Table of Content

20 August 2025, Volume 60 Issue 16

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Multi-Dimensional Nursing Practice for Heart Failure

Construction and application of a home care readiness program for caregivers of patients with chronic heart failure

WANG Yu, HE Mengyu, QI Minghao, LEI Mengling, CHEN Zhenyue, WANG Feng, ZHOU Jing

2025, 60(16):  1925-1932.  DOI: 10.3761/j.issn.0254-1769.2025.16.001

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Objective To construct a home care readiness program for caregivers of patients with chronic heart failure based on the McMaster Family Functioning Model and explore its application effects. Methods The program was developed through literature analysis，expert correspondence and pre-testing. 86 pairs of patients with chronic heart failure and their caregivers who were admitted to the Department of Cardiology of a tertiary-level hospital in Bengbu City were conveniently selected from December 2023 to April 2024 as the study subjects. Using the coin-flip method，the patients were randomly divided into 43 pairs in an experimental group and 43 pairs in a control group on a ward-by-ward basis. The experimental group implemented the program on the basis of routine care，and the control group was given routine care. Differences in caregiver home care readiness，caregiver caregiving ability and patients’ quality of life were compared between the 2 groups at the time of admission，at the time of discharge，and 1 and 3 months after discharge. Results A total of 81 pairs of patients and their caregivers completed the intervention，with 41 in the experimental group and 40 in the control group. Repeated-measures ANOVA showed that there was an interaction effect between time and group for caregiver home care readiness，caregiver caregiving ability，and patient quality of life in both groups（F=320.995，P<0.001；F=83.303，P<0.001；F=113.283，P<0.001）. Simple effect analyses showed that caregiver home care readiness and caregiver caregiving competence scores were higher in the experimental group than those in the control group at the time of discharge and at 1 and 3 months post-discharge（P<0.001）；quality of life scores of patients in the experimental group were lower than it in the control group at 1 and 3 months post-discharge（P<0.001）. Conclusion The implementation of the program can effectively improve the home care readiness and caregiving ability of caregivers of patients with chronic heart failure，and improve the quality of life of patients.

Latent profile analysis of ego depletion in patients with heart failure and its influence on self-management behavior

TAO Xiu, GAO Min, WU Fan, SUN Shuyi, LU Jing, WEN Gaoqin, WANG Qin, SUN Guozhen

2025, 60(16):  1933-1940.  DOI: 10.3761/j.issn.0254-1769.2025.16.002

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Objective To explore the characteristics of latent profiles of ego depletion in patients with heart failure，and analyze the impacts of these profiles on patients’ self-management behavior. Methods 280 heart failure patients who were hospitalized in a tertiary grade A hospital were conveniently selected in Nanjing from April to October 2024 as study subjects. The investigation utilized a general information questionnaire，the Ego-Depletion Scale for Heart Failure Patients，the Self-Management Scale of Heart Failure Patients，and the Chronic Disease Self-Efficacy Scale. The latent profile categories of ego depletion was explored in heart failure patients. Univariate analysis and multiple Logistic regression analysis were used to investigate the influencing factors of different latent profile categories and the impact of each category on patients’ self-management levels. Results The ego depletion of 255 heart failure patients could be classified into 3 latent profiles：self-adaptive low depletion group（35.29%），symptom distressed moderate depletion group（43.53%），and social life change high depletion group（21.18%）. Multiple Logistic regression analysis showed that residence，primary caregiver，education level，New York Heart Association cardiac function grade，and self-efficacy score were factors influencing the potential profile of ego depletion in heart failure patients（P<0.05）. The comparison of self-management scores among patients in different latent profiles of ego depletion showed statistically significant differences（P<0.05）. Conclusion The level of ego depletion in patients with heart failure is high with significant heterogeneity. Medical staff should pay attention to the heterogeneity and influencing factors of ego depletion in patients with heart failure in time，and develop personalized comprehensive intervention strategies to alleviate ego depletion and improve their self-management levels.

