Objective:To explore the real experience of early functional exercise of patients with kinesiophobia after cardiac pacemaker implantation, so as to provide a basis for patients to carry out early supervision exercises and behavioral support interventions.Methods:From September to December 2020, purpose sampling was used to select patients with kinesiophobia after cardiac pacemaker implantation in the Department of Cardiovascular of a Class Ⅲ Grade A general hospital in Henan Province as the research object. A semi-structured interview of 16 patients with kinesiophobia after pacemaker implantation was carried out. Colaizzi phenomenological analysis method was used to analyze, summarize the interview data and refine the themes.Results:The experience of early functional exercise in patients with kinesiophobia after cardiac pacemaker implantation could be summarized into four themes, namely, stress physical perception, negative beliefs of early functional exercise, expectation of early functional exercise and desire for professional medical support.Conclusions:Patients with kinesiophobia after cardiac pacemaker implantation have obvious fatigue, pain, fear and other experiences. The patients expect to resume daily activities as soon as possible, but lack confidence in functional exercises and desires professional support. Medical and nursing staff should pay attention to the feelings and experience of exercise of patients, and guide patients to effectively cope with fear of exercise.

Objective:To investigate the status of clinical nurses′ professional identity and disaster cognition during the post-disaster reconstruction, and to analyze the correlation between the two.Methods:With the convenient sampling method, the 346 nursing staff of the First Affiliated Hospital of Zhengzhou University participated in the disaster reconstruction for the survey, using the general questionnaire, the nurse professional identity scale, the disaster cognition questionnaire for investigation. Pearson correlation was used to analyze the correlation between disaster cognition and professional identity.Results:The disaster cognition during the post-disaster needed to be improved, the choice rate of knowing disaster nursing well was 6.36%-70.23%. Gender had significant statistical significance on the scores of thinking the importance of disaster care training and willingness to join in disaster care continuing education ( t=-2.54 and -2.32, both P<0.05). Position had significant statistical significance on the score of willing to join in the enthusiasm of emergency rescue( F=6.62, P<0.05). Whether have ever participated in disaster training had significant statistical significance on the scores of focusing on the frequency of disasters and understanding the degree of disaster care ( t=5.57, 7.88, both P<0.05). Nurse professional identity level was high during the post-disaster reconstruction, the total score was (121.73 ± 19.75). Whether have ever participated in disaster training had significant statistical significance on the score of professional identity ( t=4.57, P<0.05). And the total score and each dimension score of disaster recognition were positively correlated with the total score and each dimension score of professional identity in nurses ( r values were 0.44-0.53, all P<0.05). Conclusions:The disaster cognition level is still lacking, the professional identity level is high. The disaster cognition affects professional identity levels to a certain extent, so nursing managers should improve the disaster recognition of nursing staff by making targeted strategy, which can not only improve the professional identity levels, but also reserve power for emergency disaster and post-disaster reconstruction reserves.

Objective:To understand the current status and analyze the factors of demoralization of patients with chronic heart failure (CHF), providing references for targeted psychological interventions of nursing staff.Methods:Using the cross-sectional survey method, from August 2022 to January 2023, 282 CHF patients who were followed up in the Cardiovascular Department of the First Affiliated Hospital of Zhengzhou University were selected as the study subjects. They were investigated using the General Information Questionnaire, Demoralization Scale Revised Mandarin Version, Brief Illness Perception Questionnaire (BIPQ), Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and the factors influencing the demoralization of CHF patients were analyzed using univariate analysis and multiple linear regression.Results:Among 282 cases, male 172 cases, female 110 cases, aged (62.29±10.05) years old. The Demoralization Scale Revised Mandarin Version′s score of CHF patients was (30.30 ± 10.37) points; the score of BIPQ was (42.18 ± 13.94) points; the score of FoP-Q-SF was (35.41 ± 7.29)points, which were at high level. The results of multiple linear regression analysis showed that patient disease duration, disease stages, New York heart association cardiac function classification, the score of BIPQ, and the score of FoP-Q-SF were factors influencing the demoralization of CHF patients ( t values were 3.08 to 12.50, all P<0.05). Conclusions:There is an urgent need to focus on the current status of the demoralization of CHF patients. It is necessary to develop a systematic and effective intervention strategy for demoralization, to take into account patient disease duration, disease stages, illness perception, and fear of progression in a comprehensive manner.

