model. Methods The convenience sampling method was adopted to select patients with moderate to severe COPD admitted to the department of respiratory and critical care medicine in a tertiary A hospital in Yantai City from October 2021 to February 2022. They were randomly divided into an intervention group（32 cases） and a control group（31 cases）. The intervention group was treated with the pulmonary rehabilitation exercise program based on the IMB model on the basis of routine nursing，while the control group was treated with routine nursing. The degree of dyspnea，exercise endurance，quality of life，pulmonary rehabilitation exercise compliance，self-management ability and lung function were compared between the 2 groups before and 6 months after the intervention. Results After intervention，the degree of dyspnea，exercise endurance，quality of life，pulmonary rehabilitation exercise compliance and self-management ability were significantly different between the 2 groups（P<0.05）. There was no statistically significant difference in lung function between the 2 groups after intervention（P>0.05）. Conclusion The pulmonary rehabilitation program based on IMB model can effectively alleviate the symptoms of dyspnea in patients with moderate to severe COPD，improve exercise endurance，improve pulmonary rehabilitation exercise compliance and self-management ability，and improve the patients’ quality of life.

Facilitators and barriers of home pulmonary rehabilitation for lung transplant recipients：a qualitative study

HU Shujing, SUN Jing, WANG Yi, GAO Bao, ZHU Hong, QI Xingyu

2024, 59(17):  2070-2076.  DOI: 10.3761/j.issn.0254-1769.2024.17.003

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Objective To explore the influencing factors of home pulmonary rehabilitation for lung transplant recipients，so as to provide a basis for the construction of targeted intervention for home rehabilitation. Methods From August to November 2023，the purposive sampling was used to select 20 cases of lung transplant recipients for semi-structured interviews. Data was analyzed by traditional content analysis method based on capability，opportunity，and motivation-behavior model. Results Facilitators of rehabilitation behavior included opportunity factors（rehabilitation management of transplant center，multiple social support），motivational factors（perceived benefits，high self-efficacy，strong motivation，strong sense of responsibility，and good exercise habits）. Barriers of rehabilitation behavior included ability factors（physical dysfunction，lack of knowledge），opportunity factors（poor rehabilitation environment，heavy economic burden），motivational factors（fear of exercise，uncomfortable activity experience，and lack of rehabilitation self-discipline）. Conclusion The influencing factors of home pulmonary rehabilitation in lung transplant recipients are complex. Medical staff should take targeted measures to promote home rehabilitation to improve the exercise ability，quality of life，and clinical outcomes.

The study of the current status and influencing factors of the long-term maintenance of home-based pulmonary rehabilitation among COPD patients

ZHANG Mingyue, TIAN Yumei, GAO E, WANG Jie, XING Chaoqun, WU Yue

2024, 59(17):  2077-2083.  DOI: 10.3761/j.issn.0254-1769.2024.17.004

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Objective To comprehend the present condition of sustaining within familial pulmonary rehabilitation for COPD patients，alongside exploring the factors that impact this continuity. Methods A convenience sampling method was used to select 392 COPD patients from outpatient clinics of 2 tertiary-level A hospitals and 1 community health service center in Huaihua in Hunan Province from December 2023 to February 2024 as survey respondents. Patients were surveyed using the general information questionnaire，the COPD Assessment Test，the Modified Medical Research Council Dyspnea Scale，the Exercise Benefits/Barriers Scale，and the Brief 2-Way Social Support Scale. Results We sent out 392 questionnaires and collected 362 valid ones，with an effective response rate of 92.47%. The percentage of COPD patients who never performed home pulmonary rehabilitation was 56.08%，and the maintenance time of health behaviors in home pulmonary rehabilitation was 17.40% for 1-3 months，7.18% for 4-6 months，4.70% for 7-12 months，and 14.64% for more than 1 year. The results of multiple linear regression analysis showed that exercise place，pulmonary rehabilitation health education，exercise habits before having COPD，perceived level of exercise behavior，and two-way social support were influential factors affecting the maintenance of health behaviors in pulmonary rehabilitation in the families of COPD patients，which explained 38.5% of the variability. Conclusion Patients with COPD have a low level of maintenance of health behaviors in home pulmonary rehabilitation，and health education on exercise rehabilitation for COPD patients and caregivers should be strengthened to enhance patients’ level of exercise perception and ability to utilize social support.

