Table of Content

20 September 2024, Volume 59 Issue 18

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Research Paper

Construction and application of a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer

YU Luyan, ZHOU Ying, FAN Jiajie, WU Qian, CHU Xiaoyi, SHENG Tujun, ZHANG Xi, BAI Guannan, LIN Nan, ZHU Jihua

2024, 59(18):  2181-2188.  DOI: 10.3761/j.issn.0254-1769.2024.18.001

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Objective To construct a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer and to evaluate its efficacy. Methods Through literature review and Delphi expert correspondence，a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer was constructed. By the convenience sampling method，200 consecutive children who received chemotherapy in the neurosurgery department of a tertiary children’s hospital in Zhejiang province from February 1 to October 31，2023 were included as the application subjects，with 100 cases in an experimental group and 100 cases in a control group. The experimental group applied the non-drug intervention program of acute chemotherapy-related nausea and vomiting in children with cancer，and the routine measures were applied in the control group. The incidence of nausea and vomiting，severity of vomiting，compliance rate of normal sleep duration and incidence of negative emotions were compared between the 2 groups. Results The recovery rate of the valid questionnaire in 2 rounds of expert letter inquiry was 100%，and the expert authority coefficient was 0.836. The Kendall harmony coefficients were 0.471 and 0.820（P<0.001），and the final non-drug intervention program for pediatric acute chemotherapy-related nausea and vomiting included 5 primary，14 secondary and 18 tertiary items. The results showed that the incidence of nausea，vomiting and negative emotions in the experimental group were lower than that in the control group，with statistically significant differences（P<0.05）. The severity of vomiting was less than it in the control group，with statistically significant difference（P<0.05）. The standard rate of normal sleep time was higher than that of the control group，and the difference was statistically significant（all P<0.05）. Conclusion The non-drug intervention program of chemotherapy-related nausea and vomiting in children is scientific and feasible，and the implementation of the program can reduce the incidence of nausea，vomiting and negative emotions，reduce the severity of vomiting，and improve the standard rate of normal bedtime in children.

Construction and preliminary application of a Perioperative Exercise Program for Frail Elderly Patients with Colorectal Cancer based on the goal-directed therapy

WANG Meng, SHI Xiaoqing, LU Jing, ZHANG Yue, WU Runda, YIN Jianhua, LIU Chuandao

2024, 59(18):  2189-2196.  DOI: 10.3761/j.issn.0254-1769.2024.18.002

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Objective To construct a perioperative exercise program for older frail patients with colorectal cancer，and to verify its effect. Methods Based on Goal-directed Theory and literature review，expert consultation was carried out to establish the perioperative exercise program for older frail patients with colorectal cancer. Then，from July to December 2022，the perioperative exercise program was established for older frail patients with colorectal cancer hospitalized in the General Surgery Department of a tertiary A hospital in Suzhou by convenience sampling method for preliminary application. It was divided in to the intervention group and the control group by the ward. The intervention group was applied with the constructed perioperative exercise program on the basis of routine perioperative nursing. The safety, feasibility and intervention effect of the program were evaluated. Results 15 experts were included for 2 rounds of expert consultations. The authority coefficient was 0.880；the coefficient of variation was <0.250；the Kendall concordance coefficient was 0.167 and 0.224，respectively. The final program contained 4 stages：preoperative exercise, postoperative bed rest，sitting and standing exercise. In the end，54 specific interventions were constructed. During the preliminary application，all the patients completed the program. Generalized estimation equation showed that, on the interaction effect, there was no statistical difference（P=0.752）；there were significant differences on the intervention effect and the time effect（P<0.05）. At discharge，there were significant differences in timed up and go test and Barthel Index between the 2 groups（P<0.05）. Only 2 patients experienced mild pain in the intervention group，and no other adverse events occurred. Conclusion The perioperative exercise program for older frail patients with colorectal cancer，based on Goal-directed Theory，is scientific, reliable and safe. It has been preliminarily verified in improving postoperative physical function，activities of daily living and early postoperative recovery of elderly frail patients with colorectal cancer.