Analysis of current practice status and influencing factors of intake and output recording in patients with heart failure

YAN Lin, ZHANG Chen, LIU Zhouzhou, YOU Guiying

2025, 60(16):  1941-1947.  DOI: 10.3761/j.issn.0254-1769.2025.16.003

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Objective To investigate the current status of cardiovascular nurses in intake and output recording of heart failure patients，and to provide a basis for further standardizing these practices. Methods A convenience sampling method was used to survey 7，761 cardiovascular nurses from 31 provinces in China in May 2024 using a self-designed questionnaire. The survey content included the content and methods of recording fluid intake and output，methods of liquid measurement，health education for patients and caregivers，and verification of the accuracy of fluid intake and output records. The chi-square test was used for comparison between groups. Results A total of 7，726 valid questionnaires were collected，with an effective response rate of 99.55%. Solid food（85.00%） and insensible water loss such as sweat（59.63%） were the lowest proportion items in the recording of intake and output，respectively. A total of 6，343 nurses （82.10%） reported that their wards had standardized “intake and output record forms”. A total of 3，782 nurses（48.95%） were able to use graduated measuring cups to quantify water intake，and 3，587 nurses（46.43%） could use a “food water content table” to convert the water content of solid foods. Additionally，5，050 nurses（65.36%） involved patients and caregivers in the recording of intake and output，and 5，419 nurses（70.14%） provided health education on intake and output recording to patients and caregivers. Furthermore，4，753 nurses （61.52%） verified the accuracy of the 24-hour intake and output records after completion. Nurses whose wards regularly provided training on intake and output recording，as well as those whose wards included the accuracy of intake and output recording in quality control，demonstrated better practice outcomes in this regard（P<0.001）. Conclusion The current clinical nursing practice of cardiovascular nurses in recording the intake and output of heart failure patients needs improvement. Relevant academic organizations should further refine the standards related to intake and output recording. Medical institutions should focus on strengthening training and quality control，optimizing clinical operation procedures，and providing material，institutional，and human resource support to improve the accuracy of fluid intake and output recording for heart failure patients and ensure patient safety.

Development and preliminary application of the Treatment Burden Scale for patients with chronic heart failure

MA Mengqi, ZHANG Xiaohong, HE Hong, ZHANG Wenjing, LI Jianzhi

2025, 60(16):  1948-1954.  DOI: 10.3761/j.issn.0254-1769.2025.16.004

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Objective To develop a Treatment Burden Scale for patients with chronic heart failure （CHF） and evaluate its reliability and validity，aiming to provide an effective tool for assessing treatment burden levels in this population. Methods According to Cumulative Complexity Model，the study was conducted in 2 phases.A preliminary item pool was established through literature review and semi-structured interviews，from August 2022 to March 2023，followed by expert consultation to finalize the initial scale. A convenience sample of CHF patients from 4 tertiary A hospitals in Hunan and Hubei provinces was conducted to refine scale items and assess psychometric properties，from June 2023 to April 2024. Results The final scale contained 26 items. Exploratory factor analysis revealed 6 domains，including family financial support burden，healthcare utilization burden，the challenges patients face in acquiring knowledge about proper medication use and water/sodium dietary management，the behavioral burden associated with tracking daily water/sodium intake and symptom patterns，psychological burden，and medication management burden，cumulatively explaining 68.661% of variance.Confirmatory factor analysis demonstrated satisfactory model fit；the χ²/df was 2.076；the root mean square error of approximation was 0.070；the normed fit index was 0.912；the content validity score was 0.974. The total Cronbach’s α coefficient of the scale was 0.903；the split-half reliability was 0.785；the test-retest reliability was 0.936. Conclusion The Treatment Burden Scale for CHF patients developed in this study has good reliability and validity psychometric properties，and it can be used to evaluate treatment burden levels and influencing factors in clinical practice.

Nursing care of a patient with chronic heart failure complicated with achalasia

ZHENG Hongzhen, XU Dongping

2025, 60(16):  1955-1958.  DOI: 10.3761/j.issn.0254-1769.2025.16.005

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To summarize the nursing experience of a patient with chronic heart failure complicated with achalasia. The main nursing points were as follows：stabilizing electrolyte to correct malignant arrhythmia；providing stepped nutritional support based on swallowing function rating to improve nutritional status；acapella technology combined with micro-positive pressure high-flow oxygen therapy for airway clearance to control lung infection；implementing the whole process of psychological counseling to improve treatment confidence and compliance；formulating a systematic discharge preparation service plan to ensure continuous care. After careful care assisted by a multidisciplinary team，the patient was discharged smoothly after 13 days of hospitalization，followed up for 3 months，and recovered well.

