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    10 January 2025, Volume 60 Issue 1
    Special Planning——Quality Improvement in Perinatal Nursing Care
    Construction and application of a whole process nursing plan for women in vaginal delivery
    BAI Xue, ZHANG Guangyi, MA Pin, ZHANG Yan, JI Shuangdui, MI Guangli
    2025, 60(1):  10-17.  DOI: 10.3761/j.issn.0254-1769.2025.01.001
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    Objective To construct a whole process nursing plan for women with vaginal delivery and to evaluate its effect. Methods On the basis of literature analysis and Delphi expert consultation method,a whole process nursing plan of vaginal delivery was established. From June to September 2023,180 primiparas in a tertiary A hospital in Ningxia were selected as research subjects to carry out the preliminary application of the plan. Among them,the parturients hospitalized from August to September were in the experimental group,and those hospitalized from June to July were in the control group. The experimental group received the whole process nursing plan on the basis of routine nursing,and the control group received routine nursing. The indexes related to delivery outcomes(delivery mode,time of each labor stage,et al),the degree of labor pain,fear of labor and labor experience were compared between the 2 groups. Results The effective recovery rates of the 2 rounds of expert correspondence were 100% and 93.75%,respectively,and the coefficient of expert authority was 0.85. The finally constructed plan included 3 first-level items,10 second-level items and 29 third-level items. 86 cases and 85 cases were included in the experimental group and the control group,respectively. After intervention,there were statistically significant differences in each stage of labor between the 2 groups(P<0.05). There was significant difference in the rate of good and good control of labor pain(χ2=16.386,P<0.001). The childbirth fear questionnaire score(27.76±3.60) of the experimental group was lower than(33.06±3.36) of the control group,and the childbirth experience score(80.83±4.83) was higher than(75.79±3.46) of the control group,and the differences were statistically significant(P<0.001). Conclusion The whole process nursing plan of vaginal delivery is scientific and feasible. It can shorten the labor time,relieve labor pain,labor fear and improve labor experience.

    Construction of the theoretical framework for maternal satisfaction with childbirth
    WANG Yanchi, XU Xujuan, ZHANG Feng
    2025, 60(1):  18-23.  DOI: 10.3761/j.issn.0254-1769.2025.01.002
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    Objective To construct a theoretical framework of multidimensional level of maternal labour satisfaction to provide a scientific basis for taking measures to improve maternal labour satisfaction,in order to promote the improvement of nursing care quality. Methods A purposive sampling method was used to select 30 mothers who underwent a 42 days postpartum review in the postpartum clinics of 3 tertiary A hospitals in Nantong City from July to September 2023 for semi-structured in-depth interviews,and programmatic grounded theory was used for data analysis. Results A theoretical framework for multidimensional maternal satisfaction in childbirth was established,comprising 4 dimensions of the basic level(knowledge dissemination,resource acquisition,psychological adjustment),the core level(professionalism,interaction and cooperation,information sharing),the spiritual level(respect for autonomy,emotional care,empowerment),and the practical level(comfort and safety,skill enhancement,comprehensive recovery). Conclusion This study constructs a multidimensional theoretical framework for assessing childbirth satisfaction among parturient women,providing innovative perspectives and methodological guidance to optimize nursing practices and elevate service quality. Nursing personnel should utilize this framework to ensure the ongoing improvement and enhancement of nursing services,meeting the evolving needs of parturient women and facilitating a smooth transition through the critical life event of childbirth.