Analysis of distribution characteristics on exercise behavior stages and its predictive factors in patients with chronic obstructive pulmonary disease after discharge

TANG Huan, CHEN Guihua, LI Qin, ZHOU Xixin, WU Xiucen, SHEN Penghua

2024, 59(17):  2084-2092.  DOI: 10.3761/j.issn.0254-1769.2024.17.005

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Objective To understand the characteristics and the predictors of the distribution of exercise behavior stages in COPD patients after discharge from the hospital，and to provide a reference basis for the implementation of the whole process and continuous rehabilitation care decision-making. Methods Using the convenience sampling method，380 COPD patients who were hospitalized in the departments of respiratory medicine or geriatrics in 2 tertiary-level hospitals in Chongqing from February 2022 to February 2023 were selected for the study，and were followed up until 6 months after the patients were discharged from the hospital. Questionnaires were administered using the self-designed General and Disease-Related Information Questionnaire，Exercise Stages of Change Scale，Exercise Benefits and Barriers Scale，Exercise Self-Regulatory Efficacy Scale，Social Support Rate Scale and Hospital Anxiety and Depression Scale. Characteristics and predictors of exercise behavior in COPD patients after hospital discharge were analyzed using univariate analysis and ordered multicategorical logistic regression. Results The included 380 COPD patients of post-discharge exercise behavior were 53 cases（14.0%） in the pre-intentional stage，97 cases（25.5%） in the intentional stage，103 cases（27.1%） in the preparatory stage，75 cases（19.7%） in the action stage，and 52 cases（13.7%） in the maintenance stage. The age，monthly household income，daily chores，sleep，exercise habits，and history of the current inpatient rehabilitation，number of acute episodes in the last year，whether home oxygen therapy and regular use of medication for respiratory diseases，degree of dyspnea，perceived exercise benefit/impairment，social support，and depression were the main predictors of the distribution of the stages of exercise behavior in COPD patients after discharge from the hospital. Conclusion Most COPD patients did not develop regular exercise behavior habits after discharge，and the level of their exercise behavior was affected by a variety of factors，including individual characteristics，disease factors，decision-making balance，social support，and psychology，suggesting that healthcare professionals should develop personalized early exercise interventions according to the characteristics of the behavioral stage in which the patient is located in order to increase the long-term effects of the intervention.

Standards

Guideline for risk assessment and prevention of noninvasive ventilation related facial pressure injuries in adults

Gansu Provincial Nursing Association, School of Nursing, Lanzhou University, Gansu Provincial Hospital, Deyang People's Hospital of Sichuan Province （Writing Committee：HAN Lin, PEI Juhong, MA Yuxia, ZHANG Hongyan, LÜ Lin, TAO Hongxia, HE Lin, WEI Yuting, GUO Xiaojing）

2024, 59(17):  2093-2094.  DOI: 10.3761/j.issn.0254-1769.2024.17.006

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Objective To develop “guideline for risk assessment and prevention of noninvasive ventilation related facial pressure injuries in adults” and to provide a reference for clinical medical staff to evaluate and prevent noninvasive ventilation related facial pressure injuries. Methods Referring to the “WHO Guideline Development Manual”，clinical problems were formed through 3 rounds of Delphi expert consultation. The relevant recommendation opinions and evidence were screened，extracted，integrated and evaluated to form a draft consensus. Through a round of Delphi expert consultation and a round of expert consensus meeting，expert opinions were combined to modify and improve the content of each item to form a final draft of the expert consensus. Results Recommendations for the constructed guideline included 7 aspects of risk factors，high-risk sites，assessment tools，assessment timing and content，selection of non-invasive ventilation equipment，selection of dressings，and preventive measures，including 7 clinical questions and 15 recommendations. Conclusion The “guideline for risk assessment and prevention of noninvasive ventilation related facial pressure injuries in adults” was an evidence-based guideline based on the best evidence，Chinese clinical reality，and professional judgment，and it can provide practice bases for scientific clinical decisions making by clinical medical staff and managers.