Specialist Nursing Practice and Research

Effect of a nurse-led fluid responsiveness monitoring protocol in preventing fluid accumulation syndrome in patients with septic shock

YE Lixia, XU Ye, LI Qin, JI Kexin, ZHOU Hong

2025, 60(16):  1959-1965.  DOI: 10.3761/j.issn.0254-1769.2025.16.006

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Objective To develop a nurse-led dynamic monitoring protocol for fluid responsiveness and to evaluate its effectiveness in preventing fluid accumulation syndrome in patients with septic shock. Methods A nurse-led dynamic monitoring protocol for fluid responsiveness was developed through literature review and expert panel discussion. Using convenience sampling，160 patients with septic shock admitted to the emergency department of a tertiary hospital in Hangzhou，Zhejiang Province，were enrolled. According to admission period，80 patients admitted from November 2023 to August 2024 were assigned to an intervention group，and 80 patients admitted from January 2023 to October 2023 were assigned to a control group. The intervention group received the nurse-led dynamic monitoring in addition to routine care，while the control group received routine care and conventional fluid responsiveness monitoring. The therapeutic outcomes and incidence of complications were compared between the 2 groups. Results All 80 patients in each group completed the study. The intervention group demonstrated higher lactate clearance rates at 6 and 24 hours after fluid resuscitation，lower incidences of acute pulmonary edema and fluid accumulation syndrome，and shortened durations of mechanical ventilation and ICU stay（all P<0.05） compared to the control group. There was no statistically significant difference in 28-day mortality between the 2 groups（P=0.212）. Conclusion The nurse-led dynamic monitoring protocol for fluid responsiveness in patients with septic shock is both scientific and practical. Its implementation can effectively improve lactate clearance，reduce the incidence of fluid accumulation syndrome and acute pulmonary edema，and shorten the duration of mechanical ventilation and ICU stay.

A study of the effectiveness of an ICU transitional care program in improving relocation stress and caregiving skills of parents of critically ill children

YANG Hanlin, JI Jianlin, ZENG Chengxi, CHEN Ouyao, LU Qunfeng

2025, 60(16):  1966-1973.  DOI: 10.3761/j.issn.0254-1769.2025.16.007

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Objective Constructing a transitional care program for critically ill children in the ICU and exploring the effects of its application on the relocation stress and caregiving abilities of parents of children to improve their caregiving experience. Methods Convenience sampling method was used to select 150 children and their families transferred from PICU to the general ward of a tertiary pediatric hospital in Shanghai from January to September 2023 as research subjects. Subjects enrolled from June to September 2023 were selected as an experimental group，and were applied with the ICU transitional care program for critically ill children. Those enrolled from January to April 2023 were selected as a control group，and received routine ICU transitional care. Family Relocation Stress Scale and Family Caregiver Task Inventory were used to evaluate children’s families at 24h before，24h after，and 72h after children’s transition from ICU. The incidence of unplanned readmission to ICU within 48h and adverse events were compared between 2 groups of children. Results Eventually 74 pairs in the experimental group and 75 pairs in the control group completed the study. The Family Caregiver Task Inventory scores in the experimental group were lower than that in the control group（P=0.046）. Generalized estimation equation showed that，there were significant differences on the intervention effect，the time effect，and the interaction effect of the Family Relocation Stress Scale scores in 2 groups（P<0.05）. Conclusion The ICU transitional care program for critically ill children constructed in this study can effectively improve the level of migration stress and caregiving ability of parents of critically ill children，and optimize the quality of transitional care for critically ill children.

Latent profile analysis of nutrition literacy among young and middle-aged patients with type 2 diabetes mellitus combined with overweight or obesity and its relationship with dietary motivation

SHEN Xiangjie, YIN Wei, LIU Qiaoyan, CAO Songmei, ZU Houjuan, SHA Huiying, WANG Jingjing