    A qualitative study of the pregnancy and childbirth experience of pregnant and maternal women with the third child
    XIA Jiaai, PU Congshan, SHAN Chunjian, GU Xuan, ZHANG Xiangdi, SHAN Yan, LÜ Mingying, WANG Ying, XIE Linlin, ZHOU Hui
    2025, 60(1):  24-30.  DOI: 10.3761/j.issn.0254-1769.2025.01.003
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    Objective To explore the deeper understanding of the pregnancy and delivery experience of three-child pregnant and maternal women,and to provide a basis for healthcare personnel to provide more systematic,safe,and targeted perinatal healthcare services and care measures for three-child pregnant and maternal women. Methods Purposive sampling method was used to select 17 cases of three-child pregnant and maternal women who were admitted and delivered in a tertiary level-A maternal and child healthcare hospital in Nanjing from August 2022 to June 2023 for semi-structured interviews,and Colaizzi 7-step process of analyzing,summarizing,and refining the themes was used. Results A total of 4 themes were extracted,including determination of willingness to become pregnant,perceived risks of childbirth,perceived benefits to themselves and their families,diversified support needs. Conclusion The establishment of pregnancy intention of three-child pregnant women is affected by many factors. Relevant departments should actively implement the supporting measures of the three-child birth policy;healthcare workers should strengthen perinatal healthcare services for three-child mothers to reduce the risk of giving birth,actively strengthen their sense of benefits related to pregnancy,and establish a whole process of support system to promote the health of mothers and infants.

    Development and validation of the Perceived Spouse Support Scale for pregnant women in the second and third trimesters
    XIONG Yi, ZHANG Liuyi, HU Qiqi, LIU Zhaoping, WANG Li, ZHANG Dan, ZHANG Yuxin
    2025, 60(1):  31-36.  DOI: 10.3761/j.issn.0254-1769.2025.01.004
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    Objective To develop the Perceived Spouse Support Scale for pregnant women in the second and third trimester of pregnancy and test its reliability and validity,so as to provide an effective tool for assessing the perceived spouse support level of pregnant women. Methods With social support theory as the theoretical framework,the questionnaire item pool was initially constructed through literature review and semi-structured interview,and the initial questionnaire was formed through expert correspondence and cognitive interview. From April to November 2023,570 pregnant women in the second and third trimester of pregnancy were selected by random sampling method for investigation,item analysis and reliability and validity test of the scale. Results Eventually 558 pregnant women completed the survey. The Perceived Spouse Support Scale for pregnant women in the second and third trimesters contained 22 items,including instrumental support,informational support and emotional support. The Cronbach’s α coefficient of the scale was 0.867;the split-half reliability was 0.793;the retest reliability was 0.965;the content validity index was 0.980. The cumulative variance contribution rate of the 3 common factors was 54.138%. Confirmatory factor analysis suggested that the model fit well. Conclusion The Perceived Spouse Support Scale has good reliability and validity,and it can be used as an evaluation tool for spouse support level of pregnant women.

    Perioperative nursing care of a patient in late pregnancy complicated with acute aortic dissection:a case report
    WANG Mengtian, TAN Qikai, FAN Junhui, HE Yuxuan, HONG Min
    2025, 60(1):  37-42.  DOI: 10.3761/j.issn.0254-1769.2025.01.005
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    To summarize the perioperative nursing of a patient with type A aortic dissection in late pregnancy. Key points of nursing include:①timely activation of the aortic dissection emergency plan based on the intelligent platform to improve the efficiency of surgical preparation; forming an aortic coarctation team and rationalising surgical scheduling;②targeted blood pressure management to avoid the rupture of dissecting aneurysm;rapid establishment of extracorporeal circulation to improve the quality of surgical coordination;target temperature management throughout the whole process;close monitoring of the patient’s condition to prevent amniotic fluid embolism;real-time haemorrhage monitoring and enhanced blood product management;③adoption of the traffic light rehabilitation automatic assessment and decision-making system for early rehabilitation training after surgery;multidisciplinary joint health education to enhance self-efficacy. Through multidisciplinary integration and precise nursing care,the patient’s surgery was successfully completed and discharged 18 days later. With monthly outpatient review,the patient recovered well.

