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 effect of medical alliance combined with video recording guidance on the out-of-hospital rehabilitation of elderly patients undergoing hip replacement.Methods:Using the convenient sampling method, a total of 58 aged patients who were hospitalized in the Department of Orthopedics and underwent hip replacement in the First Affiliated Hospital of Zhengzhou University from March 2018 to June 2019 were selected as research objects. They were randomly divided into the observation group and the control group, with 29 cases in each group. The control group was given conventional out-of-hospital rehabilitation management while the observation group was given medical alliance combined with video recording guidance. The serum albumin, Harris score, total body skeletal muscle mass, skeletal muscle mass of the affected limb, incidence of deep venous thrombosis (DVT) and incidence of artificial hip dislocation were compared between the two groups before and after the intervention.Results:After intervention, the serum albumin of the observation group was (36.73±1.95) g/L, the Harris score was (89.29±5.25) , the total body skeletal muscle mass was (17.91±1.18) kg and the skeletal muscle mass of the affected limb was (5.38±0.79) kg, which were all higher than those of the control group, and the differences were statistically significant ( t=3.524, 7.231, 4.584, 4.252; P<0.05) . After intervention, the incidence of DVT in the observation group was 3.45% (1/29) , and the difference was not statistically significant when compared with 13.79% (4/29) in the control group (χ 2=1.970, P>0.05) . After the intervention, the incidence of artificial hip dislocation in the observation group was 0 (0/29) , which was lower than 20.69% (6/29) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Medical consortium combined with video guidance can effectively improve the out-of-hospital rehabilitation effect of elderly patients undergoing hip replacement surgery and reduce the occurrence of complications. Medical alliance combined with video recording guidance can effectively improve the out-of-hospital rehabilitation effect of elderly patients with artificial hip replacement and reduce the incidence of complications.

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 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 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.

Objective:To comprehensively search, evaluate and summarize the relevant evidence of early ambulation in patients with total knee arthroplasty (TKA), so as to provide evidence-based basis for the nursing practice of early ambulation in patients with TKA.Methods:Clinical decisions, best practice manuals, guidelines, systematic reviews, expert consensus and evidence summaries for early postoperative ambulation of TKA patients were searched by computer on PubMed, Web of Science, BMJ Best Practice, Cochrane Library, UpToDate, OVID, CINAHL, Embase, Joanna Briggs Institute (JBI) Centre for Evidence-based Health Care, Physiotherapy Evidence Database, China National Knowledge Infrastructure, WanFang Data, VIP, China Biology Medicine disc, Guidelines International Network, National Guideline Clearinghouse, National Institute for Health and Care Excellence, Canadian Medical Association Clinical Practice Guideline, Scottish Intercollegiate Guidelines Network, American Academy of Orthopaedic Surgeons and American Association of Hip and Knee Surgeons. The retrieval time was from the establishment of the databases to March 31, 2023. Four nursing graduate students trained in evidence-based nursing systems independently evaluated the quality of the included literature and divided the evidence levels according to the JBI Evidence Pre Grading System (2014 edition) .Results:A total of 15 articles were included, including four clinical decision papers, three guidelines, six expert consensus papers, one evidence summary and one systematic review. According to the judgment of professionals, 23 pieces of best evidence were formed from seven aspects, including the director of ambulation, evaluation before ambulation, ambulation planning, ambulation timing, ambulation content, ambulation evaluation and health education.Conclusions:The best evidence of early postoperative ambulation of patients with TKA summarized in this study is scientific and practical, which can provide evidence-based basis for clinical nursing work.