BACKGROUND:Early rehabilitation after total knee arthroplasty (TKA) can help the rapid functional recovery of knee,but some patients are fear of moving and refuse to do exercising because of kinesiophobia,thereby delaying functional recovery.Foreign study has confirmed that patients with cognitive behavioral therapy (CBT) can effectively alleviate kinesiophobia,but no related studies have been reported in China.OBJECTIVE:To explore the effectiveness of CBT on patients with kinesiophobia after TKA.METHODS:108 patients with kinesiophobia after TKA were recruited from Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,China between March 2014 and January 2015,and were then equivalently randomized into experimental and control groups using random number table.Both groups were subjected to conventional treatment,while the experimental group received extra CBT.The scores of Tampa Scale of Kinesiophobia and American Knee Society were evaluated immediately,1,3,and 6 months after hospital discharge;the hospitalization time and total hospitalization expenditure were compared between two groups immediately after discharge.RESULTS AND CONCLUSION:The scores of Tampa Scale of Kinesiophobia in the experimental group were significantly lower than those in the control group at different time points postoperatively (P ＜ 0.05).The scores of American Knee Society in the experimental group were significantly higher than those in the control group at 3 and 6 months after discharge and kept on rising (P ＜ 0.01),but showed no significant difference at discharge and 1 month after discharge (P ＞ 0.05).(2) The hospitalization time and total hospitalization expenditure in the experimental group were significantly lower than those in the control group (P ＜ 0.01).(3) To conclude,CBT cannot only shorten the hospitalization time and total hospitalization expenditure,but also relieve kinesiophobia,which is conductive for functional recovery of the knee.

Objective Currently, there are few articles about kinesiophobia in patients with total knee arthroplasty (TKA) in China.This study aims to investigate the incidence of kinesiophobia and its influencing factors in TKA patient, and provide evidence for the intervention of kinesiophobia.Methods A total of 298 TKA patients from our hospital were investigated by general information questionnaire, Tampa Scale of Kinesiophobia (TSK), Knee Self-Efficacy Scales, Simplified Coping Style Questionnaire and Social Support Rating Scale.Single-factor analysis and logistic regression analysis were conducted to explore influencing factors.Results The score of TSK was 38.50±13.52, and 31.88% of TKA patients reported kinesiophobia.Logistic regression analysis showed that duration of pain (OR=5.546, 95%CI: 2.143-14.353), education level (OR=0.145, 95%CI: 0.067-0.314), self efficacy(OR=0.606, 95%CI: 0.470-0.780), positive response (OR=0.784, 95%CI: 0.683-0.900), objective support (OR=0.807, 95%CI: 0.691-0.943) and utilization of social support (OR=0.507, 95%CI: 0.461-0.705) were factors influencing kinesiophobia in TKA patients.Conclusion Attention should be paid to the kinesiophobia in TKA patients, especially those influencing factors including duration of pain, education level, and objective support.Health care providers should encourage early stage rehabilitation exercise to improve the postoperative knee function of TKA patients.

The birth and development of oocyte donation technology have brought hope for women with poor ovarian reserve and repeated failure for in vitro fertilization, as well as for those with chromosomal abnormalities, premature ovarian failure, or at perimenopausal or menopausal stages. It has not only preserved their reproductive right, but also stabilized their families and increased social harmony. However, this technology does not only involve infertile couples themselves, but also social and ethical issues concerning their families and the society. This paper has reviewed and discussed the hot issues concerning oocyte donation, e.g., source of eggs, compensation for donors, prerequisites for recipients and donors, privacy of donors, and made suggestions for further improvement for the administration of oocyte donation.
Disclosure ; ethics ; Ethics, Medical ; Family Planning Services ; ethics ; methods ; Female ; Fertilization in Vitro ; ethics ; methods ; Humans ; Infertility, Female ; Oocyte Donation ; ethics ; methods ; Tissue Donors ; ethics

Objective To evaluate the reliability and validity of the Chinese Version of the Tampa Scale of Kinesiophobia (TSK-11) in patients receiving total knee arthroplasty. Methods The Chinese ver-sion of TSK-11 was translated from the original one,and adjusted for cultural adaptation. The reliability and validity of Chinese TSK-11 were tested among 254 eligible patients receiving total knee arthroplasty from a tertiary hospital in Henan province by convenience sampling. Results Three common factors which ex-plained 65. 177% of the total variance was extracted after the exploratory factor analysis,and each item had high factor loading quantity (>0. 4). The scale CVI was 0. 83~1. 00,the S-CVI/UA and S-CVI/Ave were 0. 91 and 0. 94,respectively. The Cronbach's α coefficient of the scale was 0. 883,and the test-retest reliabil-ity was 0. 798. The item-to-total correlations ranged from 0. 424~0. 757 (P<0. 05). Conclusion The Chi-nese version of TSK-11 has been proved to be reliable and valid with fewer understandable items,and short completion time. It can be used as a valuable tool for evaluating kinesiophobia in patients following total knee arthroplasty.