2025, 60(16):  1974-1980.  DOI: 10.3761/j.issn.0254-1769.2025.16.008

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Objective To investigate the potential categories of nutrition literacy in young and middle-aged patients with type 2 diabetes mellitus combined with overweight or obesity，and analyze the relationship between various latent categories and dietary motivation，so as to provide references for clinical working staff to develop relevant dietary intervention strategies. Methods A convenient sampling method was used to enroll 270 young and middle-aged patients with type 2 diabetes mellitus combined with overweight or obesity from the endocrine department of a tertiary general hospital in Zhenjiang City，Jiangsu province，using basic information questionnaire，Nutrition Literacy Measurement Scale for Chinese adults，and the Regulation of Eating Behaviors Scale to collect data，using latent profile analysis to extract nutrition literacy potential categories，with general data and potential categories as independent variables，dietary motivation as the dependent variable for univariate analysis and multiple linear regression analysis. Results A total of 262 young and middle-aged patients with type 2 diabetes mellitus combined with overweight or obesity completed the survey，and their nutrition literacy could be divided into 3 potential categories：low nutrition literacy group（16.41%），transformation dilemma group （54.96%），and middle and high nutrition literacy group（28.63%）. The results of multiple linear regression analysis showed that residency style，potential categories of nutrition literacy and presence of diabetic complications were the influencing factors of dietary motivation in young and middle-aged patients with type 2 diabetes mellitus combined with overweight or obesity（P<0.05）. Conclusion There was a group heterogeneity in nutrition literacy in young and middle-aged patients with type 2 diabetes mellitus combined with overweight or obesity. Clinical working staff should provide targeted interventions based on the patient’s potential categories of nutrition literacy to stimulate ongoing motivation to maintain a healthy diet.

Analysis of the current situation and potential profile of anxiety regarding missed social interaction among adolescent patients with severe accidental trauma

DUAN Jie, LI Chuanhao, TANG Zhihong

2025, 60(16):  1981-1988.  DOI: 10.3761/j.issn.0254-1769.2025.16.009

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Objective To understand the current status of fear of missing out（FoMO） social interaction in adole-scent patients with severe accidental trauma，and to explore its potential categorical characteristics，and analyze the influencing factors of different categories. Methods A convenience sampling method was employed to select 301 adolescent patients with severe accidental trauma admitted to the surgical and trauma ICU of a tertiary hospital in Chengdu City from January to December 2024. Data were collected using a general information survey，the Fear of Missing Out Scale，the Adolescent Learning Stress Scale，and the Self-Perceived Burden Scale. Latent profile analysis and multiple logistic regression analysis were used to determine different profiles and their influencing factors. Results A total of 245 adolescent patients with severe accidental trauma were ultimately included，with a Fear of Missing Out Scale score of（21.55±8.17），being categorized into 4 potential profiles of “independent type”（28.16%），“normal type”（19.59%），“social dependence type”（22.04%），and “information deficiency type”（30.20%）. The results of multiple logistic regression analysis showed that literacy，per capita monthly family income，level of academic stress，level of self-awareness of medical staff care，being an only child，level of self-perceived burden，and length of hospitalization were the factors influencing the potential profiles of FoMO social interaction in adolescent patients with unintentional trauma（all P<0.05）. Conclusion There is group heterogeneity in FoMO social interaction among adolescent patients with severe accidental trauma. Medical staff should develop targeted intervention measures based on the classification characteristics of different profiles of missing anxiety in adolescent accidental trauma patients to alleviate their levels of FoMO social interaction.

Construction and validation of a risk prediction model for emergence agitation in patients undergoing thoracoscopic radical resection of lung cancer

ZHOU Xiaoyun, HE Minzhi, ZHOU Ningning, XU Qin, JIANG Hong, ZHOU Xiaolian, NING Li

2025, 60(16):  1989-1995.  DOI: 10.3761/j.issn.0254-1769.2025.16.010

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Objective To construct and verify a risk prediction model of emergence agitation in patients undergoing thoracoscopic radical resection of lung cancer，and to screen the optimal model by using machine learning algorithm，so as to provide references for clinical formulation of a nursing risk management plan. Methods The convenience sampling method was used to retrospectively select 476 patients who underwent thoracoscopic radical resection of lung cancer in a tertiary hospital in Hangzhou，Zhejiang Province from January to December 2023 as a construction group. Logistic regression，decision tree，random forest and naive Bayesian model were constructed by SPSS 29.0 and R 4.3.0 software. The prediction performance of each model was compared by accuracy，precision，recall，F1 score and area under the receiver operating characteristic curve，and the optimal model was screened. From January to June 2024，204 patients in the unit were prospectively selected as the research subjects of an external validation group. The discrimination and calibration of the optimal model were evaluated by AUC value and calibration curve. Results A total of 680 patients completed the survey. All 4 models showed that multimodal analgesia，thoracic drainage tube type，pain score，tracheal intubation type，state anxiety and catheter indwelling time were the influencing factors of emergence agitation in patients undergoing thoracoscopic radical resection of lung cancer（P<0.05）. The 4 risk prediction models showed that the random forest prediction model had the best comprehensive performance. The external verification results showed that the AUC value was 0.913，and the calibration curve fitted well with the 45° ideal line. Conclusion Among the 4 risk prediction models，the random forest prediction model has the best performance，which is more suitable for the assessment of the risk of emergence agitation in patients undergoing thoracoscopic radical resection of lung cancer，and has good generalization and clinical application value.

