Objective? To investigate the status of knowledge-attitude-practice (KAP) on sub-syndromal delirium among intensive care unit (ICU) nurses in ClassⅢ general hospitals and to analyze its influencing factors. Methods? In June 2017, we selected 352 ICU nurses from 9 ClassⅢ general hospitals in Zhejiang Province as subjects by convenience sampling. The general hospital ICU nurses sub-syndromal delirium KAP scale was used to investigate the score of sub-syndromal delirium KAP of ICU nurses, and the multiple linear regression was used to analyze the influencing factors the total score of sub-syndromal delirium KAP of ICU nurses. Results? A total of 352 questionnaires were collected and 346 of them were valid with 98.30% for the valid recovery rate. The knowledge, nursing attitude, nursing practice score and the total score of sub-syndromal delirium of ICU nurses were (40.75±14.10), (28.33±4.24), (36.07±6.99) and (105.16±20.18) respectively. There were statistical differences in the knowledge scores of sub-syndromal delirium among ICU nurses with different ages, working lives, working lives in ICU, educational background, professional titles and marriages (F/t=30.856, 33.560, 29.311, 2.892, 22.614, 14.623;P＜ 0.01). Multiple linear regression showed that the influencing factors of the total score of KAP on sub-syndromal delirium of ICU nurses in general hospitals included ages, working lives in ICU and professional titles (P＜0.05). Conclusions? ICU nurses of Class Ⅲgeneral hospitals have attitudes towards sub-syndromal delirium, however they lack the knowledge and nursing practice related to sub-syndromal delirium. We should provide training on sub-syndromal delirium positively for ICU nurses of Class Ⅲ general hospitals to improve their recognition ability and nursing ability of sub-syndromal delirium.

Objective? To analyze the root causes of fall in elderly patients, explore the corresponding countermeasures and combine the balance function and knee joint strengthening training to reduce the incidence of fall in elderly patients. Methods? First, the cause of fall of the patients in the department of rehabilitation from November 2014 to October 2016 were analyzed with the method of root cause analysis and retrospective analysis, and targeted corrective measures were formulated. The elderly patients fell between the time period from November of 2016 to October of 2017 and November of 2017 to October of 2018 were enrolled into the control group and observation group by convenience sampling. Corrective measures were formulated based on root cause analysis and action (RCA2) to prevent falls in the control group, on the basis of that balance function training combined with strengthening training of knee joint control were adopted to prevent fall in the observation group. The two groups were compared in terms of the differences in the incidence of fall, five times of sitting and standing test(FTSST), 10 meters maximum walking speed (10MWS), Berg Balance Scale(BBS)and Tinetti Gait Analysis (TGA). The incidence of fall in the department before the implementation of corrective measures based on RCA2(November 2014 to October 2016) and the time period of November 2016 to October 2018 which is after the implementation of RCA2 based corrective measures were compared. Results? After implementing the corrective measures, the fall rate of the elderly patients reduced from 2.0% to 0.9% with statistical difference (χ2=4.343, P=0.037). There was statistical difference (χ2=3.899, P=0.048) in terms of the incidence of fall between the observation group (4.24%) and the control group (0.64%). Before intervention, the two groups had no statistical difference in the FTSST, 10MWS, BBS and TGA(P＞0.05). In the control group, there was no statistical difference before and after intervention (P＞ 0.05); in the observation group, there was statistical difference before and after intervention (P＜0.05). After intervention, the observation group was better than the control group in the FTSST, 10MWS, BBS and TGA with statistical difference (P＜0.05). Conclusions? The comprehensive use of root cause analysis and intensive training of knee joint control and balance function training to manage elderly patients scientifically can effectively reduce the incidence of falls.

