Objective:To explore the application effect of integrated Chinese and Western medicine nursing based on the individual and family self-management theory (IFSMT) in patients with urinary incontinence after stroke, and provide reference for clinical nurses to effectively rehabilitate these patients.Methods:This was a quasi-experimental study. A total of 136 patients with urinary incontinence after stroke who were hospitalized in the Department of Encephalopathy of Shanxi Acupuncture and Moxibology Hospital from February 2022 to May 2023 were selected as the study objects by convenience sampling method. The subjects were divided into the control group and the experimental group with 68 cases in each group by random number table method. The control group received routine rehabilitation nursing, and the experimental group received integrated Chinese and western medicine nursing based on IFSMT on the basis of routine rehabilitation nursing. Urinary status, activities of daily living and quality of life of 2 groups were compared.Results:Ultimately, there were 68 cases were admitted in each group. In the control group, male 45 cases, female 23 cases, aged (62.35 ± 4.94) years old. In the experimental group, male 49 cases, female 19 cases, aged (61.94 ± 5.02) years old. There was no statistical significance in urinary status, activities of daily living and quality of life scores between the 2 groups before the intervention (all P>0.05). After the intervention, the average daily urination frequency of experimental group was (7.94 ± 1.08) times, which was lower than that of control group (9.88 ± 1.09) times; the average daily frequency of incontinence in the experimental group was (3.63 ± 1.65) times, lower than (5.03 ± 3.35)times in the control group; the average daily urine volume of experimental group was (107.34 ± 4.15) ml, higher than (89.62 ± 19.71) ml of control group, and the differences were statistically significant ( t=10.46,3.09, -7.23, all P<0.05). The scores of activities of daily living in the experimental group was (60.44 ± 3.65) points, which were higher than (46.24 ± 3.29) points in the control group; the Incontinence Quality of Life Questionnaire score of experimental group was (80.38 ± 4.65) points, which was higher than (64.62 ± 5.62) points of control group; Insomnia Severity Index-Short Form score of the experimental group was (10.94 ± 5.17) points, which was lower than (12.85 ± 4.30) points of the control group, and the differences were statistically significant ( t=23.85, -17.86, 2.34, all P<0.05). Conclusions:Integrated Chinese and western medicine nursing intervention based on IFSMT has a positive effect on patients with urinary incontinence after stroke, and can significantly improve patients' urination and daily living activities, thus improving patients' quality of life.

Objective:To explore the application effect of intelligent management software and improved drug boxes in the management of emergency drugs and articles, and provide convenience for clinical emergency work.Methods:This was a quasi-experimental study. In July 2021, a research and development team was set up in the First People ′s Hospital of Pinghu to develop intelligent management software and design emergency vehicle drug boxes. The application began in October 2021, mainly for the management of emergency drugs and medical equipment. The management quality indexes of emergency vehicle, the time nurses checked emergency medical items, the time nurses took medicines from the emergency vehicle, and the satisfaction of nurses to the intelligent management software and the improved drug boxes were compared before and after the use of the intelligent management software and the improved drug boxes. Results:The management quality of rescue vehicles had been significantly improved by the use of intelligent management software. The perfect rate of first aid equipment, the coincidence rate of base, the correct rate of effective period management and the correct rate of near effective period identification were increased from 92.50% (74/80), 87.50% (70/80), 81.25% (65/80), 93.75% (75/80) before use to 100.00% (80/80) after use, respectively, the handover norm rate was increased from 87.50% (70/80) to 97.50% (78/80) and the differences were statistically significant ( χ2 values were 5.16-16.55, all P<0.05). Emergency drugs and articles had not expired after use, but the difference was not statistically significant compared with that before use ( P>0.05). After the use of intelligent management software and improved drug boxes, the time for nurses to count first aid drugs and the time for taking drugs from the rescue car were (12.39 ± 3.20) min and (2.60 ± 0.70) s, respectively, which were significantly shortened compared with (34.62 ± 29.37) min and (10.00 ± 2.54) s before use, and the differences were statistically significant ( t=8.52, 33.40, both P<0.05). The overall satisfaction rate of nurses with the intelligent management software and improved drug boxes was 99.83% (1 732/1 735). Conclusions:The combination of intelligent management software and improved drug boxes can effectively improve the standardized management of emergency drugs and articles, increase the efficiency of nurses, and deserve promotion and use in grassroots hospitals.