Expert consensus on self-management of targeted drug-related skin adverse reactions in cancer patients

Chinese Nursing Association Oncology Nursing Committee, Shanghai Anti-Cancer Association Tumor Nursing Committee （Writing Committee：YANG Yang, ZHANG Xiaoju, LU Zhenqi, GUO Xiaolu）

2024, 59(17):  2095-2099.  DOI: 10.3761/j.issn.0254-1769.2024.17.007

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Objective The development of the expert consensus on self-management of skin adverse reactions in patients undergoing targeted cancer therapy（hereinafter referred to as “the consensus”） aims to enhance the effectiveness of self-management for skin-related adverse reactions in cancer patients receiving targeted therapy. It seeks to reduce the incidence of these reactions and alleviate their severity. Methods Utilizing evidence-based approaches，a systematic search was conducted across both domestic and international databases and relevant websites. This process included the evaluation and summarization of pertinent evidence to create a preliminary draft of the consensus. Through 2 rounds of Delphi expert inquiries and a round of expert panel discussion，the content was refined，leading to the final draft of the consensus. Results The consensus comprises 11 sections：gathering information before medication，identifying risk factors prior to medication，self-assessment and proactive reporting，skin cleansing，skin moisturizing，sun protection，makeup application，appropriate clothing，engaging in household activities，prophylactic medication，and common management techniques. Conclusion This consensus provides a valuable reference for clinical nurses to guide cancer patients in the self-management of skin adverse reactions associated with targeted drug therapy.

Specialist Nursing Practice and Research

Construction and validation of a prediction model of aspiration risk of acute poisoning patients during gastric lavage

ZHANG Shuoni, WANG Junjie, ZHANG Bo, LIU Xuelan

2024, 59(17):  2100-2107.  DOI: 10.3761/j.issn.0254-1769.2024.17.008

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Objective To analyze the influencing factors of aspiration risk in patients with acute poisoning during gastric lavage，and to build and validation a prediction model of aspiration risk in patients with acute poisoning during gastric lavage. Methods Through literature search and analysis，the risk factors of aspiration during gastric lavage was summarized in patients with acute poisoning. A retrospective study was conducted on patients with acute poisoning in the emergency department of a tertiary A general hospital in Ningbo from January 2020 to June 2023. Through R 4.2.1 and Python 3.11 programming language，the random forest，logistic regression，extreme gradient boosting tree and gradient boosting decision tree algorithms in machine learning were used to establish a prediction model of aspiration risk during gastric lavage in patients with acute poisoning and carry out internal verification. The prediction effects of the 4 prediction models were evaluated by confusion matrix，calibration curve，receiver operating characteristic curve，area under curve，Kolmogorov-Smirnov value，accuracy，precision，recall rate and F1 score，and the best model was selected. Results The modeling results of the 4 machine learning algorithms show that the area under the curve of the Random Forest，Logistic Regression，Extreme Gradient Boosting Tree，and Gradient Boosting Decision Tree algorithms are 0.954（0.934~0.974），0.878（0.843~0.913），0.910（0.880~0.939），and 0.917（0.889~0.945），respectively. The internal validation results show that the area under the curve of the random forest，logistic regression，extreme gradient boosting tree，and gradient boosting decision tree algorithms are 0.910（0.864~0.955），0.877（0.824~0.931），0.849（0.790~0.908），and 0.873（0.819~0.928），respectively. Age，state of consciousness，D-dimer and the time of absorption of poison are the 3 characteristics that are particularly prominent in the order of importance of the influencing factors of aspiration during gastric lavage in patients with acute poisoning. Conclusion Among the 4 prediction models，random forest model has better prediction effect，with good discrimination ability for the risk of aspiration during gastric lavage in patients with acute poisoning，and it is convenient for clinical use，which can provide references for medical staff to take preventive treatment and care.