Specialist Nursing Practice and Research

Application of exercise-diet behavior intervention based on the transtheoretical model in patients undergoing weight loss surgery

LÜ Yinxue, FANG Xiaoxia, HAN Ling, GUO Meijuan, WANG Lingling, LI Jinjin, FAN Youjie

2024, 59(18):  2197-2205.  DOI: 10.3761/j.issn.0254-1769.2024.18.003

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Objective To evaluate the effect of exercise-diet behavior intervention based on the transtheoretical model in patients undergoing weight loss surgery. Methods By convenience sampling，72 patients undergoing weight loss surgery in a tertiary general hospital in Xinxiang City，Henan Province from February 2021 to October 2022 were selected as the research subjects. By a random number table method，they were divided into a test group and a control group，with 36 cases in each group. The test group received exercise-diet behavior intervention based on the trans-theoretical model，while the control group received conventional intervention. The intervention began on the first day after admission and ended 6 months after surgery. The body mass index，body fat，lean body mass，diastolic blood pressure，systolic blood pressure，fasting blood glucose，insulin resistance index（HOMA-IR），Health Promoting Lifestyle Profile-Ⅱ（HPLP-Ⅱ） score，and Short-Form-36 Health Survey（SF-36） score were compared between the 2 groups before and after surgery for 3 and 6 months，as well as the complications within 6 weeks after surgery. Results The results of repeated measures analysis of variance showed that there was an interaction between the 2 groups in terms of anthropometric measurements，blood pressure and blood glucose，HPLP-Ⅱ scores，and SF-36 scores，with statistically significant differences（P<0.001）. After 6 months of surgery，the body mass index （23.32±2.32），body fat（24.10±3.46） kg，and lean body mass（41.64±3.24） kg in the test group were lower than （27.32±3.64），（28.46±4.18） kg，and（46.68±4.65） kg in the control group，and the differences were statistically significant（P<0.001）. At 3 and 6 months after operation，the diastolic blood pressure，systolic blood pressure，fasting blood glucose and HOMA-IR of the test group were lower than those of the control group，and the differences were statistically significant（P<0.05）. The HPLP-Ⅱ score of the test group was higher than that of the control group at 3 and 6 months after operation（P<0.001）. The SF-36 score of the test group was significantly higher than that of the control group at 6 months after operation（P<0.05）. The incidence of complications in the test group was 2.56%，which was not significantly different from 19.44% in the control group （P>0.05）. Conclusion The exercise-dietary behavior intervention based on the transtheoretical model can promote the formation of healthy behaviors in patients undergoing weight loss surgery，maintain weight loss effects，improve blood pressure and blood glucose levels，and enhance the quality of life of patients.

Construction and validation of a risk assessment model for frailty in elderly patients with lower extremity osteoarthritis

SHEN Jiaoni, LI Hangting, WU Jia, NI Qiqi, WAN Xinrui, HE Guijuan

2024, 59(18):  2206-2213.  DOI: 10.3761/j.issn.0254-1769.2024.18.004

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Objective To analyze the influencing factors of frailty in elderly patients with lower extremity osteoarthritis，and to construct and validate the risk assessment model. Methods Convenient sampling method was used to select 535 elderly patients with lower extremity osteoarthritis from tertiary hospitals and community health service centers in Hangzhou from January to September 2022 as the survey subjects including 357 in the modeling group and 178 in the validation group. Univariate and multivariate logistic regression analysis were used to determine the risk factors of frailty，construct a risk assessment model and draw a nomogram. The discrimination and calibration of the model were evaluated by the area under the receiver operating characteristic curve and the Hosmer-Lemeshow test. The Bootstrap method was used for internal validation of the model，and the time verification method was used for external validation. Results The model variables included the number of affected joints，age-adjusted Charlson comorbidity index，pain，nutritional status，sedentary time，activity of daily living，osteoarthritis index，lower limb muscle strength，and Social Support Rating Scale score. The Hosmer-Lemeshow test results of the model showed that P=0.202，the area under the receiver operating characteristic curve was 0.942，the optimal critical value was 0.392，the sensitivity was 0.914，the specificity was 0.893，and the accuracy rate was 0.902. The internal and external validation showed that the C-statistics were 0.935 and 0.919，respectively，and the calibration curve showed good fitting. Conclusion The risk assessment model has a good degree of discrimination and calibration，which can more intuitively and easily screen elderly patients with lower extremity osteoarthritis at high risk of frailty，and provide references for early monitoring，identification，prevention and control.