    Standards
    Expert consensus on breast cancer targeted therapy with subcutaneous injection
    Cancer Nursing Committee of Chinese Nursing Association, Cancer Nursing Committee of Shanghai Anti-Cancer Association(Writing Committee:WANG Liying, QIN Huiying, LU Yuhan, QIU Jiajia, LU Zhenqi)
    2025, 60(1):  43-46.  DOI: 10.3761/j.issn.0254-1769.2025.01.006
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    Objective To develop an expert consensus on the subcutaneous injection of targeted drugs for breast cancer,to guide clinical nursing practice. Methods A consensus building group was established to create the initial draft of the consensus based on a review of literature. From December 2023 to February 2024,a total of 84 experts from various fields including breast cancer clinical nursing or medical practice,pharmacology,cancer hospital nursing or medical management were invited to participate in 2 rounds of expert letter consultations. Additionally,an on-site expert discussion meeting and an online expert finalization meeting were conducted to finalize the draft “consensus”. Results The finalized consensus includes sections covering basic drug introduction,drug injection nursing(injection personnel,injection preparation,injection points,observation and recording after injection),nursing care for adverse reactions,patient education and follow-up. Conclusion This consensus is scientific and practical. It can serve as a valuable reference for clinical practice related to subcutaneous therapy using targeted drugs for breast cancer.

    Interpretation of the group standard for measurement technique of central venous pressure
    ZHAO Mingxi, GUAN Xin, SUN Hong, MA Hongming, FENG Yueying, YU Meng, ZOU Dengxiu, LUO Hongbo, LI Zunzhu, JING Jie, WU Xinjuan
    2025, 60(1):  47-51.  DOI: 10.3761/j.issn.0254-1769.2025.01.007
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    Central venous pressure(CVP) is a commonly used hemodynamic index in clinical practice,and the accuracy of its measurement results is influenced by the measurement technical specifications. Based on research evidence and clinical practice,this article interprets the main content of the group standard of CVP measurement technology,and proposes suggestions for its use. It aims to guide clinical nursing staff to correctly understand the principles and methods of CVP measurement,and promote the standardization of nursing practice and the accuracy of measurement results.

    Specialist Nursing Practice and Research
    Research on a crisis management-based risk management protocol for dysphagia after extubation in pa-tients with tracheal intubation
    TANG Jiaying, HUANG Xiaoxia, GUO Zhiting, LIU Chang, CHEN Lan, FENG Xiuqin
    2025, 60(1):  52-60.  DOI: 10.3761/j.issn.0254-1769.2025.01.008
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    Objective To construct and implement a swallowing disorder assessment and management program for tracheal intubated patients after extubation based on the 4R crisis management theory,providing standardized and scientific interventions for oral feeding. Methods Utilizing the expert meeting method with the 4R crisis management theory framework,a swallowing disorder assessment and management program was developed for post-extubation tracheal intubated patients. A convenience sampling method was employed to select patients with tracheal intubations treated from July to December 2023 in the emergency ICU,central ICU,and cardiovascular surgery ICU of a tertiary hospital in Zhejiang Province.The patients treated from October to December were assigned to an experimental group(n=68),while those treated from July to September were designated as a control group(n=58). The experimental group received the 4R crisis management-based intervention,whereas the control group received standard ICU assessment and management. Outcomes indicators included the incidence of post-extubation swallowing disorders,time to first oral intake,incidence of aspiration during initial feeding,nasogastric and nasointestinal tube placement duration,incidence of aspiration pneumonia during hospitalization,re-intubation rates,ICU readmission rates,ICU stay duration,and total hospitalization days. Results Of the initially recruited subjects,68 in the experimental group and 54 in the control group were included in the final analysis. After the intervention,the experimental group exhibited significantly lower rates of post-extubation swallowing disorders,shorter time to first liquid oral intake,aspiration incidence during first feeding,shorter durations of nasogastric and nasointestinal tube placement,aspiration pneumonia,ICU readmission compared to the control group(P<0.05). No significant differences were observed between the groups in time to first regular oral intake,re-intubation rates(P>0.05). Conclusion The risk management program for dysphagia following tracheal extubation based on the 4R crisis management theory is scientifically robust and safe,offering a valuable reference for clinical assessments and management of swallowing and eating post-extubation in tracheal intubated patients.