Objective:To explore the effects of nutrition management based on Patient-Generated Subjective Global Assessment (PG-SGA) on nutritional idicators,quality of life and other indicators in patients with pancreatic cancer undergoing chemotherapy, to provide guidance for the implementation of the intervention plan for pancreatic cancer patients undergoing chemotherapy.Methods:This was a randomized controlled study. From January 2021 to December 2022, 96 patients with pancreatic cancer who received chemotherapy in Shanghai Changzheng Hospital and Affiliated Cancer Hospital of Fudan University were selected using convenience sampling method and divided into the observation group and the control group according to the random number table, with 48 cases in each group. The control group was given routine nursing intervention, and the observation group was given PG-SGA-based nutrition management intervention. Patients in both groups continued the intervention until discharge. Nutritional indexes, quality of life, the score of cancer-related fatigue, sleep quality and mental state before and after intervention, intervention compliance and satisfaction after intervention, and complications during intervention of both groups were compared.Results:There were 48 patients in each group ultimately. In the control group, there were 28 males, 20 females, aged (63.33 ± 4.31) years old; in the observation group, there were 27 males, 21 females, aged (63.15 ± 4.25) years old. After intervention, the PG-SGA score, serum triacylglycerol level, and scores of Revised Piper ′s Fatigue Scale and Arsens Insomnia Scale, Self-rating Anxiety Scale and Self-rating Depression Scale in the observation group were (3.87 ± 1.16) points, (1.35 ± 0.52) mmol/L, (3.79 ± 0.67) points, and (5.31 ± 2.05), (44.55 ± 5.14), (45.15 ± 5.08) points respectively, lower than the control group ′s (5.77 ± 1.58) points, (2.04 ± 0.35) mmol/L, (4.82 ± 0.88) points, and (7.29 ± 2.14), (51.74 ± 5.18), (52.26 ± 5.11) points, the differences were statistically significant ( t values were 4.63-7.63, all P<0.05); the serum levels of retinol binding protein and transferrin were (18.13 ± 2.41) mg/L and (61.25 ± 5.34) ng/L, respectively, higher than the control group ′s (15.29 ± 2.33) mg/L and (48.31 ± 5.28) ng/L, with statistical significance ( t=5.87, 11.94, both P<0.05). The symptom domain score in the observation group after intervention was (56.17 ± 5.25) points, lower than (66.22 ± 5.57) points in the control group, while the cognitive, social, emotional, role, and physical scores were (76.35 ± 5.71 ), (77.55 ± 6.51 ), (75.87 ± 6.45), (77.38 ± 6.61), (75.75 ± 6.37) points, higher than (66.29 ± 5.39), (65.74 ± 6.34 ), (64.22 ± 6.18), (66.56 ± 6.26), (65.74 ± 6.11) points in the control group ( t values were 7.86 to 9.10, all P<0.05). Conclusions:Nutritional management based on PG-SGA could reduce the degree of cancer-induced fatigue, relieve negative emotions, improve the overall nutritional status, improve intervention compliance, reduce the occurrence of complications; improve sleep quality, quality of life, and patient ′s satisfaction.