Analysis of influencing factors and impact path of benefit finding in patients with cervical cancer and their spouses

ZHANG Zhuanzhuan, LI Xia, WANG Zhe, YANG Yutong, ZHU Dongge, JIANG Xinge, LIU Mengyao

2024, 59(18):  2214-2221.  DOI: 10.3761/j.issn.0254-1769.2024.18.005

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Objective This study aims to analyze the factors influencing benefit finding among cervical cancer patients and their spouses，as well as the interconnections between these factors. The goal is to provide a foundation for developing targeted clinical interventions. Methods Using the convenience sampling method， cervical cancer patients and spouses of 245 pairs who attended or were hospitalized in a tertiary-level hospital in Taiyuan City from October 2022 to July 2023 were selected as study subjects. Data were collected using a general information questionnaire，the Distress Disclosure Index，the Connor-Davidson Resilience Scale，and the Benefit Finding Scale. Univariate analysis，Pearson correlation analysis，and multiple linear regression were employed to scrutinize the data，leading to the establishment of Actor-Partner Interdependence Model. Results Benefit finding scores for cervical cancer patients and their spouses were（65.31±7.94） and（69.87±9.63），respectively. Multiple linear regression revealed that the educational level of patients and their spouses，whether or not they received chemotherapy or radiotherapy，self-disclosure and psychological resilience were the factors that affected patients’ benefit finding. Spouse’s education level，occupation，self-disclosure，psychological resilience and patients’ self-disclosure and psychological resilience were the influencing factors of spouse’s benefit finding. The Actor-Partner Interdependence Model analysis indicated that the self-disclosure and psychological resilience of cervical cancer patients positively predicted their own benefit finding and that of their spouses（path coefficients were 0.415，0.501，0.216，and 0.168，respectively，all P<0.05）. However，spouses’ self-disclosure and psychological resilience could only positively predict their own benefit finding（path coefficients were 0.188 and 0.254，respectively，all P<0.05）. Conclusion Benefit finding among cervical cancer patients and their spouses is moderate and influenced by various factors. Both self-disclosure and psychological resilience of cervical cancer patients and their spouses have positive subjective effects on their own benefit finding. Healthcare professionals should encourage both parties to engage in healthy interactions about the disease，take steps to increase the level of psychological resilience of both，and ultimately tap into a higher level of benefit finding.

Current situation of the health behavioral decision making in ischemic stroke patients and its influencing factors analysis

HE Fupei, LIN Beilei, LIU Xueting, ZHANG Zhenxiang, WANG Jiajia

2024, 59(18):  2222-2228.  DOI: 10.3761/j.issn.0254-1769.2024.18.006

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Objective To investigate the current status of health behavioral decision-making in ischemic stroke patients and analyze its influencing factors. Methods Totally 250 ischemic stroke patients were selected from 2 hospitals in Zhengzhou and Anyang from February to May 2023. A general information questionnaire，Behavioral Decision-Making Scale for Stroke Patients，Recurrence Risk Perception Scale for Patients with Stroke，and Stroke Self-Efficacy Questionnaire were used to conduct the questionnaire survey. Results The Behavioral Decision-Making Scale for Stroke Patients score of 229 ischemic stroke patients was （117.83±7.15） scores. The results of multiple linear regression analysis showed that occupational status，glycemic compliance，primary caregiver，current symptoms，stroke self-efficacy，and recurrence risk perception were the influencing factors of health behavioral decision making in ischemic stroke patients（P<0.05）. Conclusion The health behavioral decision making of ischemic stroke patients is at an upper-middle level. Individualized interventions can be carried out for patients with different characteristics to promote the patients’ ability to behavior decision making and the formation of preventive behaviors.

Research on a model of risk perception of venous thromboembolism in pregnant women

LIU Haoxin, HUANG Lili, CUI Xiaohua, TAO Fuying, ZHOU Man, ZHANG Panpan, TIAN Yingying

