Objective:To explore the journey map of patients with chronic constipation during fecal microbiota transplantation.Methods:This study adopted phenomenological methods. From October to December 2023, purposive sampling was used to select chronic constipation follow-up patients who underwent fecal microbiota transplantation at the Intestinal Microecology Center of Shanghai Tenth People's Hospital as respondents for semi-structured interviews. Colaizzi 7-step analysis method and NVivo 11.0 software were used for data analysis.Results:A total of 15 interviewees were interviewed. During fecal microbiota transplantation, the journey map of constipation patients included stages, mood changes, touchpoints, themes, emotional experiences and opportunities. The patient's experience and needs were summarized into three themes and ten sub-themes, including pre-transplant adaptation disorders to new environments (unfamiliarity and confusion-admission coordination disorders, anxiety and expectations-diverse complex emotions, puzzle and helplessness-asymmetric doctor and patient information), effectiveness-related psychological and social experiences in transplantation (attention and expectations-longing for positive efficacy, perception of benefits and risk avoidance, shame and inferiority-treatment stigmatization experience, questioning and despair-unrealized expectations, treatment resistance-sensitive economic burden), post-transplant transition dilemmas (inaccessible medical services-lack of continuous treatment and nursing, disease recurrence troubles) .Conclusions:This study visualizes the experiences and needs of constipation patients during microbiota transplantation through a patient journey map and identifies multidimensional issues and needs of patients. Clinical medical and nursing staff should pay attention to the needs of patients at different stages of the treatment process when formulating intervention programs to improve the quality of fecal microbiota transplantation nursing.

Objective To explore the dilemmas faced by surrogate decision-makers of severe stroke patients in treatment decision-making,and to provide a basis for developing decision support strategies.Methods From April to December 2023,through phenomenological qualitative research with 16 surrogate decision-makers with severe stroke patients from ICU of the department of neurology in a tertiary hospital in Jing'an District,Shanghai.semi-structured in-depth interviews were used to examine the perceptions of decision-making on surrogate.Data were analyzed via Braun's style of thematic analysis.Results 4 themes and 10 sub-themes were identified.Theme 1:negative emotional dilemmas(urgent decision-making leads to anxiety,fear,and unknown stroke trajectory increases the sense of uncertainty).Theme 2:supportive environment dilemmas(lack of information support delays decision-making;lack of family support increases decision-making stress;insufficient economic support increases the burden of decision-making).Theme 3:the dilemma of weighing the pros and cons(difficult trade-offs between risk and reward,tough decisions between reality and ethics,conflicting choices of life and dignity).Theme 4:preference management dilemmas(practical difficulties in adhering to patient preferences,impediments to decision-making due to unknown patient preferences).Conclusion Surrogate decision-makers of severe stroke patients face multiple decision-making dilemmas.Healthcare professionals should provide emotional support in multiple ways and comprehensive support to reduce the decision-making dilemmas experienced by surrogate decision-makers,as well as implement death education for surrogate decision-makers and promote advance care planning to reduce their decision-making stress.

Objective:To analyze the relationship between each dimension of emotional intelligence and interpersonal communication ability, and explore how to improve the interpersonal communication ability of residents through targeted emotional intelligence training.Methods:A total of 132 first-year residents of clinical medicine in the residency training base were jointly measured with emotional intelligence and interpersonal communication evaluation scale on the basis of self-assessment and grading. The differences between groups in self-assessment and grading were detected by one-way ANOVA, and the relationship between various dimensions of emotional intelligence and interpersonal communication ability was explored by correlation analysis and multiple linear stepwise regression analysis. SPSS 19.0 was used to conduct statistical analysis.Results:The self rating scale clearly divided the subjects into three levels. In the total score of emotional intelligence and its various dimensions, the differences between the three levels were statistically significant; the scores of the "good" group were higher than those of the "fair" group and the "slightly insufficient" group. There were statistical significance in the total score of emotional intelligence ( P<0.001) and its emotional perception ( P<0.001), self emotional management ( P<0.001), others' emotional management ( P<0.001) and emotional utilization ( P<0.001). In the total score of interpersonal communication ability and its various dimensions, the differences among the three levels were statistically significant. In the conflict management, the difference between the "good" group and the "fair" group was not statistically significant, and the differences in other items were statistically significant. The total score of emotional intelligence and its dimensions were positively correlated with interpersonal communication ability ( P<0.001), but the two dimensions that had the most significant impact on interpersonal communication ability were emotional perception and others' emotional management ( R2=0.531, P<0.001). Conclusion:By focusing on the cultivation of each dimensions of emotional perception and other emotional management for residents, it is expected to play a positive role in achieving the national goal of cultivating interpersonal communication skills.

Objective To systematically evaluate the predictive value of controlling nutritional status(CONUT)score for short-term neurological function and clinical outcome of stroke.Methods Cochrane library,PubMed,Web of Science,Embase,CNKI,Wan-fang,VIP,and CBM were searched by computer to find studies on the use of CONUT score to evaluate the nutritional status and follow-up of stroke patients from the establishment of the database to April 11,2023.Literature was searched and screened independently by two researchers.The Newcastle-Ottawa scale(NOS)was used to evaluate the quality of the included studies.Stata 15.Osoftware was used for Meta-analysis.Results A total of 12 literatures were included,all of which were high quality.Meta-analysis results showed that high CONUT score(≥2)was strongly associated with poorer functional outcomes(OR=1.41,95％CI:1.25-1.60,P＜0.001,I2=49.4％),and associated with increased mortality(OR=2.85,95％CI:2.03-4.00,P＜0.001,I2=0)increase.Conclusion High CONUT score may be a predictor of neurological recovery status and survival outcome in patients after stroke,and the prognostic mechanism of CONUT score in stroke patients is unclear and needs to be confirmed by further studies.