Objective:To explore the application effect of slope adjustment mattresses in the position management of pediatric intensive care unit (PICU) mechanically ventilated children, in order to seek methods for maintaining effective posture in clinical practice.Methods:This was a quasi-experimental study. In this study, the mechanically ventilated children in PICU of Hunan Children′s Hospital from January 1 to December 31, 2022 were selected by convenient sampling method and divided into control group ( n=21) and experimental group ( n=21) according to random number table. Children in control group used the hospital bed and the traditional posture management, and children in experimental group used the slope adjustment mattress for posture management. The comfort scores, mechanical ventilation time, PICU length of stay, postural decline, unplanned extubation and blood gas analysis index were compared between the two groups. Results:There were 21 cases were admitted in each group ultimately. In the control group, there were 10 males and 11 females, the age was (31.43 ± 27.01) months. There were 11 males and 10 females in the experimental group, the age was (24.57 ± 24.20) months. The comfort scores of the experimental group were (13.57 ± 0.93) and (12.52 ± 0.60) points at the 24 hour and 72 hour respectively; while the comfort scores of the control group were (16.05 ± 1.72) and (15.81 ± 1.66) points at the 24 hour and 72 hour respectively. There were significant differences between the two groups ( t=5.82, 8.52, both P<0.05). The mechanical ventilation time was (5.43 ± 2.48) d, the PICU length of stay was (9.29 ± 3.04) d, and the number of postural decline was (7.52 ± 2.06) times in the experimental group which was superior to control group (8.52 ± 4.65) d, (12.71 ± 6.76) d, (14.95 ± 6.86) times, the differences were significant ( t=2.69, 2.12, 4.75, all P<0.05). There were 0 case of unplanned extubation in the experimental group and 4 cases of unplanned extubation in the control group .The difference was significant ( χ2=5.97, P<0.05). For blood gas analysis, PaCO 2 on the second day were (56.90 ± 6.77) mmHg (1 mmHg=0.133 kPa) in the control group, and (48.67 ± 8.13) mmHg in the experimental group; PaO 2, oxygenation index, PaCO 2 on the third day were (91.19 ± 16.27), (278.19 ± 71.54), (51.62 ± 4.73) mmHg in the control group, and (110.43 ± 21.73), (347.33 ± 90.95), (40.24 ± 5.57) mmHg in the experimental group, the differences were significant ( t values were 7.50-51.00, all P<0.05). There were significant differences about blood gas analysis of time interaction, inter-group interaction, time and inter-group interaction were compared between the two groups ( F values were 3.62-66.38, all P<0.05). Conclusions:Slope adjustment mattresses can maintain effective posture, improve comfort, shorten PICU hospital stay and mechanical ventilation time, significantly reduce posture decline and the risk of unplanned tube withdrawal adverse events in PICU mechanically ventilated children. Improving ventilation and ventilation disorders to enhance blood gas analysis indicators.This appliance can be used as an optimized choice for posture management and expected to effectively improve the quality of nursing care.

Objective:To explore the impact of Cox interaction model of client health behavior (IMCHB) on stress response and rehabilitation outcome in patients undergoing coronary artery bypass graft, and to provide reference for caregivers to reduce stress response in such patients and improve rehabilitation outcomes.Methods:This was a quasi-experimental study, and 62 surgical patients undergoing coronary artery bypass graft in the cardiac surgery department of the First Affiliated Hospital of Xinjiang Medical University were selected from January to June 2023.Among them, 31 patients admitted from January to March 2023 were in the control group, and routine nursing measures were taken; 31 patients admitted from April to June 2023 were in the intervention group with IMCHB nursing based on this routine nursing. The anxiety, depression, quality of life, hemodynamic indicators, postoperative activity time, evacuation time, pericardial/mediastinal drainage time, ICU stay length and total hospitalization length between the two groups were compared.Results:There were 31 cases were admitted in each group. There were 28 males and 3 females,aged (57.42 ± 7.38) years old in the control group. There were 27 males and 4 females, aged (56.29 ± 7.29) years old in the intervention group. After intervention, the total score of anxiety and depression and SF-36 in the intervention group were respectively (16.87 ± 4.83) points and (78.32 ± 13.41) points, and the control group were (20.81 ± 6.35) points and (69.97 ± 11.37) points, respectively, and the differences between the two groups were statistically significant ( t=2.75, -2.65, both P<0.05). Immediately after completion of cardiopulmonary bypass (T3), the mean arterial pressure in the intervention group was (85.55 ± 8.46) mmHg (1 mmHg=0.133 kPa), higher than (74.33 ± 17.40) mmHg in the control group, heart rate was (77.72 ± 10.97) times/min, lower than (88.35 ± 15.96) times/min in the control group. At the beginning of cardiopulmonary bypass (T2), and when leaving the operation room (T4), the heart rate of patients in the intervention group was (69.50 ± 10.94), (81.11 ± 10.22) times/min, significantly lower than (77.98 ± 14.51), (90.47 ± 15.44) times/min in the control group, the differences were statistically significant ( t values were -3.23 to 3.06, all P<0.05). In the intervention group, first ambulation, exhaust, pericardial/mediastinal drain retention, ICU stay, total hospitalization were (7.48 ± 2.83), (3.06 ± 0.99), (6.52 ± 2.39), (5.35 ± 3.20), (28.90 ± 5.63) d, all were significantly lower than (12.81 ± 4.84),(4.55 ± 1.65), (8.87 ± 3.30), (12.74 ± 7.31), (35.94 ± 8.82) d in the control group with statistical differences ( t values were 3.21-5.29, all P<0.05). Conclusions:The application of Cox health behavior interaction mode can reduce the anxiety and depression in coronary artery bypass graft patients, improve the quality of life, reduce the stress response of patients, and improve the rehabilitation outcomes.