Construction and validation of a predictive model for kinetophobia in patients after percutaneous coronary intervention

WANG Haizhen, ZHOU Lili, CHENG Pengfei, KE Sheng, SONG Yuan, WU Rui, FENG Xiuqin, JIN Jingfen

2024, 59(17):  2108-2115.  DOI: 10.3761/j.issn.0254-1769.2024.17.009

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Objective This study aims to develop and validate a dynamic web-based nomogram for predicting kinetophobia in patients following percutaneous coronary intervention（PCI）. Methods A prospective design was employed to selectively enroll 330 PCI patients admitted to a hospital in Hangzhou from December 2022 to July 2023. Single-factor analysis and Lasso regression were utilized to identify independent risk factors for kinesophobia post-PCI. Logistic regression was performed using R software，and a nomogram was constructed. The model was assessed through the area under the receiver operating characteristic curve（AUC） and Hosmer-Lemeshow tests. Results There were 206 cases of kinesiophobia in 330 patients after PCI，and the incidence was 62.4%. Logistic regression analysis identified combined heart failure，emergency surgery，NYHA cardiac function grade，ADL level，sedentary behavior，Chinese version of PROMIS Physical Function Summary Table score，and Chinese version of Perceptive Social Support Scale score as independent influencing factors for kinesophobia after PCI（P<0.05）. The AUC value of the model was 0.821，with a sensitivity of 70.4% and specificity of 82.0%. The Hosmer-Lemeshow fit test yielded a non-significant result（χ²=9.350，P=0.314）. Calibration and decision curves demonstrated the model’s favorable calibration and clinical practicability. The C-index of the nomogram prediction model was 0.778，0.774，and 0.800，respectively，by 5-fold cross-validation，10-fold cross-validation，and the Bootstrap method. Conclusion The dynamic nomogram model developed in this study effectively predicts kinesophobia in patients after PCI. It provides valuable references and support for clinical staff in early identification of high-risk patients，enabling the formulation of individualized health education strategies and exercise rehabilitation plans.

A study on dyadic relationship between benefit finding and positive psychological capital in stroke patients and their spouses

SUN Qianqian, MEI Yongxia, SONG Wangtao, HUANG Zhen, LIU Zhiwei, DUAN Bomei, ZHANG Zhenxiang

2024, 59(17):  2116-2122.  DOI: 10.3761/j.issn.0254-1769.2024.17.010

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Objective To investigate the level of benefit finding and positive psychological capital of stroke patients and their spouses，and to analyse the dyadic interaction between benefit finding and positive psychological capital of patients and their spouses. Methods From March to August 2023，235 stroke patients and their spouses were conveniently selected from the neurology wards of 3 tertiary hospitals in Henan Province，and were surveyed using a general information questionnaire，the positive psychological capital questionnaire，revised version of benefit finding scale，and caregiver benefit finding scale. Results The positive psychological capital scores of stroke patients and their spouses were （4.29±0.75） and（4.56±0.71）；benefit finding scores of the dyads were（2.85±0.69） and（3.64±0.68）. The results of actor-partner interdependence model showed that positive psychological capital of stroke patients and their spouses positively predicted their benefit finding；positive psychological capital of patients positively predicted benefit finding of spouses，and positive psychological capital of spouses positively predicted benefit finding of patients（all P<0.05）. In particular，spousal self-efficacy and resilience positively predicted their benefit finding；their optimism positively predicted the patient’s benefit finding；their hopefulness negatively predicted the patient’s benefit finding（all P<0.05）. Conclusion There was a dyadic interaction between benefit finding and positive psychological capital for stroke patients and their spouses. The role of spouses on patients’ positive psychological capital should not be overlooked，and nurses should develop positive psychological capital intervention strategies centered on couples of stroke patients to enhance positive couple experiences.

