Objective To investigate the functional ankle instability in nurses,and provide references for increase preventive and protective awareness and establishment of preventive measures.Methods 100 nurses recruited from 10 wards of Provincial Hospital Affiliated to Shandong University were included into this study.Chinese version of the Cumberland Ankle Instability Tool (CAIT) was used to investigate the condition of functional ankle instability of these nurses.A self-designed questionnaire was used to investigate cognitive degree of ankle sprain prevention and treatment knowledge.Results Only 16％ of these nurses had no unstable problems in both of their two ankles.There were functional ankle instable problems in either single or both of the two ankles of the other 84％ nurses.And most of the nurses had little knowledge of how to prevent or treat ankle sprain properly.Conclusions There is a high rote of functional ankle instability in nurses.It is necessary to pay great attention to the prevention of ankle sprain and instability in nurses,which is of great importance to health and occupational safety assurance of nurses.

Objective To apply the evidence-based nursing to discuss the feasibility of nose, pharynx and throat disease in aged patients after radical gastric cancer selective indwelling gastric tube and the individualized nursing care during the phase. Methods We used evidence-based nursing care, searched related literature at home and abroad, then assessed the evidences of elderly patients with nose, pharynx and throat diseases who accepted radical resection of gastric cancer after selective indwelling gastric tube, then we applied the evidences and evidence of the nursing care plans. A total of 82 elderly patients with nose, pharynx and throat diseases were treated as the research objects. The subjects were divided into experimental group (42 cases) and control group (40 cases) by the random number table. We investigated the basis of selectively indwelling gastric tube and time of the elderly patients with nose, pharynx and throat disease of radical gastric cancer. We observed the indwelling gastric tube rate of the experimental group, the extubation rate, anal exhaust time, for the first time into the liquid or defecation time, postoperative abdominal distention, nausea, vomiting unwell, anastomotic fistula, pulmonary infection etc. between the two groups. We compared symptom improvement rate of nose, pharynx and throat by their subjective evaluation. Results There were 4 patients indwelled gastric tube in the experimental group patients. In the experimental group, the postoperative nasal, throat discomfort were improved, the rate of removal of tube indwelling gastric tube were reduced, compared with the control group (P<0. 05);anal exhaust, defecate, the first liquid meal time in the experimental was lower than that in the control group (P <0. 05). The nausea rate, vomiting rate of two groups were statistically significant (P<0. 05). Conclusions Application of evidence-based nursing practice in elderly patients with nose, pharynx and throat disease of radical gastric made our known that patient after radical gastric cancer should not routine indwelling gastric tube, and could improve the postoperative nasal, throat comfort level, accelerate gastrointestinal function recovery.

Objective To improve the operation method of external application of Kujiu ointment, which can enhance satisfaction and comfort level of patients, as well as improving the nursing quality. Methods Totally 112 cases of injured tendons in the ankle were chosen and divided into two groups randomly by retrospective study. Each group included 56 cases. Patients in the control group ( July 2013-June 2014) were treated by conventional methods of operation, and the ointment was fixed to the wound surface with gauze and bandage. Patients in the treatment group ( July 2014-June 2015 ) were treated with the improved medical plaster application which was fixed to the wound surface. Satisfaction degree of traditional Chinese medicine ( TCM ) nursing, comfort degree , retention time, condition of leakage ointment were compared between two groups. Results After the improvement of TCM operation methods, the patient satisfaction, comfort degree of patients in the treatment group were significantly higher than the control group ( P<0.01) . The leakage rate of ointment in the treatment group was significantly lower than the control group ( P<0. 01 ) . Conclusions The improved external application of Kujiu ointment can increase patient satisfaction and comfort level, and make more patients accept this treatment, and it also can improve the quality of nursing. It is worthy of further promotion in the clinical practice.