Relationship between active exercise rehabilitation behavior and symptoms trajectory in middle aged patients with chronic obstructive pulmonary disease

CHENG Rong, ZHANG Zhixia, LIU Limin, CHEN Qiuxia, YANG Zhen, WU Hui, JIANG Fang, QIAO Linru

2025, 60(16):  1996-2001.  DOI: 10.3761/j.issn.0254-1769.2025.16.011

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Objective To explore the temporal characteristics and correlation between active exercise rehabilitation behaviour and related symptoms in middle-aged chronic obstructive pulmonary disease（COPD） patients，and to provide a basis for constructing a full cycle precision rehabilitation management system. Methods The ecological momentary assessment method was used to select 63 middle-aged COPD patients from the respiratory and critical care medicine department of a tertiary comprehensive hospital in Wuhan from October 15 to December 1，2024，using convenience sampling. Their active exercise rehabilitation behaviour（number of exercise projects，duration） and related symptoms（dyspnea，fatigue，anxiety） were continuously monitored for a week by using baseline survey，daily active exercise rehabilitation behavior assessment questionnaire，daily symptom assessment questionnaire. A multi-layer linear model was used to analyze the dynamic correlation between active exercise rehabilitation behaviour and symptoms. Results 58 patients were included. During the 1-week ecological momentary assessment，the system triggered a total of 1，218 momentary assessments and obtained 1，120 valid responses（with the valid response rate of 91.95%），with patients completing an average of（2.76±0.39） assessments per day. Multilevel linear models showed that momentary dyspnoea，fatigue，anxiety symptoms and baseline kinesiophobia all significantly negatively influenced active exercise rehabilitation behaviour（P<0.05）. Conclusion There are dynamic changes in the active exercise rehabilitation behaviour and related symptoms of middle-aged COPD patients. Nursing staff should establish a precise rehabilitation intervention system based on symptom fluctuations，strengthen patient self-management efficiency through dynamic monitoring and hierarchical management，and achieve long-term optimization of lung rehabilitation effects.

Care Quality and Safety

Construction and application of an inpatient hospital discharge preparation service management platform

LI Ying, SUN Wenxin, SUN Furong, YAO Xinyu, CAO Qiuning, LIU Haochen, SUN Xiujie

2025, 60(16):  2002-2008.  DOI: 10.3761/j.issn.0254-1769.2025.16.012

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Objective To build an inpatient hospital discharge preparation service management platform，to explore its application outcomes，and to enhance the quality of discharge preparation service management. Methods A research team was set up，and the literature was referenced. The platform was built on the basis of connecting and optimizing various existing information systems in the hospital，including 6 modules：evaluation，implementation of nursing，referral，monitoring feedback，follow-up，and continued nursing. Patients admitted to a tertiary comprehensive hospital were conveniently selected as research subjects in Shandong Province from August 2023 to January 2024. The 97 patients included after the platform application（November 2023 to January 2024） were selected as an experimental group，and the 97 patients included before the platform application（August to October 2023） were selected as a control group. The rate of unplanned readmission within 30 days，the utilization rate of “Internet + Nursing Services”，and the time for assessing the demand for discharge planning service were compared between the 2 groups. In addition，in February 2024，300 healthcare professionals from the same hospital were selected to evaluate their satisfaction with the use of the platform. Results There were 7 cases dropping out in each of the 2 groups. The rate of unplanned readmission within 30 days in the experimental group was lower than that in the control group；the utilization rate of “Internet + Nursing Services” was higher than that in the control group；the time for assessing the demand for discharge planning service was less than that in the control group，with statistically significant differences（P<0.05）. In the satisfaction survey of medical staff on the use of the platform，the effective questionnaire response rate was 94.67%，and the score of the clinical nursing information system effectiveness evaluation scale was（100.84±16.48） points. Conclusion The use of this platform can reduce the unplanned readmission rate of patients within 30 days，promote the development of “Internet + Nursing Services”，reduce the time for assessing the needs of discharge planning services，and medical staff are highly satisfied with the use of the platform.