Enteral and Parenteral Nutrition

The application of nurse-performed point-of-care ultrasound in the management of abdominal distension in patients with enteral nutrition in ICU

NI Xiumei, HU Shaohua, HAN Jiangying, FU Hong, CAI Yuehong, ZHAO Lican, WANG Jihai, ZHAN Xuemei

2024, 59(17):  2123-2129.  DOI: 10.3761/j.issn.0254-1769.2024.17.011

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Objective To explore the application of nurse-performed point-of-care ultrasound in abdominal distension of ICU patients with enteral nutrition. Methods Purposive sampling method was used to select 108 patients with enteral nutrition abdominal distension admitted to the ICU of a tertiary A general hospital in Hefei City from January to December 2022，and they were divided into an experimental group and a control group according to random number table method. The experimental group used bedside ultrasound to evaluate the stomach，intestine and abdominal cavity of patients with abdominal distension，and implemented targeted treatment measures according to the evaluation results. The control group was given corresponding treatment measures according to the abdominal sight，touch，tapping，listening and traditional syringe withdrawal method. Intra-abdominal pressure，abdominal circumference，feeding compliance rate and feeding interruption rate，ICU stay time and mechanical ventilation time were compared at the 1st，3rd and 5th day. Results 11 cases dropped out of the study due to transfer，automatic discharge，death，etc.，and 97 cases were included 51 cases in the experimental group and 46 cases in the control group. Repeated measurement ANOVA showed that intra-abdominal pressure and abdominal circumference time in the 2 groups had interaction with each other（F=41.724，P<0.001；F=17.762，P<0.001）. Generalised estimating equations showed that there was only a between-group effect for the rates of feeding compliance and feeding disruption in 2 groups（Wald χ²=18.033，P<0.001；Wald χ²=6.567，P<0.001）. Simple effect analysis showed that on the 3rd and 5th day after intervention. The experimental group had lower abdominal depression and the feeding interruption rate was lower than the control group（P<0.05）. On the 5th day after interven-tion，the abdominal circumference of the experimental group was lower than that of the control group，the feeding compliance rate was higher than that of control group（P<0.05）. After intervention，in the experimental group，the mechanical ventilation time was shorter than that of the control group（P<0.05）. There was no significant difference in ICU stay time between the 2 groups（P=0.095）. Conclusion The application of nurse-performed point-of-care ultrasound in the management of abdominal distension in patients with enteral nutrition in ICU is feasible and scientific，which is helpful for the management of patients with enteral nutrition abdominal distension in ICU，reducing internal abdominal pressure，shortening mechanical ventilation time，and avoiding the occurrence of feeding intolerance.

Rare Disease and Critical Care

Nursing care of a patient with schizophrenia complicated by severe neurdeptics malignant syndrome

WENG Hui, GENG Feng, WANG Yanmei, LIN Tingrong, ZHANG Qin, ZHANG Miao

2024, 59(17):  2130-2133.  DOI: 10.3761/j.issn.0254-1769.2024.17.012

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To summarize the nursing experience of a patient with schizophrenia complicated by severe neurodeptic malignant syndrome. Nursing points include：to emphasize monitoring of antipsychotic medications to detect the onset of neurodeptic malignant syndrome as early as possible；to leverage the multidisciplinary team for rapid initiation of acute phase management interventions；to combine multimodal cooling to help rewarm the patient；to implement the stepwise intervention program to promote recovery of bowel function；to emphasize family supportive therapy to restore social functioning；to continue case management by developing a multidisciplinary follow-up plan. After careful management and care by the multidisciplinary team，the patient was successfully discharged from the hospital after a total stay of 47 days. After 3 months of follow-up，the patient’s daily life was basically back to normal.