Objective? To investigate the status of caregiver preparedness and adult attachment among the spouse of young and middle-aged stroke patients,and to analyze the correlation between them. Methods? From January 2017 to May 2018,110 spouses of stroke patients who were treated in Affiliated Hangzhou First People＇s Hospital, Zhejiang University School of Medicine were selected as subjects by convenience sampling. The General Information Questionnaire,Care Preparedness Scale (CPS),and Experience in Close Relationship Scale (ECR) were used in the survey. Totally 110 questionnaires were distributed, and 102 valid ones were retrieved, yielding an effective recovery rate of 92.73%. Results? The total CPS score of 102 young and middle-aged stroke patients was (12.87±5.39). The scores of attachment anxiety and attachment avoidance in ECR were (57.96 ±11.69) and (48.06 ±12.10). There were statistically significant differences in the scores of preparedness of caregivers among spouse caregivers of different ages, self reported health status and nursing experience (P＜ 0.05). Attachment anxiety dimension was negatively correlated with caregiver preparedness score (r=-0.318,P＜0.01), and attachment avoidance dimension was negatively correlated with caregiver preparedness score (r=-0.233,P＜ 0.01). Conclusions? The preparedness status of the spouses caregivers of young and middle-aged stroke patients are at a low level. Medical workers can improve their care preparedness by giving them home care knowledge guidance,reducing their attachment avoidance and attachment anxiety so as to improve their preparedness.

ObjectiveTo investigate the acceptance and influencing factors of manual hyperinflation (MIH) in patients with open sputum suction after tracheotomy, so as to provide reference for improving the acceptance of MIH for patients. MethodsBy convenience sampling, 140 patients with tracheotomy on open suction in Affiliated Hangzhou First People＇s Hospital, Zhejiang University School of Medicine from October 2016 to September 2018 were selected as participants in the study and the Self-Designed Questionnaire was used to study the acceptance towards MIH of the patients. Univariate analysis and Logistics regression analysis were conducted to analyze the influencing factors of the acceptance of patients on MIH. A total of 140 questionnaires were distributed, and 134 valid ones were collected. ResultsUnivariate analysis showed that there were statistical difference in age, gender, family support, duration of tracheotomy, whether the medical staff had explained the relevant knowledge of MIH, and whether the patients had experienced MIH on patients＇acceptance of MIH (P＜ 0.05). The above 6 statistically significant factors were analyzed by multivariate Logistic regression and the results showed that age, gender, duration of tracheotomy, whether the patients had experienced MIH before were the influencing factors of the patients＇ acceptance on MIH(P＜ 0.05). ConclusionsAge, gender, duration of tracheotomy, whether or not the patents have experienced MIH are independent impact factors for the patients＇ acceptance of MIH and the above factors can be the cut-in points of explanation and education in the process of MIH,so as to improve the patients＇ acceptance of MIH and promote recovery.

This article summarizes the application of cardiac rehabilitation from the aspects of the generation, demand and feasibility, application status and effects of cardiac rehabilitation, so as to provide a basis for the development of cardiac rehabilitation in our country.

Objective To explore the potential category characteristics of self-management behavior in patients with lung cancer based on potential profile analysis,and to analyze the characteristic differences and influencing factors of self-management behavior in patients with different categories of lung cancer.Methods A total of 260 patients with lung cancer who had completed the main treatment program and were about to enter the follow-up period in a tertiary A general hospital in Zhejiang Province from July 2022 to May 2023 were selected by convenience sampling method as the investigation subjects.General Information Questionnaire,Lung Cancer Survivor Self-management Behavior Assessment Scale,Strategies Used by People to Promote Health,Hospital Anxiety and Depression Scale and Social Support Rating Scale were used for investigation.Potential profile analysis was used to explore the potential categories of self-management behavior in lung cancer patients and analyze its influencing factors.Results 252 patients were finally included.The results of potential profile analysis showed that lung cancer patients'self-management behavior could be divided into 3 potential categories,namely low self-management behavior-low emotion management group(11.90％),medium self-management behavior-low resource management group(45.24％),and high self-management behavior-low hope management group(42.86％).Logistic regression analysis showed that education level,previous surgery,tumor stage,anxiety level,depression level,self-efficacy level and social support level were the influencing factors of lung cancer patients'self-management behavior(P＜0.05).Conclusion The self-management behavior of lung cancer patients is at a moderate level,and there are obvious classification characteristics.It is suggested that medical staff should carry out personalized intervention measures according to the characteristics of self-management behavior of patients of various categories,so as to improve the level of self-management behavior of lung cancer survivors.