Objective To study the effect of comprehensive interventions on anxiety of nursing students at internship. Methods Comprehensive educational interventions were practiced at the beginning,middle-term and end of their internship. The Self-Rating Anxiety Scale(SAS)was adopted to assess their level of anxiety.Results There were differences in SAS scores between the three phases(F=2.680,P<0.05).The scores were decreased from the beginning to the end.Conclusion Targeted comprehensive educational interventions can reduce anxiety and stress of nursing students.

Objective To explore the effect of multimodal analgesia methods on postoperative pain in patients with calcaneal fracture. Methods Totally 96 cases of the patients with calcaneal fracture were divided into the control group and the observation group, there were 48 cases in each group. The control group was treated with conventional methods of postoperative analgesia, the observation group was given with the multimodal analgesia method. The VAS scores,functional exercises compliance and the incidence of adverse reaction for patients between the two group were observed and compared. Results The scores of pain at different time points in the observation group was 3.40 ± 0.41, 2.50 ± 0.75, 2.10 ± 0.84, 2.00 ± 0.52 respectively, while in the control group was 5.50 ± 0.35, 4.50 ± 0.55, 3.60 ± 0.62, 3.10 ± 0.45 respectively, the difference between the two groups was significant, t=6.85-11.62, P < 0.01. The good functional exercises compliance in the observation group was 87.5%(42/48), which was higher than the 68.8%(33/48) in the control group, the difference between the two groups was significant (χ2=7.571, P<0.05). The occurrence of nausea and vomiting was lower than the control group (χ2=4.800 and 4.360, P<0.05). Conclusion Multimodal analgesia method can improve analgesia effect obviously, improve functional exercises compliance, reduce the incidence of adverse reaction.

Objective? To investigate the current situation of the first aid capability of operating room nurses and analyze the influencing factors of their first aid capability, so as to provide reference for operating room nursing managers to carry out first aid training. Methods? Using cluster random sampling method, from February to March of 2018, 432 operating room nurses from 4 operating room nurse competency certificate training base hospitals in Shanghai were selected as the research participants. The Self-Designed General Information Questionnaire was used to collect the nurses' clinical data, and the Operating Room Nurses First Aid capability Assessment Scale was used for the operating room nurses in self-evaluation about their first aid capability. Univariate analysis was used to analyze the differences of first aid capability among the operating room nurses with different characteristics, and multivariate linear regression was used to analyze the influencing factors of the operating room nurses' first aid capability. Results? The score of operating room nurses' first aid capability was (110.95±13.09), which was at a high level. Univariate analysis showed that there were statistically significant differences in the overall score of first aid capability among nurses with different professional levels, nursing ages, emergency working experience, first aid experience, first aid training participating experience and first aid drill participating experience (P＜ 0.05). Nurses with different ages, educational backgrounds and professional titles achieved different scores in the 5 sub-dimensions of Operating Room Nurses First Aid capability Assessment Scale with statistical significance(P＜ 0.05), but showed no statistical difference in the total score (P＞ 0.05). Multivariate linear regression analysis indicated that, "whether had participated in first aid training", "professional level", "whether had emergency working experience", "nursing age"were the influencing factors on the operating room nurses' first aid capability (P＜0.05). Conclusions? Operating room nurses with high professional levels, long nursing ages, emergency working experience, and have participated first aid training have high levels of first aid capability, therefore the operating room managers should carry out individualized, professional, staged training and education targeting the nurses with low professional levels, short nursing ages, lacking in emergency working experience and first aid training, so as to improve their first aid capability and success rate of rescue for patients.

Neurogenic bowel dysfunction is a common complication after spinal cord injury mainly on abdominal distension, constipation and fecal incontinence which has serious negative influences on patients' lives. Transanal irrigation is a novel intervention method which has been widely used at home and abroad. Clinical practice results showed that transanal irrigation can improve the intestinal function as well as quality of life of patients. A total of five aspects were reviewed in this article, the summary of neurogenic bowel dysfunction, summary of transanal irrigation, intervention strategies, complications and continuous nursing.

Objective:To investigate the risk factors of postoperative delirium in elderly patients with hip fracture.Methods:Using the convenient sampling method, a total of 141 elderly patients with hip fractures who were admitted to Trauma Department of Shanghai Sixth People's Hospital from November 2018 to April 2019 were selected as the research objects. The incidence of postoperative delirium was assessed by Confusion Assessment Method (CAM) , and patients were divided into the delirium group ( n=40) and the non-delirium group ( n=101) . Binomial Logistic regression analysis was used to analyze the risk factors of postoperative delirium in elderly patients with hip fracture. Results:Postoperative delirium occurred in 40 of 141 patients (28.37%) . Binomial logistic regression analysis showed that age, history of stroke, preoperative serum albumin level, intraoperative hypoxemia, and ICU stay were influencing factors for postoperative delirium in elderly patients with hip fracture ( P<0.05) . Conclusions:Postoperative delirium is more common in elderly patients with hip fractures. In addition, advanced age, history of stroke, high preoperative serum albumin level, intraoperative hypoxemia, long ICU stay were risk factors of postoperative delirium occurrence.