    Development and practicality of an intelligent management platform for postoperative rehabilitation of patients with head and neck tumors
    SHEN Lifeng, CHEN Piaopiao, QIAN Yafen, XU Yan, GUO Haiwei, JIN Aixiang
    2025, 60(1):  61-68.  DOI: 10.3761/j.issn.0254-1769.2025.01.009
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    Objective To construct an intelligent postoperative rehabilitation management platform and evaluate its effect in patients with head and neck cancer. Methods The postoperative intelligent rehabilitation management platform of head and neck cancer patients was divided into 5 layers from bottom to top,including the underlying environment, platform support, core database, analysis algorithm and application platform. Through the construction of head and neck tumor postoperative complications knowledge base and risk prediction model and wearable device auxiliary precision prediction risk,the head and neck cancer patients with postoperative intelligent rehabilitation management was realized. A historical controlled study was conducted and 90 participants with head and neck cancer were selected who underwent the surgical treatment in a hospital in Hangzhou,Zhejiang Province. The experimental group(45 participants admitted from February to July) received the intervention by the intelligent rehabilitation management platform,while the control group(45 patients from August to December) received the routine rehabilitation management. The outcome measures including NRS scores at 12 h,24 h,48 h and 72 h after surgery,incidence of postoperative complications,postoperative length of hospital stay,and patient satisfaction were compared between the 2 groups. Results The scores of incidences of complications,postoperative hospital stay,and NRS scores at 12 h,24 h,48 h and 72 h after surgery in the experimental group were lower than those in the control group(P<0.05),while the scores of patient satisfaction in the experimental group were higher than those of the control group(P<0.05). Conclusion The intelligent postoperative rehabilitation management platform can achieve accurate prediction of postoperative complications,reduce postoperative complications of head and neck tumors,timely intervene to relieve patients’ pain and discomfort,shorten hospital stays,improve nursing work efficiency and improve patient satisfaction.

    Evidence-based practices for exercise management in patients with metabolic associated fatty liver disease
    LIN Jingjing, WANG Bifen, CHEN Xiaoyi, ZHANG Xueling, FU Jie, LIN Yan, JI Xiaoyan, YAO Lixi, FANG Yan, LIN Rongjin
    2025, 60(1):  69-76.  DOI: 10.3761/j.issn.0254-1769.2025.01.010
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    Objective To analyze challenges in translating exercise management evidence for patients with metabolism-associated fatty liver disease(MAFLD),develop actionable strategies,and evaluate the application of best evidence. Methods Utilizing the evidence translation model,the best evidence was implemented for MAFLD patients in 4 phases:evidence acquisition,baseline practice review,intervention,and outcome evaluation. We compared the knowledge of exercise management evidence,implementation rates of review indicators,completion of exercise programs,BMI,liver stiffness measurement,controlled attenuation parameters,and patient satisfaction among medical staff at a tertiary hospital in Fujian Province during baseline(March-May 2023),mid-practice(June-August 2023),and late-practice(September-November 2023) phases. Results A total of 88 patients were included at baseline review,95 during mid-practice,and 107 in late-practice. Significant improvements were observed in the implementation rates of 21 review indicators,nurses’ knowledge,completion rate,BMI,and controlled attenuation parameters compared to the data at baseline(P<0.05). Conclusion The application of best evidence in exercise management for MAFLD patients enhances nurses’ knowledge,standardizes nursing practices,and reduces patients’ BMI and controlled attenuation parameters.