Construction and application of a platform for reporting medication near-miss events

WANG Fang, YANG Xiaoguo, SHEN Dexin, ZHENG Xican, DING Xiaoyong, JIANG Xiaomeng, HUANGFU Jiaxin, QU Jingrui

2025, 60(16):  2009-2015.  DOI: 10.3761/j.issn.0254-1769.2025.16.013

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Objective To develop a platform for reporting medication near miss events and evaluate its application effectiveness，aiming to enhance medication safety of patients. Methods Based on literature review，qualitative interviews，and expert group meetings，a medication near-miss event reporting platform was constructed，including 4 modules：event content filling，event risk grading，event handling，and statistical analysis. 50 nurses were conveniently selected from the pediatric ward of a tertiary grade A hospital in Henan Province as the application subjects. The reporting situation and filling duration of medication near miss events，the score of the Medication Near Miss Reporting Disorder Scale，and the incidence of medication near miss events were compared after the application of the platform（from March to August 2023） and before the application（from September 2022 to February 2023）. Results The reporting rate of medication near miss events after the application of the platform was higher than that before the application of the platform，and the comparison of the distribution of event nature and occurrence links showed statistically significant differences（P<0.05）. After the application of the platform，the reporting duration of medication near miss events was shorter than that before the application of the platform，and the score of the Medication Near Miss Reporting Disorder Scale was lower than that before the application of the platform. The differences were statistically significant（P<0.001）. There was no statistically significant difference in the incidence of medication near miss events before and after the application of the platform（P=0.241）. Conclusion Using this platform can help improve the reporting rate of medication near miss events，reduce the time taken to fill out reports，and minimize reporting barriers for nurses.

Rare Disease and Critical Care

Perioperative care of a preterm infant with ABO hemolytic disease undergoing resection of a giant sacrococcygeal teratoma

MENG Dan, XIAO Juan, ZENG Yuling, WANG Liping, LIU Xian, CHEN Peiwei

2025, 60(16):  2016-2020.  DOI: 10.3761/j.issn.0254-1769.2025.16.014

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To summarize the perioperative nursing experience of a premature infant with ABO hemolytic disease who underwent resection of giant Altman type I sacrococcygeal teratoma at 43 hours after birth. Key points of preoperative nursing care include the cooperative blood transfusion to correct anemia，and the protection of tumor body，the prevention of rupture and bleeding. Key points of intraoperative nursing care include the personalized postural safety management，the target-oriented fluid therapy to maintain circulation stability，and composite insulation measures to prevent hypothermia. Key points of postoperative nursing care include sequential fluid replenishment to treat neonatal capillary leakage syndrome；protective ventilation strategies to maintain effective breathing；precision wound care，prevention and control of postoperative infection；progressive mixed feeding；to empower family members and improve the quality of continuous rehabilitation. After careful treatment and nursing care，the patient was discharged 18 days after surgery. During the 7-month follow-up，the growth and development were normal.

Nursing care of a patient with dilated cardiomyopathy accompanied by recurrent superior mesenteric artery embolism and massive gastrointestinal hemorrhage

CHEN Jianfen, ZHU Huidi, JIANG Yuehong, Kimberly Dong

2025, 60(16):  2021-2025.  DOI: 10.3761/j.issn.0254-1769.2025.16.015

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To summarize the nursing experience of a patient with dilated cardiomyopathy experiencing recurrent superior mesenteric artery embolism and gastrointestinal hemorrhage post-enterectomy. Nursing key points：the development of a hemorrhage-embolism dual-risk assessment program and prevention and control interventions；the implementation of rapid-response emergency care for hemorrhagic shock combined with septic shock；active anti-infective care；the implementation of sudden cardiac death and ventricular arrhythmia early warning care；the establishment of a collaborative community follow-up management mechanism. The patient was discharged successfully after 44 d of hospitalization. During the 12-week follow-up，LVEF was 41%，and the patient could take care of himself in daily life.

