Chronic obstructive pulmonary disease (COPD) is the leading death cause of pulmonary diseases, ranking the fourth of global death causes. Self-management program is able to gradually improve the Airways of COPD patients with ventilation, reduce the degree of lung failure, elevate the health status as well as promoting self-efficacy, which is the key process to effectively control COPD relapse. In recent years, more and more domestic and foreign academic employ the widely-used network technology and carry out a large number of information study on COPD self-management intervention. This article reviewed literatures about the intervention methods on self-management of patients suffered from COPD, aimed at providing a better basis for exploring more effective self-management.

Objective To set up weight coefficient of qualification and evaluation system so as to implement a normative and standardized system for assessment of clinical teachers of master of nursing specialist (MNS) postgraduates. Methods The indicator system was established by Delphi method. The indicators weight was obtained through analytic hierarchy process, and the logic consistency test was calculated. Results The first five weight of qualification indicators were as follows: registered nurse (0.1686), clinical working experiences (0.2352), clinical teaching experiences (0.2016), education background and professional title (0.1410), research subjects they preside over or participate in (0.0817). The results of indicators order in single level and whole system had a satisfied consistency (CR<0.10). Conclusions The study on weighting values of the system could help it more scientific,reliable and practical.

Objective To explore the continuous improvement to reduce the suctioning pediatrics lumen instruments return-cleaning rate of the first time washing, improve work efficiency and reduce the cost by applying root cause analysis. Methods Using causal analysis of fishbone diagram to analysis and verify the main reason of leading to high lumen instruments return-cleaning rate. According to the three terminal factors of continuous quality improvement, quality control group was set up, lumen instruments cleaning quality control standards was made, water flow mode of lumen instruments cleaning was changed, selected the appropriate cleaning tools and real picture show, synchronize quality control measures of publishing the quality and safety board. Compared before and after return-cleaning rate of three different detection methods and the different parts of the same suction lumen instruments. Results Before carrying out eye-measurement, cotton swab to wipe, ATP bioluminescence back washing rate was 0.89% (2/225), 7.11%(16/225), 27.11%(61/225), respectively after implementation of 0, 0.44%(1/226), 3.98%(9/226), visual observation before and after the return rate of washing was no statistically significant difference (χ2=2.018, P>0.05);Cotton swab to wipe, ATP bioluminescence back washing rate difference was statistically significant (χ2=13.820, 45.999, P<0.01). The lumen instruments total return-washing rate was decreased from 35.11% (79/225) to 4.42% (10/226). Among them, the return- washing rate of the inside surface of lumen instruments was decreased from 32.89% (74/225) to the 3.10% (7/226) and the difference was statistically significant(χ2=67.028, 67.915,P<0.01). By contraries, the thread interface and the outside surface of lumen instruments return- cleaning rate before and after the implementation has no statistical significance (P>0.05). Conclusions ATP bioluminescence assay has fine effects to detect the return-washing rate of the inner wall of the lumen instruments. The Root Cause Analysis method significantly reduced the return-washing rate of the inside surface of the suction lumen instruments, improve the efficiency, save the medical cost and reduce the hospital infection.

Objective To explore nursing scheduling mode in ICU. Methods Grouping was carried out on the basis of nursing decentralized management and the two-way selection between group heads and group members. The research target was the 60 nurses in ICU. Degrees of the nurses' job satisfaction and changes of nursing quality before and after grouping were compared and analyzed. Results The general degree of the nurses' satisfaction towards scheduling was (3.75±0.70) points before grouping while (4.30±0.50) points six months after grouping. The difference had the statistical significance (t=6.5645, P < 0.01);the scores of nursing quality check on classification management, ward management, nursing security, emergency management and hospital infection management were (91.97±1.47), (93.07± 1.66), (93.43 ± 1.50), (94.03 ± 1.10), (94.07 ± 1.39) points respectively before grouping and (95.08 ± 1.63), (95.77±1.55), (96.07±1.41), (97.37±1.56) and (97.07±1.48) points respectively six months after grouping. The differences had the statistical significance (t=6.5192-10.9934, P<0.01). Conclusions The two-way selection among nurses and decentralized management grouping can improve the degree of nurses′job satisfaction and nursing quality.