    Analysis of the current situation and influencing factors of osteoporosis knowledge among orthopedic nurses in 621 hospitals
    SONG Mi, QIU Chen, SU Qingqing, SHAO Mengqi, WANG Qingmei, GAO Yuan
    2025, 60(1):  77-82.  DOI: 10.3761/j.issn.0254-1769.2025.01.011
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    Objective To investigate the current status and analyze the factors affecting the osteoporosis knowledge among orthopedic nurses,and to provide references for improving osteoporosis knowledge among orthopedic nurses. Methods We investigated 5 681 orthopedic nurses from 621 hospitals in 31 provinces (autonomous regions/municipalities) using a convenient sampling method from September 2023 to November 2023. We collected information using a general information questionnaire and osteoporosis knowledge assessment tool. We used univariate and multivariate logistic regression to identify risk factors. Results A total of 5 204 orthopedic nurses were included. The total mean score of osteoporosis knowledge assessment tool of nurses was [13.00(12.00,14.00)],and 23.48% nurses had a low level of osteoporosis awareness. Logistic regression analysis showed that the age,title and position of the nurses,location of the hospital,the level of the hospital,whether to conduct the fracture liaison service/to set up the refracture prevention team,whether to use calcium tablets/vitamin D,whether to carry out anti-osteoporosis drug therapy,and whether to conduct topical lectures on osteoporosis or secondary fractures,were the factors that affected orthopedic nurses’ knowledge of osteoporosis(P<0.05). Conclusion The osteoporosis knowledge of orthopedic nurses needs to be improved. Nursing managers should carry out personalized interventions from both hospital and nurse levels to improve the osteoporosis knowledge of orthopedic nurses in our country.

    A mixed study of factors influencing quality of life in elderly patients with minor amputations of the diabetic foot
    ZHU Hongjuan, WANG Qian, WANG Shujun, ZENG Dengfen, CHU Wanli, Munire· Mutailipu, YU Hongli, WANG Liwei
    2025, 60(1):  83-89.  DOI: 10.3761/j.issn.0254-1769.2025.01.012
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    Objective To investigate the current status of quality of life and its influencing factors in elderly patients with minor amputations of the diabetic foot,providing a basis for medical staff to formulate intervention strategies. Methods A convergent mixed study design was used. A single-centre cross-sectional survey research method was used to select 168 elderly patients with minor amputation of the diabetic foot admitted to the Department of Wound Repair of a tertiary-level hospital in Beijing from May 2022 to May 2024 for questionnaire surveys and multivariate linear regression analyses of factors affecting the quality of life. During the same period,15 patients were selected for semi-structured interviews using purposive sampling based on ternary interaction determinism. Results Quantitative findings:A total of 167 valid questionnaires were retrieved, and the recovery rate of valid questionnaires was 99.4%. the total quality of life score of 167 respondents was(84.22±12.49) scores;the results of multivariate linear regression analyses showed that age and self-care ability were the independent risk factors affecting the quality of life of patients with minor amputation of the diabetic foot(P<0.05). Qualitative findings:a total of 3 themes were extracted based on the triadic interactive determinism,including subject level,environmental level and behavioural level. Mixed findings:age and amputation affect the physical and mental state of patients and hinders quality of life improvement;limited work and life,and scarce external resources;the level of self-care ability restricts self-management behaviours and makes it difficult to improve quality of life. Conclusion Elderly patients with minor amputations of the diabetic foot have impaired physiological and psychological health to some degree,and healthcare professionals should be concerned about the negative impact of minor amputations on elderly diabetic foot patients,while also focusing on their individual needs and providing support.