Objective? To explore the effects of National Institute for Health and Care Excellence (NICE) Guideline based palliative care in end-stage heart failure patients. Methods? From October 2016 to May 2017, we selected end-stage heart failure patients from four wards of cardiovascular department at a ClassⅢ Grade A hospital in Zhengzhou as subjects by convenience sampling. Patients from the first to the third ward were in experimental group (n=143), and those from the fourth ward were in control group (n=135). Control group carried out routine palliative care. On the basis of that in control group, experimental group adopted individual palliative care according to the National Institute for Health and Care Excellence (NICE) guideline. Four months after intervention, we compared the intervention effects with the Chinese version of palliative care outcome scale (POS) and the medical outcomes study short form 12-item version 2 (SF-12v2). Results? Four months after intervention, the total score of POS of patients in experimental group was lower than that in control group with a statistical difference (P＜ 0.01). The total scores of physical and mental health of SF-12v2 of patients in experimental group were higher than those in control group with statistical differences (P＜ 0.01). Conclusions?NICE guideline based palliative care can reduce the anxiety of patients and their family members, and can improve quality of life of patients.

Objective:To explore effects of health education based on teach-back method on functional exercise compliance in patients with kinesophobia after total knee arthroplasty (TKA) .Methods:Using the convenient sampling method, a total of 104 patients with TKA kinesiophobia who were admitted to First Ward of Department of Orthopedics in the First Affiliated Hospital of Zhengzhou University from August 2019 to November 2020 were selected as the research objects. Among them, 52 patients admitted from August 2019 to March 2020 were set as the control group, while 52 patients admitted from April to November 2020 were set as the experimental group. They were respectively given routine health education and health education based on teach-back method. Before the intervention and 2 weeks after the intervention, the differences in Functional Exercise Compliance Scale for Orthopedic Patients, Hospital for Special Surgery Knee Score (HSS) and Modified Barthel Index (MBI) scores were compared between the two groups.Results:After implementing the health education intervention program based on the teach-back method, the total score of Functional Exercise Compliance Scale for Orthopedic Patients of patients and dimensions scores of exercise compliance related to physical aspects, the exercise compliance related to psychological aspects and the exercise compliance related to active learning in the experimental group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of HSS and MBI in the experimental group were higher than those in the control group after intervention, and the differences were statistically significant ( P<0.01) . Conclusions:The health education intervention program based on the teach-back method is scientific and reliable, which can effectively improve the functional exercise compliance of TKA patients with kinesiophobia, promote recovery of knee joint function and improve their activities of daily living.

Objective:To explore the mediating role of disease progression′s fear and positive affect in the relationship between disease perception and demoralization in patients with chronic heart failure. It provided a theoretical basis for targeted interventions for healthcare workers.Methods:From October 2022 to March 2023, 320 patients with chronic heart failure in the First Affiliated Hospital of Zhengzhou University were selected as the research objects by convenience sampling. The General Information Questionnaire, Demoralization Scale Redacted Mandarin Version, Brief Illness Perception Questionnaire, Fear of Progression Questionnaire-Short Form, Positive and Negative Affect Schedule (Positive Affect Schedule) were used to conduct the questionnaire survey exploring the mediating effects of fear of disease progression and positive emotions between disease perception and disorientation by construction structural equation model.Results:There were 268 valid questionnaires. Of the 268 patients, 168 were male and 100 were female, 3.36% (9/268) were ≤40 years old, 55.22% (148/268) were 41-65 years old, and 41.42% (111/268) were >65 years old. Correlation analysis showed that disease perception was positively correlated with disease progression ′s fear, and every dimension of demoralization ( r values were 0.300-0.586, all P<0.01), and negatively correlated with positive affect ( r=-0.374, P<0.01); disease progression′s fear was negatively correlated with positive affect ( r=-0.318, P<0.01), and positively correlated with every dimension of demoralization ( r values were 0.339-0.464, all P<0.01); positive affect was negatively correlated with every dimension of demoralization ( r values were -0.430--0.334, all P<0.01). Structural equation model analysis showed that the direct effect of disease perception on demoralization was significant ( β=0.407, P<0.01), and both mediating effects of disease progression ′s fear and positive affect between disease perception and demoralization in patients with chronic heart failure were significant ( β=0.074, 0.079, both P<0.01). The chain mediating effect of disease progression ′s fear and positive effect was also significant ( β=0.019, P<0.01). Conclusions:Disease perception could directly predict the demoralization of patients with chronic heart failure and indirectly predict the demoralization of patients with chronic heart failure through the mediating effect of disease progression ′s fear, positive affect, and the chain mediating effect of disease progression ′s fear and positive affect.