Evidence Synthesis Research

Systematic review of measurement properties of patient-reported outcome measures for transnasal endoscopic pituitary adenoma surgery

HAN Xiaoxu, WANG Wei, HUANG Qinghua, ZHANG Yuping, QIAN Yuehong

2025, 60(16):  2026-2032.  DOI: 10.3761/j.issn.0254-1769.2025.16.016

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Objective To systematically evaluate the psychometric properties of specific self-reported outcome assessment tools for patients undergoing Endoscopic Transnasal Transsphenoidal Surgery（ETTS），with the aim of pro-viding clinical healthcare professionals with evidence to guide the selection of appropriate assessment tools. Methods A systematic search was performed across multiple databases，including the North American Skull Base Society，PubMed，Embase，CINAHL，Web of Science，Cochrane Library，CNKI，VIP database，Wanfang database，and the China Biomedical Literature Database，for studies published from the inception of each database to January 9，2025，that are related to ETTS-specific symptom assessment tools. Totally 2 independent researchers screened the literature and extracted relevant data. The consensus-based health measurement tool selection bias risk checklist and quality standards were used to evaluate the methodological quality and psychometric properties of the included studies，which helped to form the development of recommendations. Results A total of 11 articles were included，covering 8 specific self-reported outcome assessment tools for patients undergoing endonasal transsphenoidal pituitary tumor resection. Of these，the Pituitary Outcome Score and the Leiden Bother and Needs Questionnaire for patients with pituitary disease 2 tools were rated as Grade A recommendations，and 6 tools were rated as Grade B recommendations. Conclusion POS and LBNQ-Pituitary are recommended due to their relatively strong overall methodological quality and psychometric properties. However，further validation with larger sample sizes is necessary.

Summary of the best evidence for foot offloading care to prevent diabetic foot recurrence

WAN Yan, JIA Qing, BAI Jiaojiao

2025, 60(16):  2033-2039.  DOI: 10.3761/j.issn.0254-1769.2025.16.017

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Objective To retrieve，screen，and integrate evidence related to foot offloading care for preventing the recurrence of diabetic foot，and provide a reference for clinical nursing practice. Methods According to the “6S” pyramid model of evidence-based resources，relevant domestic and foreign databases and professional websites were systematically searched for the literature on foot offloading care to prevent the recurrence of diabetic foot. The retrieval time limit was from the establishment of the database to January 2025. Totally 2 researchers independently evaluated the quality of the literature，and the evidence was extracted from the literature that met the quality standards. Results A total of 14 pieces of the literature were included，including 8 guidelines，4 expert consensuses，1 evidence summary，and 1 systematic review. A total of 36 pieces of evidence were summarized from 4 dimensions，including foot pressure assessment，local pressure adjustment，daily foot offloading behaviors，and offloading prevention health education. Conclusion This study summarizes the best evidence of foot offloading care for the prevention of diabetic foot recurrence，which is scientific and comprehensive，and it can provide an evidence-based basis for clinical practice. It is recommended to apply the evidence according to specific clinical scenarios and the personalized characteristics of patients to better improve the clinical outcomes of patients.

Review

Progress in the application of time perspective therapy in self-management of chronic disease patients

CHEN Ciai, DING Shanni, PAN Hongying, GUO Jing, ZHOU Jinyan, WU Wenjin

2025, 60(16):  2040-2043.  DOI: 10.3761/j.issn.0254-1769.2025.16.018

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Time perspective therapy can reshape the time perspective of chronic disease patients，improve their psychological state，optimize behavioral patterns，and enhance self-management awareness. This article reviews the concept and theoretical basis of time perspective therapy，assessment methods of time perspective，and influencing factors of time perspective in chronic disease patients，as well as methods and effects of applying time perspective therapy in self-management. Additionally，it analyzes challenges in implementation and proposes practical recommendations，aiming to provide psychological guidance for self-management interventions in chronic disease patients.

Research progress on cognitive load theory in digital health education for the elderly

YAN Chuchu, LI Yawen, LIU Mengnan, SHAN Yawei

2025, 60(16):  2044-2049.  DOI: 10.3761/j.issn.0254-1769.2025.16.019

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Digital health education is a crucial means to enhance the accessibility and effectiveness of medical services. The "new digital gap" faced by the elderly population makes them a marginalized group in digital health education and disease management. This paper takes cognitive load theory as its starting point，outlines the theoretical foundation of cognitive load，and systematically reviews the factors that influence cognitive load in digital health education for the elderly and propose corresponding optimization inspirations. The aim is to provide references for optimizing digital education models and program designs for the elderly.