    Current status and latent profile analysis of nurses’ caring behaviors in hospice care
    WANG Tiantian, CHEN Jie, REN Nanxiao, LI Yunrong, ZHANG Liuliu, WU Bing, ZHAO Yun
    2025, 60(1):  90-98.  DOI: 10.3761/j.issn.0254-1769.2025.01.013
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    Objective To explore the current situation of caring behavior among hospice nurses,and to analyze its latent profiles and population characteristics,so as to provide ideas for targeted interventions. Methods From August to November 2023,convenience sampling was used to select hospice nurses from 22 secondary and above hospitals in Jiangsu Province,Zhejiang Province,Shanghai City,Shandong Province,Anhui Province,Beijing City,Guangdong Province,and Sichuan Province. The demographic characteristics questionnaire,the Caring Behaviors Inventory,the Empathy Ability Scale for Hospice Nurses,and the Practice Environment Scale were used for investigation. Latent profile analysis was conducted based on 24 items of the Caring Behaviors Inventory as explicit indicators,and the influencing factors of different profiles were analyzed through multivariate logistic regression model. Results A total of 420 questionnaires were collected,of which 393 were valid,with a valid questionnaire response rate of 93.57%. The caring behavior of hospice nurses could be divided into 3 latent profiles,namely high level of care-low respect and connection group(49.62%),high to low caring behavior-overall fluctuation group(30.79%),and medium level of care-high knowledge and skills group(19.59%). The results of multivariate logistic regression showed that age,the dimensions of cognitive and emotional empathy in the Empathy Ability Scale for Hospice Nurses and the dimension of nursing foundations for quality of care in the Practice Environment Scale were the influencing factors of the latent profile of hospice nurses’ caring behavior(P<0.05). Conclusion There is significant heterogeneity in the caring behavior of hospice nurses. Nursing managers should develop individualized interventions for hospice nurses according to the influencing factors of different latent profiles to improve their level of caring behavior.

    Study of an Assessment Tool for Social Care Needs of Terminal Patients at Home and its reliability and validity
    XIAO Yao, ZHANG Xiaotian, WEI Yongting, MA Yinghui, GONG Ni, YANG Jing, WANG Zishen, YUE Peng
    2025, 60(1):  99-105.  DOI: 10.3761/j.issn.0254-1769.2025.01.014
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    Objective A Social Care Needs Assessment Tool for Terminal Patients at Home is constructed and tested for its reliability and validity. Methods In view of the Social Ecosystem Theory,based on the semi-structured interviews,participatory observation and literature analysis of the social care needs of terminal patients at home,a questionnaire item pool was formed. Through 3 rounds of Delphi expert consultations,the initial version of the tool was formed. From April to December 2023,a convenient sampling method was used to select 504 terminal patients from 22 hospitals in 5 provinces as the research subjects. The reliability and validity of the tool were tested. Result The constructed tool in this study contained 3 dimensions:micro,meso,macro,with a total of 34 items. Cronbach’s α of the tool was 0.966 and split-half reliability was 0.877;I-CVI at the item level was 0.875~1.000 and S-CVI/Ave was 0.989;the exploratory factor analysis results showed that the factors load of each dimension were greater than 0.4;the results of confirmatory factor analysis showed that the tool had good fitting degree. Conclusion The reliability and validity of the nursing-based social care needs assessment tool for terminal patients at home constructed in this study are good,and it can provide a valid tool for healthcare professionals to assess the home-based social care needs of terminal patients.

    Enteral and Parenteral Nutrition
    Application of a refined early diet plan in patients with gastric cancer after laparoscopic radical surgery
    LI Yan, HE Ping, GAO Beilei, XU Huili, ZHU Huidi, LI Beibei, JIANG Yuehong, MA Yingchun
    2025, 60(1):  106-112.  DOI: 10.3761/j.issn.0254-1769.2025.01.015
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    Objective To investigate the application effect of a refined early diet plan in patients with distal gastric cancer after laparoscopic radical surgery. Methods By convenience sampling method,46 patients with laparoscopic radical gastrectomy for distal gastric cancer admitted to a tertiary hospital in Zhejiang Province from July to December 2023 were selected as an experimental group,while 49 patients admitted from January to June 2023 as a control group. The experimental group was administered with the refined early diet plan,and the control group was administered with conventional methods. The intervention period was from the first day after surgery to discharge. The differences of the first postoperative defecation time,perioperative thirst and hunger score,postoperative hospitalization time,hospitalization cost,postoperative complications and the incidence of readmission 30 days after surgery were compared between the 2 groups. Results 42 patients in the experimental group and 49 patients in the control group completed the study. First postoperative exhaust time(t=4.922,P<0.001),first postopera-tive defecation time(Z=-2.440,P=0.015),perioperative thirst score(Z=-8.024,P<0.001),perioperative hunger score (Z=-8.192,P<0.001),postoperative hospitalization time(Z=-7.622,P<0.001) and hospitalization cost(Z=-4.522,P<0.001) were lower than those of the control group,and the difference was statistically significant. There was no significant difference in complication rate and 30-day readmission rate between the experimental group and the control group(P>0.05). Conclusion The refined early diet plan is safe and effective for early recovery of patients after laparoscopic radical gastrectomy for distal gastric cancer,promoting intestinal function recovery,shortening hospital stay,reducing hospital costs,and improving patients’ subjective comfort.