2024, 59(18):  2229-2237.  DOI: 10.3761/j.issn.0254-1769.2024.18.007

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Objective To construct a theoretical model of venous thromboembolism（VTE） risk perception in pregnant women，so as to provide a scientific basis for promoting pregnant women to form a correct risk perception of VTE and actively take preventive behaviors. Methods A qualitative research approach guided by the procedural grounded theory was adopted. Data were collected by a semi-structured deep interview on 18 pregnant women who received prenatal examination in the outpatient department of a tertiary A obstetrics and gynecology hospital in Nanjing from June to July 2023，and the data were analyzed by three-level coding and continuous comparison method. Results The VTE risk perception of pregnant women was affected by 6 factors including social coupling system，self health status，life behavior habits，knowledge on disease，compliance behavior and emotional stimulation. Pregnant women perceived VTE risk from 3 aspects：threats to maternal and child safety，increased family economic burden and increased time cost，impact on social roles. Thus，3 health behavior decisions were formed，including taking preventive behaviors，overcoming implementation barriers，and seeking knowledge behaviors，in order to reduce their own risk of VTE，and prevent the occurrence of VTE. Conclusion The theoretical model of VTE risk perception of pregnant women can guide medical staff to comprehensively consider the influencing factors of VTE risk perception of pregnant women，optimize the form and content of VTE health education，give pregnant women individualized and sustainable VTE prevention guidance，and strengthen pregnant women’s perception of VTE risk and the benefits of preventive behavior，so as to actively take the correct health behavior decisions.

Traditional Chinese Medicine Nursing Care

Examining core symptoms and influencing factors of patients with gastric cancer undergoing chemotherapy：the role of Traditional Chinese Medicine constitutional traits

ZOU Yanling, LI Yi, ZHANG Ziyan, LI Xun, YANG Lihua, WANG Xiaoqing, GAO Juan, GUAN Huiyun, DUAN Peibei

2024, 59(18):  2238-2243.  DOI: 10.3761/j.issn.0254-1769.2024.18.008

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Objective To investigate the incidence and severity of symptoms in patients with gastric cancer who received chemotherapy，we constructed a symptom network to explore core symptoms and bridge symptoms. Furthermore，the study explores the association between core symptoms and Traditional Chinese Medicine（TCM） constitutions. Methods Patients with gastric cancer who received chemotherapy in the medical oncology and surgical oncology department from March to August 2023 were selected for the study using a convenience sampling method. The MD Anderson Symptom Inventory Gastrointestinal Cancer was used for evaluating gastrointestinal symptoms and their severity among patients receiving chemotherapy for gastric cancer，as well as assessing the classification of TCM constitution among patients. The symptom network model was constructed using the R programming language，and the central index was analyzed to determine the core symptoms and bridge symptoms. Binary logistic regression analysis was employed to assess the association between different physical conditions and the occurrence of core symptoms. Results A total of 346 electronic questionnaires were collected，with 340 valid ones，and the effective recovery rate was 98.3%. The 3 most prevalent and severe symptoms among the 340 patients with gastric cancer were fatigue（85.59%），lack of appetite（82.35%），and taste alteration（81.18%）. The centrality index results indicated that grief exhibited the highest intensity，medium，and compactness centrality values（r_s=8.23，r_b=2.00，r_c=0.03），making it the core symptom of this condition. Sleep disorders，lack of appetite，drowsiness，and taste alteration were identified as bridging symptoms with bridge intensities of 0.74，0.76，0.99，and 0.94 respectively. The results of Spearman correlation analysis showed that there was a positive correlation between sadness and qi-deficiency constitution，phlegm-dampness constitution（P<0.05）. The phlegm-dampness constitution was positively correlated with the taste alterations（P<0.05）. Conclusion In patients with gastric cancer，fatigue emerges as the most prominent symptom，while sadness assumes the core symptom. Additionally，sleep disorder，lack of appetite，drowsiness，and taste alteration are bridge symptoms. According to the principles of TCM constitution，qi-deficiency and phlegm-dampness are constitutions associated with a higher risk of experiencing sadness，and phlegm-dampness is a constitution associated with a higher risk of taste changes. Nurses can integrate core symptoms and TCM constitutions characteristics to optimize the strategies for symptom intervention.

Construction of a quality evaluation system for the implementation of TCM nursing program