Objective To explore and analyze the risk factors affecting psychological status of adolescent orthodontic patients in stomatology department, and to develop intervention strategies according to the results. Methods A total of 186 cases of adolescent orthodontic patients in stomatology department from September 2012 to September 2015 were selected, and psychological status was investigated by Chinese Middle School Students Mental Health Scale (MMHI-60 scale) and Symptom Self-rating Scale (SCL-90).The patients were divided into observation group (with psychological problems) and control group (without psychological problems) according to the psychological status scale scores. Univariate descriptive analysis and multivariate Logistic regression analysis were used to determine related factors of the possible influencing factors, and the intervention strategies were developed. Results The factors such as social roles, living area, single parent, only child, internal and external tropism, neuroticism, being given health education, malocclusion severities of the deformities were closely related to psychological status of adolescent orthodontic patients in stomatology department (χ2=2.534-44.297, P<0.05 or 0.01). The independent risk factors were classified as high to low according to the degrees of danger: severe malocclusion (OR=3.578, P=0.000), instability emotional (OR=2.934,P=0.000), workers (OR=1.857, P=0.011) and rural life (OR=1.632, P=0.014), while the factors such as outgoing personality (OR=0.628, P=0.008) and being given health education (OR=0.746, P=0.010) were protective factors. Conclusions The factors such as severe malocclusion, instability emotional, workers,rural life,outgoing personality and health education are the related risk factors affecting psychological status of adolescent orthodontic patients in stomatology department, and psychological health intervention should be strengthened in the clinical practice to improve the psychological status and compliance.

Objective To analyze the correlation between health quotient and quality of life by investigated and studied the relationship between the two. Methods One hundred and ninty three caregivers of cancer patients were investigated by the general situation questionnaire, Health Quotient Questionnaire and Health Survey Short Form (SF-36). Results Different age, gender, education, marriage status, income, occupation, whether suffering from chronic diseases, physical examination frequency, care time and care relationship had a significant differences on quality of life of caregivers ( t/F=7.618-21.043, P < 0.05 or 0.01); the dimension scores of health quotient of caregivers were self-care (4.87±1.65) points, health knowledge (4.53±1.50) points, life style (4.47±1.65) points, state of mind (4.66± 1.87) points, life skills (4.73±1.78) points, were all on the alert value;caregiver′s level influenced by age, income, education level, occupation, whether suffering from chronic diseases and other factors (F=5.227-11.143, P<0.05);the dimension of health quotientand quality of life of caregivers were significantly correlated (r=0.506-0.771, P<0.01). Conclusions The status on quality of life and health quotient of caregivers are poor, and there is a positive correlation between the two, the level of health quotient is higher, the quality of life is better. Therefore, as for improving the quality of nursing care, clinical nursing staff should pay more attention to improve their health quotient level so as to improve the quality of life better.

Objective To explore an assessment questionnaire for assessing caregiving knowledge of primary caregivers in children with nephrotic syndrome. Methods Delphi method was used to review the literature. Ten primary caregivers of children with nephrotic syndrome were interviewed and five medical, nursing experts were pre-surveyed to form an expert consultation questionnaire. Sixteen experts from some provinces were selected to carry out two rounds expert consultation. To screen the dimensions, factors, entries of the questionnaire and to analyze the reliability and validity of the questionnaire. Results The positive coefficient was 100%, the expert authority coefficient was 0.95 and the expert co-ordination coefficient W test was P<0.05 of the two rounds expert consultation. The questionnaire data included 6 dimensions, 26 factors, 106 items. The basic knowledge of disease, diet knowledge, medication knowledge, personal hygiene and infection prevention, activity and rest, home care constitute the dimensions. The Cronbach α coefficient was 0.872, the test-retest reliability was 0.823, the split-half reliability was 0.855, and the average overall validity index of the questionnaire was 0.948. Six common factors were extracted for exploratory factor analysis and the cumulative variance contribution> 65.633%. Conclusions The questionnaire of caregiving knowledge of primary caregivers of children with nephrotic syndrome developed by Delphi method has high reliability. The questionnaire is of practical significance for evaluating the care of primary caregivers of children with nephrotic syndrome.