[Abstracct] With the wide application of standardized patient in nursing teaching, its advantages are gradually highlighted, recognized by a majority of nursing scholars. This paper reviewed the background, classification, case design and its application situation and effects in the field of nursing teaching, and propose further expectation of improving the management of standardized patient interventions.

Objective:To explore the effects of the intervention program for intestinal dysfunction after spinal cord injury during the acute spinal cord injury period.Methods:Totally 76 patients with intestinal dysfunction during acute spinal cord injury who were admitted into Shanghai Sixth People's Hospital and Shanghai Changzheng Hospital between March and December 2019 were selected by convenient sampling. According to the non-concomitant controlled study design, 42 patients admitted from March to May 2019 were included into the control group, while 34 patients admitted from October to December 2019 were included into the intervention group. Patients in the control group received routine care, while the intervention program for intestinal dysfunction after spinal cord injury was adopted for patients in the intervention group. After 2 weeks of intervention, the intestinal function indicators were compared between the two groups.Results:After 2 weeks of intervention, the improvement of abdominal distension and constipation of the intervention group was better than that of the control group, and the difference was statistically significant ( P< 0.05) . Conclusions:The intervention program for intestinal dysfunction during acute spinal cord injury can effectively improve the intestinal function of patients and reduce the incidence of abdominal distension and constipation.

Objective To investigate the compliance of the early functional exercise in the patients with lumbar disc herniation ( LDH) and analyze its influencing factors for exploring the methods to improve their compliance of the early functional exercise .Methods Through referencing literature and scales a postoperative functional exercise compliance questionnaire was designed for the patients with LDH .The compliance and its influencing factors of 147 LDH patients were analyzed.Results Among the 147 patients, the full compliance of the early functional exercise only accounted for 25.2%.The compliance significantly differed in the education level and the type of personalities ( P<0.05).The reasons of the poor compliance included fearing pain , worrying about healing , insufficient understanding of the importance of the postoperative functional exercise , and lack of social support ( P <0.05 ) .Conclusions The importance of rehabilitation knowledge should be propagated to patients in the early period , especially for the patients with a low education level , strong dependence , and fear of pain . Corresponding nursing measures are taken to improve the patient′s compliance of the postoperative functional exercise maximally , in order to recover and improve the ability in activities of daily living and the quality of life in LDH patients after the operation .

Objective To compare the effect of closed wet dressing and vaseline gauze applied in donor site.Methods A total of 60 patients with donor site wound (lateral thigh) underwent surgery were divided into wet dressing group (30 cases) and vaseline gauze group (30 cases),and the pain degree of donor area,exudation,healing time and incision scar were compared.Results Pain degree at 4,7 and 10 days after operation in wet dressing group was lighter than that of vaseline gauze group,the difference was statistically significant (P ＜ 0.05);but pain at 15 d showed no statistically significant difference (P ＞ 0.05).Exudate in wet dressing group was obviously less,wound healing time was shorter,and scar as well as pigmentation ratio was lower than that in vaseline gauze group,and the differences were statistically significant (P ＜ 0.05).Conclusion Application of closed wet dressing in the donor site can relieve the pain of patients with early postoperative pain,reduce the leakage of the wound,shorten the healing time,and has less pigmentation and scar hyperplasia.

Objective? To explore the mental feelings and demands of main caregivers of patients with multiple trauma under closed-off management in emergency room and to provide a reference for targeted interventions. Methods? The main caregivers of the patients with multiple trauma in the Emergency Department of a hospital between June and December 2017 were selected by purposive sampling. The patients received profound semi-structural interview based on phenomenological methods in qualitative studies. The data were organized and analyzed according to Colaizzi phenomenological analysis. Results? Totally 4 themes were obtained by classification and refining: mental pressure, too much mental pressure, accepting the reality but uncertain about the future, and weak support systems. Conclusion? Nursing workers should pay more attention to the physical and psychological pressure of main caregivers of patients with multiple trauma under closed-off management in emergency room as well as their mental demands. Information should be effectively communicated in order to improve the patients' confidence in and satisfaction with nursing work.