Objective:To construct a communication strategy and implementation method for advanced cancer patients based on two communication models widely used at home and abroad, so as to reduce the difficulty of clinical disease notification.Methods:From January to October 2022, based on the communication model of SPIKES (Setting, Perception, Invitation, Knowledge, Empathy, Summary) and NURSE(Name, Understand, Respect, Support, Explore), combined with literature analysis, qualitative interviews, and expert argumentation, the communication strategy items of advanced cancer patients were constructed.Results:A total of 18 articles were included in the literature analysis. Qualitative interviews were conducted with 20 interviewees (including 4 doctors, 11 nurses, and 5 patients),6 males, 14 females, aged (35.94 ± 8.03) years old. A total of 8 experts participated in the demonstration, 2 males and 6 females, aged (41.88 ± 6.58) years old. Finally, the specific items and words of the disease notification process and communication strategies of advanced cancer patients in line with China ′s clinical practice were constructed. A total of 3 first-level items, 16 second-level items, 53 third-level items, and speech techniques were constructed, including pre-communication preparation, regular communication strategies, and poor communication disposal strategies. The importance score of the item was 4.50 to 5.00, and the coefficient of variation of the item was 0 to 0.12. Conclusions:The communication strategy of advanced cancer patients based on the communication model is scientific and feasible, and can be used as a tool to inform advanced cancer patients.

Objective:To investigate the status quo and influencing factors of support perception of spouses of breast cancer patients, and to provide reference for clinical intervention.Methods:A cross-sectional study was conducted to facilitate the selection of 180 breast cancer patients who were treated at the Sun Yat-sen University Cancer Center from January 2022 to June 2023. The general information questionnaire, the Perceived Support Scale for Spouses of Breast Cancer Patients, the Hospital Anxiety and Depression Scale, the Locke-Wallace Marriage Adjustment Scale, and the Brief Illness Perception Questionnaire were used to investigate them. Multiple linear regression was used to analyze the influencing factors of perceived support level of spouses of breast cancer patients.Results:A total of 180 patients were admitted ultimately, all of them were females, aged (49.88 ± 8.95) years old. The total score of Perceived Support Scale for Spouses of Breast Cancer Patients was (62.38 ± 6.54) points. The average scores of each dimension from high to low were emotional support (2.70 ± 0.48) points, information support (2.65 ± 0.52) points and actual support (2.51 ± 0.62) points. There were significant differences in the scores of spouse support perception among breast cancer patients with different educational levels, surgical methods and self-care ability ( F=4.08, 17.63, t=2.41, all P<0.05). Pearson correlation analysis showed that the total score of Perceived Support Scale for Spouses of Breast Cancer Patients was negatively correlated with anxiety score, depression score and disease perception score ( r=-0.388, -0.410, -0.350, all P<0.01), and positively correlated with marital adjustment score ( r=0.692, P<0.01). The results of multiple linear regression showed that education level, surgical method, anxiety, depression, disease perception and marital adjustment were the influencing factors of spouse support perception level of breast cancer patients ( t values were 3.04-4.44, all P<0.05 ), which could explain 54.6 % of the total variation. Conclusions:The level of support perception of spouses of breast cancer patients needs to be improved. Education level, surgical method, anxiety, depression, disease perception and marital adjustment are the influencing factors of patients ′ perception of spouse support level.