Objective To explore the effect of continuity of midwifery service model on delivery outcomes in pregnant women. Methods From January 2015 to June 2016,100 single pregnant women with full-term and cephalic presentation who accepted midwife outpatient education were selected from our hospital and divided into observation group, at the same time,100 cases of full-term and cephalic presentation accepting obstetrics regular check as control group. Both delivery methods and total labor time were compared between two groups; the rates of episiotomy, weight gain during pregnancy, postpartum hemorrhage, neonatal asphyxia and macrosomia were all observed. Results The observation group maternal weight gained, the total labor time were (12.26±0.95) kg, (445.21±246.34) min, the control group were (14.48± 1.89) kg, (642.26±258.81) min, there wwa significant difference (t=-10.534,-3.456, P < 0.01).The observation group cesarean section rate, postpartum hemorrhage rate, the rate of fetal macrosomia were 29%(29/100), 2%(2/100), 3%(3/100), the control group were 45%(45/100),10%(10/100),12%(12/100), there was significant difference (χ2=7.040, 5.674, 5.838, P<0.05). In the observation group, the rate of perineal resection were 26% (26/100) and 0 respectively, the control group were 30%(30/100) and 2% (2/100), there was no difference between the two groups (χ2=1.109, 2.020, P > 0.05). Conclusions Continuous care provided by midwife can effectively promote natural birth, reduce the incidences of macrosomia and postpartum hemorrhage, enhance the quality of obstetric services, is worth promoting in clinical application.

Objective To describe self-care agency and its influence factors of the patients with temporary ileum stoma. Methods The descriptive statistics of non-experimental study was performed in the study. The convenience sample consisted of 144 patients from 3 hospitals in Shanghai. The self-care agency was measured by the Colostomy Self-care Agency Scale. Results 144 cases of colorectal cancer temporary ileum stoma patients′ self-care ability scored an average of 57.02 ± 7.00, including self- care willingness (37.19 ± 4.04) points, self-care knowledge 17 points, self-care skills 3 points. The multiple stepwise regression analysis showed that seven factors were statistically significant including age, gender, culture level, living area, postoperative months, presence of complications, whether to accept professional nursing training or education. Conclusions Temporary ileum stoma in patients of rectal cancer with medium self-care ability, but self-care skill level is relatively not high and should be strengthen attention in patients with rectal cancer undergoing ileum stoma. Targeted nursing intervention should be carried out to improve the self-care ability and improve the quality of life of patients with stoma.

Objective To construct Four in One informational teaching model based on cloud platforms, simulation training, nursing micro-lectures and multidimensional evaluation investigate, and to explore the effect of theFour in Oneinformational teaching model applied in Medical Nursing teaching. Methods Two classes students of 2014 were selected by randomized sampling and were divided into experiment group and control group, the experiment group operated the Four in One informational teaching mod, the control group operated regular teaching. After the experiment,using the medical nursing theory test, the skill test, the questionnaire survey to evaluate the teaching effectiveness. Results The theoretical examination score, skill examination score and overall results of experiment group were (78.81±6.44), (82.01±5.22), (80.41±6.32) points, while (71.12±8.12), (76.74±6.3), (75.57±5.51) points of control group, and the difference was statistically significant (t=5.47, 4.86, 3.22, P<0.01 or 0.05). The students' interested in the informational teaching model of the experimental group reached 78.72%(37/47) and learning satisfaction reached 91.48% (43/47). Conclusions The Four in One informational teaching model applied in Medical Nursing teaching can improve the study effect .