Nursing care of a patient with right-to-left inverted lung transplantation

ZENG Fei, LAN Meijuan, LIANG Jiangshuyuan, GU Peipei

2024, 59(17):  2134-2137.  DOI: 10.3761/j.issn.0254-1769.2024.17.013

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The nursing experience of a patient with right-to-left inverted lung transplantation was summarized. The key points of nursing care：closely monitoring frequent arrhythmiac；developing excessive pulmonary rehabilitation strategies based on heart rate；being alert to carbon dioxide retention caused by pulmonary insufficiency；performing non-invasive ventilation combined with nitric oxide inhalation for pulmonary hypertension care；early identification and management of gastrointestinal dysfunction；and strengthening the prevention and management of complications. After fine care，the patient recovered well，and the transplanted lung function was normal，and he was discharged smoothly.

Evidence Synthesis Research

Best evidence summary for anticoagulation management in blood purification of perioperative liver transplantation patients

ZHAO Yangyang, PAN Wenyan, CHENG Lihong, ZHANG Qi, ZHANG Xiaoyun, ZHOU Zilin

2024, 59(17):  2138-2146.  DOI: 10.3761/j.issn.0254-1769.2024.17.014

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Objective To search and evaluate the relevant evidence of blood purification and anticoagulant management of perioperative liver transplantation patients，and to summarize the best evidence，so as to provide evidence-based evidence for clinical blood purification and anticoagulant management practice. Methods Evidence-based questions were determined. Systematic search was conducted on relevant domestic and foreign databases and websites for clinical decisions，guidelines，evidence summaries，system evaluations，and expert consensuses related to blood purification anticoagulation management. The retrieval period is from the establishment to May 2，2023. Literature screening，quality evaluation and evidence summary were conducted by 2 researchers. Results A total of 17 articles were included，including 2 clinical decisions，3 guidelines，2 evidence summaries，4 systematic evaluations and 6 expert consensuses. 24 pieces of best evidence were summarized from 6 dimensions，including coagulation function evaluation，anticoagulant strategy，mode selection，vascular access，standardized operation implementation points and personnel organization management. Conclusion The best evidence was summarized in the study on perioperative blood purification and anticoagulant management of liver transplantation，which can provide evidence-based basis for clinical medical staff to implement anticoagulant management. However，it is necessary to further carry out evidence-based practice of perioperative blood purification and anticoagulant management of liver transplantation to verify its anticoagulation effect and nursing safety in clinical practice.

Experiences of patients with hematologic neoplasm regarding T-cell immunotherapy：a meta-synthesis review and inspiration for nursing care

HUANG Ying, WANG Huafen, SHAO Lifang, ZHENG Li, SUN Danping, LOU Fangyuan, YAO Xiaofei

2024, 59(17):  2147-2155.  DOI: 10.3761/j.issn.0254-1769.2024.17.015

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Objective This study aims to systematically evaluate the experiences of patients with hematologic neoplasm undergoing chimeric antigen receptor T-cell（CAR-T） therapy and nursing care，and to provide a reference basis for healthcare providers to develop personalized intervention strategies. Methods PubMed，Web of Science，Embase，CINAHL，Cochrane Library，PsycINFO，Scopus，Australia Joanna Briggs Institute（JBI） EBP Database，China National Knowledge Infrastructure（CNKI），Wanfang Data，VIP Database，and China Biology Medicine（CBM） Database were systematically searched for qualitative studies on the experiences of patients with hematologic neoplasm undergoing CAR-T therapy and nursing care. The search period extended up to September 2023. The quality of the literature was reviewed according to the JBI Qualitative Assessment and Review Instrument，and a pooled analysis was applied to integrate the results. Results A total of 15 studies were included，generating 76 findings，which were then organized into 8 categories，resulting in 3 integrated findings.（1）Patients experienced conflicting emotions，with expectations often at odds with reality，leading to emotional fluctuations：expectations about treatment were entangled with concerns about risks；emotions fluctuated with expectations and actual experiences. （2）Patients experienced physical and social functional impairments，but as the disease eased，normal functioning recovered：rapid decline and improvement in physical functions；loss and recovery of social functions. （3）Patients desired access to professional guidance and psychosocial support. Conclusion Patients undergoing CAR-T therapy often contend with emotional conflicts. Changes in physical and social functions after the completion of treatment result in needs for seeking comprehensive medical and nursing support. It is recommended that healthcare providers conduct dynamic assessments and interventions regarding patients’ emotional states before treatment，focus on early identification and management of adverse reactions after treatment，and offer continuous nursing services after discharge to enhance patients’ confidence in participating in CAR-T therapy and improve their overall quality of life.