Objective:To systematically search, evaluate and integrate the relevant evidence of nutrition management in breast cancer patients, and summarize the best evidence, so as to provide evidence for the clinical practice of nutrition management in breast cancer patients.Methods:Evidence-based nursing method was adopted. The BMJ Best Practice, Cochrane Library, etc. and websites were systematically searched for relevant clinical decisions, guidelines, expert consensus,etc. on nutrition management in breast cancer patients. The search period was from the establishment of the database to June 21, 2023. Three researchers independently evaluated the quality of the included literature and the level of evidence and recommendation.Results:A total of 17 pieces of literature were included, including 2 clinical decisions, 6 guidelines, 1 expert consensus and 8 systematic reviews. A total of 33 pieces of best evidence were summarized on 8 aspects, including objective, nutrition screening and assessment, nutrition management population, body mass index management, nutrient structure, diet type and quantity, the use of health products and nutritional supplements, and nutritional monitoring and follow-up.Conclusions:The study summarized the best evidence on nutrition management in breast cancer patients, and provided evidence-based basis for healthcare professionals to better manage nutrition in breast cancer patients. In the practical application of evidence, the differences in dietary habits, structures and religious beliefs of different regions and cultures should be considered, and the best evidence appropriate for individuals should be reasonably selected, taking patients′ own wishes and preferences into account, so as to provide more scientific and comprehensive nutrition management for breast cancer patients.

Objective:To explore the application effect of "Internet plus" exercise program in patients with chronic heart failure, and provide reference for health management of patients with chronic heart failure.Methods:This was a prospective randomized controlled trial study. A total of 130 patients with chronic heart failure who received treatment in the Cardiology Department of Xiang ′an Hospital Affiliated to Xiamen University from January 2022 to February 2023 were selected by convenient sampling method. According to the random number table method, they were divided into the control group and the intervention group with 65 cases in each group. The control group adopted routine nursing methods, and the intervention group implemented 12 week "Internet plus" exercise program intervention on the basis of routine nursing. The exercise compliance after intervention as well as cardiac function (6-minute walking distance) and quality of life of two groups of patients before and after intervention were compared between two groups. Results:Ultimately, there were 63 cases in the control group and 61 cases in the intervention group. In the control group, there were 45 males and 18 females, aged (61.77 ± 9.56) years old, in the intervention group, there were 49 males and 12 females, aged (61.08 ± 9.72) years old. After intervention, the ratio and frequency of completing aerobic exercise, resistance exercise, exercise frequency, exercise duration in the intervention group were 95.08%(58/61), 77.05%(47/61), (3.94 ± 1.18) times/week, (4.08 ± 1.33) times/week, (29.65 ± 7.83) min/time, which were better than 84.13%(53/63), 47.62%(30/63), (3.15 ± 0.94) times/week, (3.37 ± 0.99) times/week and (23.37 ± 6.79) min/time in the control group. The results showed statistically significant differences ( χ2=3.96, 11.41, t=4.13, 3.38, 4.78, all P<0.05). After intervention, the 6-minute walking distance in the intervention group was (351.22 ± 33.06) m, which was higher than (323.64 ± 31.85) m in the control group, with a statistically significant difference ( t=4.73, P<0.01). After intervention, the total quality of life scores and scores in various dimensions (physical, emotional, and other fields) in the intervention group were (44.45 ± 10.46), (19.19 ± 4.28), (9.95 ± 2.44), and (15.31 ± 4.75) points, which were lower than those in the control group (53.57 ± 11.02), (22.17 ± 4.51), (12.31 ± 2.69), and (19.09 ± 4.96) points, with statistically significant differences ( t values were 3.77 to 5.11, all P<0.01). Conclusions:The "Internet plus" exercise program is convenient, intuitive and operable, which is conducive to improving the exercise compliance, cardiac function and quality of life of patients with chronic heart failure.

Objective:To investigate the real experience of patients returning to work after total hip and knee arthroplasty, in order to provide a reference for patients to return to work successfully.Methods:We searched for qualitative studies on the real experience of patients after total hip and knee arthroplasty in the returning to work process at home and abroad in the databases such as Cochrane Library, PubMed and Embase, etc, and the search period was from the establishment of the library to May 29, 2023, and the results were integrated by Meta-integration.Results:A total of 6 studies were included, 46 results were extracted, and 9 categories were formed and integrated into 4 themes, patients had different motivations for returning to work, there were many factors influencing patients′ return to work, and patients were eager to be helped in the process of returning to work, and learned from experience to improve their confidence in successfully returning to work.Conclusions:Patients with joint replacement have many obstacles and psychological burden in the process of regression, and hope to receive support from many aspects. Healthcare workers should pay attention to the needs of these populations, provide improved medical support, and actively promote the return of patients to work.