SHAO Yashuang, SU Qian, WU Bainü, KAN Yanan, BAO Yunchun, YE Fuying

2024, 59(18):  2244-2250.  DOI: 10.3761/j.issn.0254-1769.2024.18.009

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Objective To establish a scientific and systematic quality evaluation system for the implementation of TCM nursing programs，and to provide references for promoting the standardized implementation and quality improvement of TCM nursing programs. Methods From October 2023 to December 2023，a research team was set up to form the first draft of the quality evaluation system for the implementation of TCM nursing programs based on the “structure-process-results” three-dimensional quality model，by combining literature research and focus group interviews，and the quality evaluation system for the implementation of TCM nursing programs was formulated by means of Delphi expert letter consultation and analytic hierarchy process. Results 2 rounds of professional consultations resulted in an excellent recovery rate of 100%；the expert authority coefficients were 0.853 and 0.958；the Kendall harmony coefficients of expert opinions were 0.151 and 0.152，respectively. Finally，the quality evaluation system of TCM nursing program implementation was determined，including 3 first-level indicators，including structure，process and result. There are 6 secondary indicators，including system management，implementation management，quality management，effect evaluation，safety evaluation，and satisfaction evaluation. There are 18 three-level indicators，including the implementation management system of TCM nursing program and regular optimization of TCM nursing program. Conclusion The quality evaluation system for the implementation of TCM nursing programs is scientific and reliable，but its practicability needs to be tested in clinical practice.

Rare Disease and Critical Care

Nursing care of an elderly postoperative laryngeal cancer patient with a large type IV hiatal hernia

JIN Yongyan, ZHOU Haiyan, XU Caijuan

2024, 59(18):  2251-2255.  DOI: 10.3761/j.issn.0254-1769.2024.010

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To summarize the nursing experience of an elderly postoperative laryngeal cancer patient who developed a Type IV hiatal hernia. Key nursing care points included the monitoring of shock index and MEWS to promptly activate the rapid response team and implement the Surviving Sepsis Campaign，active fluid resuscitation and continuous monitoring of central venous pressure to prevent cardiopulmonary failure，implementing a personalized postoperative respiratory rehabilitation plan to promote lung re-expansion and prevent pulmonary infection，monitoring and controlling intra-abdominal hypertension，and implementing an intra-abdominal pressure-guided enteral nutrition management plan，employing a restrictive fluid management strategy to reduce tissue edema and maintain fluid and electrolyte balance，implementing an integrated “hospital-community-home” health management plan to improve the patient’s quality of life. The patient was hospitalized for 23 days and discharged smoothly，with good recovery after a 3-month follow-up.

Nursing care of a pregnant patient in awake prone position combined with acute respiratory distress syndrome

MA Rong, CHEN Guanjie, SHEN Chen, MA Lu

2024, 59(18):  2256-2260.  DOI: 10.3761/j.issn.0254-1769.2024.18.011

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To summarize the nursing experience of a patient with moderate acute respiratory distress syndrome in the third trimester of pregnancy in awake prone position. Nursing points include the guidance for the implementation of prone position throughout the whole process based on the integrated theory of health behavior change；the refined evaluation and the implemention of personalized prone position；the visual monitoring of the efficacy of prone position；the monitoring of the intrauterine state of the fetus to ensure fetal safety；the implemention of personalized psychological nursing in stages. After 7 days of targeted treatment and care，the patient improved and was transferred to obstetrics for continued treatment.

Evidence Synthesis Research

The best evidence summary for prevention and rehabilitation nursing of pregnancy-induced diastasis recti abdominis

LI Min, HAN Wenping, HAO Limin, CHAI Peishan, SUN Qiao, CAO Yanxing, SONG Jiaxin

2024, 59(18):  2261-2268.  DOI: 10.3761/j.issn.0254-1769.2024.18.012

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Objective To retrieve，evaluate and summarize the best evidence summary for prevention and nursing care of pregnancy-induced diastasis recti abdominis and to provide references for clinical practice. Methods We systematically searched computer decision support systems，guideline websites，association official websites and databases for evidence on prevention and nursing care of pregnancy-induced diastasis recti abdominis，including guidelines，expert consensuses，clinical decision-making，systematic reviews and randomized controlled trials. The retrieval period was from the inception of databases to January 2024. There were 4 researchers who evaluated the quality of the included literature independently，extracted and summarized the evidence according to the subject. Results A total of 18 articles were included，including 2 clinical decisions，4 guidelines，5 expert consensuses，3 systematic reviews，and 4 randomized controlled trials. 24 pieces of best evidence were summarized from 5 aspects，including the antenatal prevention，team building，nursing assessment，intervention strategies，and effecti-veness evaluation. Conclusion This study summarizes the best evidence summary for prevention and nursing care of pregnancy-induced diastasis recti abdominis，which can provide a reference basis for nurses to manage diastasis recti abdominis and improve the life quality of maternal woman.

