Objective To explore the change of sexual life quality and its influencing factors of premenopausal breast cancer patients.Methods 94 premenopausal breast cancer patients were included. Changes in Sexual Functioning Questionnaire short-form (CSFQ-14) was used and part of its items was changed. Their sexual life was evaluated before and after treatment by using depth interview and anonymous methods. Results 94 cases received face-to-face communication and study. 88 (93.6%) questionnaires were received, in which 81 (92.1%) questionnaires were effective. Their sexual life quality and sexual satisfaction significantly decreased and there was significant difference in the CSFQ-14 score (P<0.001) before and after treatment. The ratio of bad, worse, and worst sexual life were 39.5%, 29.6%, and 14.8% respectively after treatment. 65.4% of the patients had no sexual activity. The reasons included medical related factors, fear of cancer metastasis and recurrence, physical discomfort, poorer body image, partner sexual attitudes changed, life stress, common psychological problems, traditional ideas and so on. Conclusion Sexual dysfunction was obvious and sexual life quality significantly decreased in premenopausal breast cancer patients after treatment. Patients' physical and mental damage, the change of body image and spouse's attitude are significant influencing factors. It is necessary to give sexual rehabilitation guidance to patients and their spouses.

Objective To understand the whole level of head nurses ’ servant leadership behavior in Shanghai hospitals , so as to provide theoretical basis for optimal management .Methods A total of 2 000 nurses were chosen from two first-level hospitals , two second-level hospitals and two third-level hospitals from February to March 2012 , by the methods combined with step sampling and cluster sampling .Scale for head nurses ’ servant leadership behavior was used to investigate the whole level .SPSS 19.0 was used to analyze the data , descriptive analysis was used to analyze the scores , one-way anova or t test was used to compare perception of leadership behavior between different clusters , and LSD-t was used for pairwise comparison .P<0.05 indicated statistical significance .Results A total of 2 000 questionnaires were handed out and 1 511 effective questionnaires were recovered ,with the rate of 75 .6%.The average score of head nurses ’ servant leadership behavior in Shanghai hospitals was (84.54 ±17.98), which was higher than the median of the scale which was 60.The recognition degree about easy-going was the highest while the recognition degree about authorization was the lowest.The scores of head nurses from first-level hospitals, second-level hospitals and third-level hospitals were(91.62 ±9.40),(90.53 ±11.49),(80.53 ±17.98), respectively, and the difference was statistically significant (F=61.88,P <0.01).There was statistically significant difference in perception toward head nurses’ servant leadership behavior from nurses of different ages , degrees, titles and genders (P<0.05).And there was no statistically significant difference in perception toward head nurses ’ servant leadership behavior from nurses of different working years and marriage status (P >0.05).Conclusions The level of head nurses’ servant leadership behavior in Shanghai hospitals is comparatively good , but there is still room for improvement , especially for head nurses in third-level hospitals .Evaluation of head nurses ’ servant leadership behavior should consider and control the initialization of nurses , in order to prevent differences of perception from affecting the accuracy .

Objective To discuss the effects of community diabetes specialist nurse training practice from the perspective of knowledge management, in order to provide some references for personnel training mode of the community nurses. Methods We established community diabetes specialist nurse training practices, screened 80 community nurses to participate in training, and implemented the training practices. The training objects were surveyed with the diabetes knowledge and performed duties questionnaires before and after the training. Diabetes knowledge level and the degree of willingness to perform duties were as evaluation indexes, SPSS 18. 0 software was used for analyzing and processing the date, and studying training effects from the perspective of knowledge management. Results Diabetes knowledge test accuracy of community nurses were 37. 0%, 68. 4% before and after the training (Z=7. 36, P<0. 01);willingness to perform their duties showed that options of very willing were 52. 5%(42/80), and options of willing were 46. 2%(37/80), and only one person said reluctantly willing. Conclusions The training practice can guarantee quality of nursing knowledge resources which were imported community health service centers, promote effectively spread, flow and use of knowledge resources in the community health service centers, then to promote knowledge utilization value.