    Evidence Synthesis Research
    Meta-synthesis of qualitative research of exercise behavior perception in community-dwelling older adults with frailty
    JIANG Siqi, HUANG Huanhuan, CHEN Lijuan, PENG Ying, YU Xinyu, WANG Chunni, CHEN Mei, XU Li, ZHAO Qinghua
    2025, 60(1):  113-120.  DOI: 10.3761/j.issn.0254-1769.2025.01.016
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    Objective To systematically evaluate and integrate qualitative studies on perception of exercise behaviors in community-dwelling older adults with frailty,and to provide references for clinical development of targeted exercise intervention strategies. Methods A systematic search of PubMed,Medline,Embase,PsycINFO,the Cochrane Library,SinoMed,Wanfang Database,CNKI,and VIP Database for qualitative studies on perception of exercise behaviors in older adults with frailty in the community was conducted from the inception of the databases to June 2024. Literature quality was evaluated using the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016 edition),and Meta-synthesis was performed using the theme synthesis method. Results A total of 10 papers were included,grouped into 10 categories and integrated into the 3 domains of the capability,opportunity,and motivation-behavior model(COM-B model),i.e. Preparation for exercise behavior is influenced by capability factors(physical reserve,knowledge reserve,psychological preparation);stage-specific motivational evolution promotes the internalization of exercise behavior(guiding,focusing,stimulating,and maintaining);external conditions provide opportunities for exercise behavior(individual interaction,community environment,and social support). Conclusion Perceptions of exercise behavior among community-dwelling older adults with frailty or are complex and influenced by a variety of factors. Future exercise intervention strategies should consider modifiable factors,enhance knowledge education,stimulate intrinsic motivation,and solidify external conditions,while also accommodating individual differences and preferences,so as to promote exercise participation and health enhancement in this group.

    Self-determination experience in home-based exercise rehabilitation of stroke patients:a qualitative meta-synthesis
    XU Jie, WANG Qing, SHAO Jianing, XU Wenjin, DAI Yuting, JI Kangling
    2025, 60(1):  121-128.  DOI: 10.3761/j.issn.0254-1769.2025.01.017
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    Objective To systematically evaluate and integrate real experience and feelings of self-determination in home-based exercise rehabilitation of stroke patients. Methods We searched databases including PubMed,Embase,Web of Science,Cochrane Library,CINAHL,CNKI,Wanfang,VIP,Sinomed. The literature of qualitative research on self-determination experience in home-based exercise rehabilitation of stroke patients from the establishment of the database to February 2024 was retrieved. 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 23 theme were extracted,and 10 new categories were formed after induction and integration,which were finally merged into 3 integrated results,including multiple dilemmas in rehabilitation self-determination,motivation transformation during self-determination,strategies to achieve self-determination. Conclusion During the process of home-based exercise rehabilitation for stroke patients,medical personnel should pay attention to patients’ determination dilemma,motivation changes and related strategies they adopt. Targeted decision-making programs should be developed for stroke patients,aiming for the scientific and precise advancement of exercise rehabilitation.