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 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.

Life-space, as a multidimensional structure, is an important indicator for measuring individual movement. Since the first proposal of life-space in 1985, it has gradually been applied in multiple fields. At present, the development of life-space in foreign countries is becoming increasingly mature, while there is little research on this aspect in China. This article reviews the definition, evaluation tools, and application progress of life-space in cardiac rehabilitation, so as to provide reference for the research and application of life-space in home-based cardiac rehabilitation in China.

Objective:To explore the experience and feelings of undergraduate nurses in low-value care de-implementation, so as to provide reference for formulating specific strategies for low-value care de-implementation.Methods:From July to October 2023, purposive sampling was used to select 14 full-time undergraduate nurses from the First Affiliated Hospital of Zhengzhou University as research subjects. The phenomenological research method was used to conduct semi-structured in-depth interviews, and Colaizzi 7-step analysis method was used to analyze the data.Results:Three themes were extracted in total. Highly recognizing the low-value care de-implementation included reducing nurses' workload, improving patients' medical experience, and promoting harmonious nurse-patient relationships. Cognitive dissonance for low-value care de-implementation involved low efficiency cognition and maintaining a wait-and-see attitude. Low-value care de-implementation was hindered by multiple factors, including a lack of critical thinking, concerns about medical nursing risks, a lack of evidence-based nursing skills, a lack of organizational support, and a lack of medical knowledge among patients.Conclusions:Undergraduate nurses highly recognize the significance of low-value care de-implementation, but still face many challenges in their clinical practice. Multiple measures should be taken to promote the low-value care de-implementation in clinical practice.

Objective:To develop a virtual reality (VR) exercise rehabilitation system for home-based patients with spinal cord injury, and test patients' acceptance and experience.Methods:The VR exercise rehabilitation system for home-based patients with spinal cord injury was developed by a multidisciplinary team based on the home rehabilitation needs, evidence, and clinical experience of spinal cord injury patients, and further improved after recommendations from experts and patients. From February to July 2024, convenience sampling was used to select 148 patients with spinal cord injuries admitted to the Department of Spinal Cord and Neurological Function Reconstruction at the China Rehabilitation Research Center. Acceptance Questionnaire was used to investigate patients' acceptance of the system. Thirteen patients with spinal cord injuries were selected for semi-structured interviews to explore the themes of their experiences using VR exercise rehabilitation system for home-based patients with spinal cord injury.Results:A VR exercise rehabilitation system for home-based patients with spinal cord injury was developed, which includes four aspects of personal profile, personal assessment, training selection, and care knowledge. The total acceptance score of this system among 148 patients was (87.69±1.59). Through semi-structured interviews, three themes were identified involving excellent experience, expectation of rehabilitation effects, satisfaction with functionality and hope for continuous system updates.Conclusions:The design of VR exercise rehabilitation system for home-based patients with spinal cord injury is scientifically reasonable, which can further verify the rehabilitation effect of the system.

Objective:To construct an early rehabilitation program suitable for patients with cervical spondylosis after minimally invasive cervical laminoplasty and explore its clinical effect, in order to promote postoperative spinal cord function recovery and reduce complications.Methods:The early rehabilitation program after minimally invasive cervical laminoplasty was constructed by literature search, research group discussion and two rounds of Delphi expert correspondence. The convenient sampling was used to select 136 patients who underwent minimally invasive cervical laminoplasty by the posterior cervical approach who were admitted to the First Affiliated Hospital of Zhengzhou University from May 2018 to May 2020. They were divided into control group and observation group by the random number table method, with 68 cases in each group. The control group underwent rehabilitation according to the conventional rehabilitation methods after cervical spine surgery, while the observation group was given the early rehabilitation program intervention after minimally invasive cervical laminoplasty. They were followed up 12 months after surgery. The differences in Japanese Orthopaedic Association Scores (JOA) score, Neck Disability Index (NDI) score and Visual Analogue Scale (VAS) for axial pain were compared between the two groups before intervention and 12 months after surgery.Results:There were no statistically significant differences in the JOA, NDI and VAS scores between the two groups before intervention ( P>0.05) . After 12 months of follow-up, there was no statistically significant difference in the cervical spine JOA score between the two groups ( t=1.655, P=0.101) . The NDI score of the observation group [ (17.68±5.73) ] was lower than that of the control group [ (27.39±11.01) ] , and the difference was statistically significant ( t=-5.846, P<0.01) . The VAS score of the observation group [ (1.59±0.86) ] was lower than that of the control group [ (2.31±1.12) ] , and the difference was statistically significant ( t=-3.801, P<0.01) . Conclusions:The early rehabilitation program after minimally invasive cervical laminoplasty constructed in this study is scientific and reliable, which is helpful to improve the cervical spine function and daily activities of patients with cervical spondylosis after surgery and reduce the occurrence of axial pain.