Objective:To analyze risk factors of pleural effusion in elderly patients after radical gastrectomy and formulate lung protection interventions on this basis to explore the effect of reducing the occurrence of pleural effusion after radical gastrectomy in elderly patients.Methods:By reviewing medical records, clinical data of 208 elderly patients with gastric cancer undergoing radical gastrectomy in Shandong Provincial Hospital Affiliated to Shandong First Medical University before January 2019 were retrospectively analyzed. Univariate analysis and Logistic regression analysis were used to explore risk factors of pleural effusion in elderly patients after radical gastric cancer surgery, and based on this, lung protection interventions were formulated. A total of 200 elderly patients with gastric cancer who underwent radical gastrectomy from January 2019 to June 2020 were selected as the observation group and they were given lung protection intervention. A total of 208 elderly patients undergoing radical gastrectomy before January 2019 were used as the control group. The occurrence of postoperative pleural effusion was observed and compared between the two groups.Results:Logistic regression analysis showed that preoperative albumin level less than 30 g/L, combination with COPD, operation time more than 4 h, lung function Ⅱ-Ⅳ grade and open surgery were the risk factors for pleural effusion after radical gastrectomy in elderly patients with gastric cancer ( P<0.05) . The incidence of pleural effusion in the observation group was lower than that in the control group, and the difference was statistically significant ( χ2=7.353, P=0.005) . The degree of pleural effusion in the observation group was lighter than that in the control group, and the difference was statistically significant ( χ2=7.052, P=0.029) . Conclusions:Preoperative albumin level less than 30 g/L, combination with COPD, operation time more than 4 h, lung function Ⅱ-Ⅳ grade and open surgery are the risk factors for pleural effusion after radical gastrectomy in elderly patients with gastric cancer. According to the above risk factors, pulmonary protective interventions can effectively reduce the incidence and degree of postoperative pleural effusion in elderly patients after gastric cancer surgery.

Objective:To investigate the chronic disease self efficacy, mental resilience and spiritual well-being level in patients undergoing chemotherapy after radical mastectomy for breast cancer, and to explore whether there is a mediating effect among them.Methods:This study was a cross-sectional study. A total of 376 patients undergoing chemotherapy after radical mastectomy for breast cancer were selected as the survey objects by convenience sampling method from July 2020 to April 2021 in Shandong Provincial Hospital Affiliated to Shandong First Medical University. The chronic disease self efficacy, mental resilience and spiritual well-being were evaluated by Self-Efficacy Scale for Managing Chronic Disease, Functional Assessment of Chronic Illness Therapy Spiritual Well-being, Connor-Davidson Resilience Scale. The correlation among the chronic disease self efficacy, mental resilience and spiritual well-being was tested by Pearson correlation analysis. Structural equation model was used to analyze the intermediary mechanism of the chronic disease self efficacy, mental resilience and spiritual well-being.Results:The total score for chronic disease self-efficacy of the research objects was (33.34 ± 12.77) points, the total score for mental resilience was (66.13 ± 21.67) points, and the total score for spiritual well-being was (28.41 ± 10.13) points. The chronic disease self-efficacy, mental resilience, and spiritual well-being were all positively correlated ( r values were 0.689-0.949, all P<0.01). The chronic disease self-efficacy played a partially mediating role in spiritual well-being and mental resilience in patients undergoing chemotherapy after radical mastectomy for breast cancer ( β=0.387, P<0.01), the mediating effect accounted for 43.33% of the total effect. Conclusions:The chronic disease self-efficacy can indirectly affect the level of spiritual well-being in patients undergoing chemotherapy after radical mastectomy for breast cancer. Clinical medical staff should pay attention to their psychological counseling, broaden their minds, enhance spiritual well-being, and help them recover from adversity.