Facilitators and barriers to adherence to diet or exercise interventions in patients with overweight or obesity：a Meta-synthesis

GOU Xiaoyu, LI Mengjie, LU Nan, YU Wanhui, CHI Jiajing, YANG Lijuan

2024, 59(18):  2269-2276.  DOI: 10.3761/j.issn.0254-1769.2024.18.013

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Objective To evaluate and integrate the facilitators and barriers to adherence to diet or exercise interventions in patients with overweight or obesity. Methods PubMed，Web of Science，Embase，CINAHL，Cochrane Library，China National Knowledge Infrastructure，Wanfang，and VIP Chinese Biomedical Literature Database were searched by computer from the establishment of the database to October 14，2023. The 2016 edition of the Joanna Briggs Institute（JBI） evidence-based health care center qualitative research evaluation criteria was used to evaluate and integrate the included literature. Results A total of 19 studies were included，and 38 outcomes were distilled into 12 categories，and the results were consolidated into facilitators（disease threat perception，self-body perception，self-adjustment，sense of responsibility，social support） and barriers to intervention adherence（poor treatment benefit，low self-efficacy，lack of knowledge，competitive priorities，external environmental constraints，economic conditions，poor intervention design）. Conclusion There are many facilitators and barriers of diet or exercise intervention perceived by patients. It is suggested that follow-up intervention research should be used as a reference to improve the treatment compliance of patients.

Review

Application of intelligent robots on pain intervention of children：a scoping review

FAN Wenqi, ZHAO Rui, LIU Xiaoxia, GE Lina

2024, 59(18):  2277-2282.  DOI: 10.3761/j.issn.0254-1769.2024.18.014

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Objective To review the application of intelligent robots in the pain intervention of children，and identify the elements of the intervention，so as to guide future research and practice. Methods A literature search was performed in the PubMed，Cochrane Library，Embase，Web of Science，CINAHL，CNKI，Wanfang database，and CBM. Following the methodology of the scoping review，the retrieval time was from the establishment of the database to November 2023. The included studies were summarized and analyzed. Results A total of 10 articles were included，including 7 randomized controlled trials，2 quasi-experimental studies，and 1 mixed method research study. The working principles of intelligent robots in pain intervention for pediatric patients include distraction and pain empathy. Functions of intelligent robots included verbal interaction，limb motion，facial expression，and haptic recognition. Interventions included pre-intervention preparation，intervention content，and intervention duration，of which the intervention content included question-and-answer conversations，breathing exercises，recreation，and verbal encouragement，and the duration of the intervention ranged from 3 to 11 minutes. The outcome indicators included pain level，negative emotions，and feasibility. The results showed the positive feasibility of the application of intelligent robots in pain intervention for children，which may help to reduce the level of pain and improve children’s negative emotions such as anxiety and distress. Conclusion Intelligent robots in the field of pain intervention of children present preliminary effects and feasibility. It is recommended that researchers should enrich the functions of intelligent robots，enhance human-robot interaction，carry out personalized interventions，and add physiological indexes as effect evaluation indexes to further validate its application effects.

Symptom clusters in patients with lung cancer patients during chemotherapy：a scoping review

LI Fulan, XIE Haixia, YU Tianshuang, HAN Ruijuan

2024, 59(18):  2283-2289.  DOI: 10.3761/j.issn.0254-1769.2024.18.015

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Objective To identify the characteristics and research status of symptom clusters in patients with lung cancer patients during chemotherapy. Methods This scoping review was conducted under the Joanna Briggs Institute guidelines. A literature search was performed in the PubMed，Embase，CINAHL，Web of Science，Scopus，CNKI，Wanfang，and CBM databases to identify relevant studies about symptom clusters in patients with lung cancer from inception until December 31，2023. The included studies were summarized and analyzed. Results 19 papers were included and 22 symptom clusters were extracted，mainly including psychological，gastrointestinal，lung cancer-specific，fatigue-related，and respiratory symptom clusters. There are 6 symptom cluster assessment tools，of which 4 were M.D Anderson Symptom Inventory in different version；the symptom clusters were dynamically changing during chemotherapy in patients with lung cancer，with variations in core symptom clusters at different stages. Conclusion Multiple symptom clusters exist during chemotherapy in lung cancer patients，and the naming of symptom clusters and attribution of symptoms need to be further standardized. The assessment tools for symptom clusters in patients undergoing chemotherapy for lung cancer are mainly based on the Anderson Symptom Assessment Scale and other language versions. Symptom clusters in patients with lung cancer during chemotherapy show dynamic changes，and there are differences in core symptom groups at different stages.