Objective:To explore the effects of smart cloud follow-up platform in home care for elderly patients with pacemakers.Methods:Totally 120 elderly patients who received pacemaker implantation in a ClassⅢ Grade A hospital in Henan province between August 2018 and August 2019 were selected by convenient sampling. The 60 patients admitted from August 2018 to February 2019 were included into the control group, while the 60 patients admitted from March to August 2019 were selected into the experimental group. Patients in the experimental group received home care based on the cloud follow-up platform, while patients in the control group received routine continuing care at home. After 3 months of intervention, the complication rate, functional exercise compliance and quality of life were compared between the two groups using χ 2 test and t test. Results:Totally 59 patients in the experimental group and 58 patients in the control group completed the study. After intervention, the complication rate in the experimental group was 32.2% (19/59) , lower than 89.7% (52/58) in the control group, and the difference was statistically significant (χ 2=9.307, P< 0.05) ; the scores of physical exercise compliance after pacemaker implantation, postoperative precautions compliance and compliance of initiative advice seeking in the experimental group were (26.05±3.07) , (15.42±1.24) and (11.85±1.96) , higher than those in the control group (18.53±2.93) , (9.66±2.40) and (6.05±1.58) in the control group, and the differences were statistically significant ( t=13.548, 16.331, 17.558; P< 0.01) ; the total quality of life score in the experimental group was (161.12±9.94) , higher than (132.50±9.20) in the control group, and the difference was statistically significant ( t=16.149, P < 0.01) . Conclusions:The home management model based on the smart cloud follow-up platform improves home follow-up experience of elderly patients with pacemaker, the compliance of home functional exercises, and their quality of life.

Objective:To construct a risk prediction model for unplanned readmission of patients undergoing cardiac resynchronization therapy (CRT) and verify the performance of the model.Methods:Using convenience sampling, patients who underwent CRT at the Department of Cardiovascular of the First Affiliated Hospital of Zhengzhou University from July 2017 to July 2020 were selected as the modeling group ( n=279) and the internal validation group ( n=120). CRT patients admitted to the Department of Cardiovascular of the First Affiliated Hospital of Zhengzhou University from August 2021 to August 2022 due to the same or related diseases were selected as the external validation group ( n=86). Multivariate Logistic regression was used to explore the influencing factors of unplanned readmission of CRT patients and establish the prediction model. The fitting effect and discrimination of the model were evaluated through the Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve. The nomogram was established based on R-4.1.2 and Rstudio software. Results:The multivariate Logistic regression analysis showed that creatinine, left atrial diameter, pulmonary artery systolic pressure, New York Heart Association (NYHA) classification, and body mass index (BMI) were risk factors for unplanned readmission in CRT patients, with statistically significant differences ( P<0.05). The prediction model formula was: P=1/{1+exp[- (0.792×creatinine+1.408×left atrial inner diameter+0.887×pulmonary artery systolic pressure+0.769×NYHA classification-0.970×BMI-2.266) ]}. The area under the ROC curve was 0.874, the maximum value of the Jordan index was 0.636, the optimal threshold was 0.256, the sensitivity was 0.826, and the specificity was 0.810. The accuracy of internal validation and external validation was 90.00% and 90.70%, respectively. Conclusions:The constructed prediction model for unplanned readmission of CRT patients has good predictive performance, and the visualized nomogram improves the practical performance of the model. It helps medical and nursing staff identify high-risk groups of unplanned readmission of CRT patients in the early stage and provides a basis for formulating nursing strategies for different risk groups.