Due to the particularity of the Intensive Care Unit(ICU)environment,the visiting time of family members is strictly limited,resulting in family members being unable to communicate with patients in time to understand their wishes and preferences.Moreover,the sudden onset of the diseases and clinical uncertainty can easily lead to ambivalence among family members in decision-making,leading to decision-making dilemmas.This paper reviewed the concepts,assessment tools,causes,effects,and coping strategies of decision-making dilemmas for family members of ICU patients,with a view to providing a theoretical basis for future intervention in decision-making dilemmas for family members of ICU patients,improving their quality of agency decision-making,shortening patient hospitalization time,improving the health outcomes of patients,and ultimately increasing the satisfaction of medical and nursing.

Objective To build scientific and sensitive nursing quality indicators on hepatic encephalopathy, so as to provide and promote the improvement of nursing quality. Methods The hepatic encephalopathy nursing-sensitive quality indicators was eventually built through literature reviews、evidence classification、indicators selected、experts consultations、data analysis. Results Eighteen hepatic encephalopathy nursing sensitive quality indicators, such as percentage of driving risk disclosure, percentage of nutritional assessment regularly were identified. The positive coefficients in the two rounds of expert consultation were 78.95% and 93.33%. And the authoritative coefficients were 0.930 and 0.945. The coefficients of variation ranged from 0.00 to 0.29. Conclusions The hepatic encephalopathy nursing-sensitive quality indicators are scientific and practical,which can be applied to clinical utilization.

Objective:To investigate the current situation of the patients receiving the appropriate technical service of Traditional Chinese Medicine (TCM) nursing at home in Shanghai community health service centers, so as to provide reference for the supervision, management and policy making of health administrative departments.Methods:This study is a cross-sectional survey. The convenient sampling method was used to select 700 patients who were treated in 9 community health service centers in Shanghai from October 2020 to January 2021. The self-developed questionnaire on the Status of Home Care Services with Suitable Chinese Medical Care Technology (patient version) was used to investigate patients. A total of 700 questionnaires were sent out and 688 were effectively received, with the effective recovery of 98.3% (688/700) .Results:Among the 688 patients, 39.2% (270/688) of the patients knew that home care services could provide suitable TCM care technology, 1.7% (12/688) of patients had received TCM care suitable technology home care services; 66.0% (454/668) of patients had a higher willingness to receive home care services with appropriate technologies for TCM nursing. Service price and service quality were the main concerns of patients receiving home nursing service with suitable technology of TCM nursing.Conclusions:Home nursing service with appropriate technology of TCM nursing is still in its infancy, so it is necessary to further strengthen the promotion of home nursing service with appropriate technology of TCM nursing and improve nurses' ability of TCM nursing service to ensure patient safety and medical quality.

Cognitive impairment is the most common and often underestimated complication after ischemic stroke, which seriously affects the rehabilitation of patients. This article reviews the risk factors and prevention strategies of cognitive impairment after ischemic stroke, in order to provide a reference for the prevention of cognitive impairment after ischemic stroke.

Objective To investigated the current situation and to explore the risk factors of venous thromboembolism ( VTE) among inpatients according to the retrospective analysis. Methods 539 VTE patients who had treated in a grade III class A hospital in Shanghai during September 2011 to September 2014 were chosen as the case group. The control group included patients who had no VTE but treated in the same hospital during that time. The clinical data of the participants were collected and retrospectively analyzed.Results Univariate analysis demonstrated significant differences in age ( t=5.421, P<0.05) , BMI>25 kg/m2 , major surgery, malignancy, VTE history, pneumonia, central venous catheter, stay in bed>72 h, stroke, immobilization, pelvis/lower extremity fractures, and joint arthroplasty between the two groups (χ2=9.868, 29.711, 16.230, 48.050,5. 613, 16.443, 5.735, 20.403, 4.340, 20.646, 10.343; P<0.05). Furthermore, the logistic regression analysis indicated that the risk factors of VTE were related to stroke[OR=6.414 (2.421,16.995)], joint arthroplasty [OR=5.718(1.268,25.777)], pelvic/lowers extremity fractures[OR=4.918 (2.074,11.659)], central venous catheters[OR=3.446 (1.671,7.107)], surgery history[OR=2.245 (1.338,3.767)], major surgery [ OR=2.189 ( 1. 553, 3. 085 ) ] , BMI>25 kg/m2 [ OR=1. 913 ( 1. 450, 2. 523 ) ] , malignancy [ OR=1. 713 (1. 184,2.477)], and age[OR=1.559 (1.343,1.810)].Conclusions More specific preventive strategies should be focused on and implemented to VTE patients as they suffered from various risk factors at the same time.

Ethical dilemmas commonly exist among nurses during the epidemic prevention and control of major infectious diseases, which can affect their physical and mental health and nursing quality. This paper reviewed the ethical dilemmas of nurses in the epidemic prevention and control of major infectious diseases from four aspects, including concepts, current situation, evaluation tools, and influencing factors, with a view to raising the attention of nurses, nursing administrators, and health management organizations to the ethical dilemmas of nurses in the epidemic prevention and control of major infectious diseases, and providing theoretical references for further formulating strategies. In terms of ethical dilemmas research of nurses during the prevention and control of major infectious diseases, domestic and foreign studies mostly used scales and qualitative interviews to investigate. Research has found that the ethical dilemmas of nurses during the period include the ethical dilemma of visiting restrictions, the ethical dilemma of fair allocation of scarce resources, and the ethical dilemma of nurses’ rights and obligations. The main influencing factors include demographic factors, psychological factors, risk perception, and social support. It is recommended to develop suitable assessment tools from the perspective of ethical in the future, timely grasp the current situation of ethical dilemmas of nurses during the prevention and control of major infectious diseases, and deeply explore influencing factors.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.