Review

Mobile health applications in secondary prevention of patients with coronary heart disease：a scoping review

ZHU Yining, ZHAO Yuhan, WU Ying

2024, 59(17):  2156-2165.  DOI: 10.3761/j.issn.0254-1769.2024.17.016

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Objective To identify the features and effects of mHealth App interventions，so as to provide guidance for future research. Methods A literature search was performed in the PubMed，Embase，Web of Science，CINAHL，Cochrane Library，CNKI，Wanfang，VIP，and CBM databases to identify relevant studies from the establishment of databases to April 2023. The included literature was summarized and analyzed. Results A total of 42 articles were included，involving 18 Chinese articles and 24 English ones. Functional features of the mHealth App include patient history and healthcare assessment，decision support for healthcare professionals，health education development and push；presentation features are personalization，visualization and gamification. The outcome indicators evaluation was mainly on mental health，multiple risk factor control，medication adherence，self-management，quality of life，and clinical outcomes. Conclusion Mobile health Apps have been effective in the application of secondary prevention of coronary heart disease，which can be better improved by combining WeChat groups and wearable devices and presenting them in a personalized and visual way. In the future，it is necessary to improve the function of the App and carry out studies with larger scale and long-term follow-up.

Virtual reality motor sensing exercise in the elderly patients with dementia：a scoping review

YANG Teng, LI Wen, LU Nan, YAN Luyao, LI Mengjie, GOU Xiaoyu, YANG Lijuan

2024, 59(17):  2166-2171.  DOI: 10.3761/j.issn.0254-1769.2024.17.017

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Objective To conduct a scoping review of virtual reality motor sensing exercise in the elderly with dementia，so as to identify the types of intervention，outcome indicators，evaluation tools and application effects of virtual reality motor sensing exercise and provide guidance for future research. Methods A literature search was performed in the PubMed，Embase，CINAHL，Web of Science，Cochrane Library，CNKI，Wanfang，VIP，and CMB databases to identify relevant studies. The search period is from the establishment of databases to October 15，2023. The included studies were summarized and analyzed. Results A total of 18 articles were included in this study，including 14 randomised controlled trials, one class-experimental study and three mixed studies involving a total of 1,054 elderly dementia patients. The types of virtual reality motor sensing exercise included motor sensing interactive games，interactive bicycle riding，remote game exercise，Wii Fit exercise and virtual reality environment exercise. The outcome indicators involve 4 aspects of physical indicators，psychological indicators，cognitive function and quality of life. Conclusion Virtual reality motor sensing exercise is feasible and effective in the elderly with dementia. However，large sample and high-quality randomized controlled trials are still needed in the future to verify the feasibility and application effect of virtual reality exercise in the elderly with dementia，so as to provide evidence-based basis for formulating the best exercise intervention program for the elderly with dementia.

The life space overview and enlightenment for the nursing care of elderly stroke patients

WANG Yingqiao, MA Li, LI Weiping, YANG Meng, DOU Xinman, WANG Xinglei

2024, 59(17):  2172-2176.  DOI: 10.3761/j.issn.0254-1769.2024.17.018

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Elderly stroke patients generally have restricted life space，which increases the incidence of falls，weakness，and dementia，reduces their quality of life，and ultimately leads to an increase in readmission and mortality rates. This article mainly introduces the concept，theoretical model and measuring tools of life space. The level and influencing factors of life space in elderly stroke patients were reviewed in order to provide references for medical staff to carry out relevant research and formulate targeted intervention programs about life space for elderly stroke patients