Objective:To explore the perioperative nursing model of endoscopic thyroidectomy through the oral vestibule and its effects.Methods:Totally 127 patients who planned to undergo thyroidectomy from January 2018 to June 2019 were selected. A total of 65 patients receiving traditional surgery between January and June 2018 were included into the control group, while 62 patients who underwent endoscopic thyroidectomy through the oral vestibule from October 2018 to June 2019 were included into the experimental group. Patients in the control group received routine care, while the perioperative nursing model of endoscopic thyroidectomy through the oral vestibule was explored in the experimental group. The differences in pain scores 72 hours after surgery, days of drainage tube indwelling, length of hospital stay and complications were compared between the two groups.Results:There was statistically significant difference in the incidence of postoperative complications between the two groups ( P<0.05) ; the differences in pain scores 72 hours after surgery, days of drainage tube indwelling and length of hospital stay between the two groups were statistically significant ( P< 0.01) . Conclusions:The perioperative nursing practice of endoscopic thyroidectomy through the oral vestibule can effectively reduce the postoperative pain, number of days of drainage tube indwelling, length of hospital stay and postoperative complications in the patients.

Objective:To explore the mediating effect of chronic disease self-efficacy between fatigue and social support in breast cancer patients undergoing chemotherapy.Methods:This study was a cross-sectional study. From July 2020 to April 2021, convenience sampling was used to select 376 patients with breast cancer undergoing chemotherapy in the Shandong Provincial Hospital Affiliated to Shandong First Medical University as the research object. The General Information Questionnaire, Fatigue Scale-14, Chronic Disease Self-Efficacy Scale and Social Support Rating Scale were used to investigate the patients. Structural equation modeling was used to test the mediating effect among variables. A total of 376 questionnaires were distributed, and 372 valid questionnaires were recovered, with a valid recovery rate of 98.94%.Results:Among 372 breast cancer patients undergoing chemotherapy, the total scores of the Fatigue Scale-14, Chronic Disease Self-Efficacy Scale and Social Support Rating Scale were (10.61±1.81) , (5.00±2.53) and (43.42±12.59) , respectively. Chronic disease self-efficacy was positively correlated with social support in breast cancer patients undergoing chemotherapy ( r=0.493-0.648, P<0.01) , and social support was negatively correlated with fatigue ( r=-0.703--0.234, P<0.01) , and self-efficacy was negatively correlated with fatigue ( r=-0.729--0.220, P<0.01) . Chronic disease self-efficacy played a partial mediating role between fatigue and social support in breast cancer patients undergoing chemotherapy (β=-0.335, P<0.01) , and the mediating effect accounted for 47.59% of the total effect. Conclusions:Social support can indirectly affect fatigue through chronic disease self-efficacy in breast cancer patients undergoing chemotherapy. Nurses should focus on improving the chronic disease self-efficacy and social support of breast cancer patients undergoing chemotherapy.

Objective:To explore the application effect of defect scenario simulation combined with joint review action in the training of blood-borne occupational exposure of nursing assistants.Methods:From February 1, 2020 to February 1, 2021, a total of 97 nursing assistants from Central District of Provincial Hospital Affiliated to Shandong First Medical University, were selected as the experimental group and 89 nursing assistants from the Eastern District were selected as the control group. The control group received routine training, while the observation group received defect scenario simulation combined with action training. After 1 year of training, the incidence of blood-borne occupational exposure and blood-borne occupational exposure knowledge scores of nursing assistants in the two groups were compared.Results:During the intervention period, 1 nursing assistant in the experimental group resigned, 2 nursing assistants asked for leave twice or more, and 94 nursing assistants were finally enrolled. In the control group, 2 nursing assistants resigned and 3 nursing assistants asked for leave twice or more, and 84 nursing assistants were eventually enrolled. The incidence of blood-borne occupational exposure of nursing assistants in the experimental group was lower than that in the control group and the score of blood-borne occupational exposure knowledge was higher than that in the control group, and the differences were all statistically significant ( P<0.05) . Conclusions:Defect scenario simulation combined with joint review action has a good effect in blood-borne occupational exposure training of nursing assistants, which can reduce the incidence of blood-borne occupational exposure and improve their blood-borne occupational exposure knowledge scores. It is worthy of clinical promotion.