Research progress on barriers to clinical application of evidence in nursing

YANG Funa, XU Xiaoxia, SHI Hongying, Eva Ho Ka Yan, ZHU Ping, WANG Huilin

2024, 59(18):  2290-2296.  DOI: 10.3761/j.issn.0254-1769.2024.18.016

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As an integral part of worldwide healthcare，nursing still has a big task to make in conducting implementation research. Addressing the pressing challenges of closing the gap between evidence and nursing practice，and effectively disseminating and applying evidence within the nursing discipline，remains a top priority. This paper presents a compilation of the status of evidence implementation in clinical nursing from an implementation science perspective，including the theoretical framework of barriers to evidence implementation，common research methodologies，and research progress of related factors in the field of nursing. The goal of this work is to bring more insights to further advance the implementation of evidence in nursing.

Nursing Instruments Innovation

The development and implementation of a 3D technology-based female bed urinal

CHEN Yanling, LI Hongyan, WANG Xiaobo, XU Shanshan, YAO Yuhong, WANG Ping, SUN Xiaomei

2024, 59(18):  2297-2299.  DOI: 10.3761/j.issn.0254-1769.2024.18.017

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Objective To utilize a 3D technology in the design of a female bed urinal and to evaluate its clinical efficacy. Methods A total of 102 adult female fracture patients with normal urination function admitted to a tertiary hospital in Hangzhou City from October 2022 to June 2023 were included in the study. They were divided into a control group（n=51） and an experimental group（n=51） according to random number method. Patients in control group used a regular urinal，while patients in the experimental group used the 3D technology-based female bed urinal. The level of physical pain caused by urination，the rate of urine immersion in the sacrococcygeal or gluteal cleft and the rate of bed unit or clothing of contamination were compared between the 2 groups. Results There was no significant difference in the rate of bed unit or clothing contamination between the 2 groups（P>0.05）. However，the experimental group experienced significantly lower pain caused by urination，a lower rate of urine impregnation in the sacrococcygeal or gluteal fissure（P<0.001），compared to the control group. Conclusion The 3D technology-based female bed urinal has reasonable structure and simple operation，which can significantly reduce the physical pain caused by the change of body position，reduce the incidence of urine immersion events.

Design and application effect of a multisensory supported device for preterm infants

SHA Sha, TANG Xiaoli, ZHANG Ying, QIN Yanmin, SHEN Junyi, JIN Qian, YANG Xiaochen

2024, 59(18):  2300-2304.  DOI: 10.3761/j.issn.0254-1769.2024.18.018

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Objective To design a multisensory supported device and evaluate its effectiveness on preterm infants（born before 34 weeks） during NICU hospitalization. Methods The multisensory supported device is composed of a basement，several soft cushions and an adjustable eye mask. The inner layer of the device comprises of the head and tail boundaries，serves as uterine wall-like circular boundaries. The outer skeleton is equipped with multisensory stimulation modules to provide visual，hearing，and tactile sensory stimulations for premature infants. The study was conducted in a NICU of a tertiary A children specialist hospital in Shanghai，China. The convenience sampling method was used and based on the ratio of 1∶2 between the experimental and the control group in this study. The control group was treated by standard nursing care，while the experiment group was treated with the multisensory supported device in addition to NICU conventional care. All infants were assessed during the week of admission and again at corrected gestational age of 36 weeks. The actigraphy watch which was used for 72 hours continuous record of the activities of study infants，allows the researcher to compare the activity scores，wakefulness and sleep indicators of 2 groups of infants. Results 71 preterm infants were enrolled in the study，and 60 preterm infants completed data collection for study data analysis，including 20 in the experimental group and 40 in the control group. There were no statistical differences in demographic characteristics and clinical status regarding wakefulness，sleep and physical development between the 2 groups in baseline（P>0.05）. At 36 weeks of corrected gestational age，the activity score of the experimental group was（46.61±12.14） points，and that of the control group was（57.33±18.36） points，with statistically significant differences in 2 groups （P=0.024）. The total waking time of the experimental group was（384.85±169.42） min，and that of the control group was（492.08±220.45） min，with statistically significant differences in 2 groups（P=0.049）. There was no statistical difference in other indicators between 2 groups（P>0.05）. Conclusion The multisensory supported device can reduce high-frequency unpleasant activity as well as frequent wakefulness status，which could promote the sleeping quality of preterm infants. Further studies are needed to verify further effects of the device on premature infants’ physical development.