Objective:To investigate sedation level for postoperative patients with mechanical ventilation in ICU, and to explore the related factors and patient outcomes with different sedation level.Methods:Totally 163 postoperative ICU patients from 11th June to 30th October 2018 were prospectively analyzed. Medical information and all the RASS (Richmond Agitation Sedation Scale) scores was recorded by nurses.Results:The 163 enrolled patients received 11 261.62 hours mechanical ventilation therapy, and 2 815 RASS scores were assessed and recorded by nurses. Among these scores, 80.3% (2 261/2 815) were at light sedation level, while 17.4% (490/2 815) and 2.3% (64/2 815) were at excessive or insufficient sedation level, respectively. All patients were divided into satisfactory sedation group and unsatisfactory sedation group according to the recommendations of guidelines, and used both univariate analysis and multivariate analysis. Compared to males, female patients tend to be in a satisfactory sedation level ( OR value was 0.39, P<0.05); use of midazolam may increase the risk of unsatisfactory sedation level ( OR value was 5.60, P<0.05); the longer sedation assessment interval ( OR value was 1.70, P<0.05), the more likely the patient′s sedation level is unsatisfactory ( OR value was 1.70, P<0.05) . Patients in sedation unsatisfactory group have higher rate of tracheostomy ( χ 2 value was 9.70, P<0.01), longer ICU stay ( U value was -2.33, P<0.05) and more medical expense ( t value was -4.26, P<0.01). Conclusion:The current sedation management in our ICU is satisfactory, but there is still a small part of patients in a state of insufficient sedation or excessive sedation. Sedation level is closely related to sedatives, RASS assessments interval performed by the nurses. This study provides a reference and basis for clinical sedation management and the sedation assessment strategies in the ICU.

Objective: Constructing and applying the multi-module training program for junior midwives to improve the training quality. Methods: The training program was constructed according to different modules of core competence. 11 junior midwives were selected from a hospital in Zhengzhou as trainees. The training effect was evaluated. Results: Their core competence has been enhanced in theory knowledge, operating skills and training satisfaction (P < 0.05). After training, the rate of episiotomy and the rate of postpartum hemorrhage were lower than before (P<0.05). Conclusion The multi-module training program can improve the core competence of junior midwives, which provides effective training method and promotes the quality of training.

Objective: To investigate the sources of meaning in life of the elderly in the community. Methods: The phenomenological approach was conducted in Guangzhou Yuexiu Liurong community health service center and Shouxing nursing home in Baiyun District, a total of 21 elderly were interviewed by semi-structured in-depth interviews. Interviews data were analyzed by Nvivo11. Results: The elderly in the community were less concerned about the meaning in life. The level of meaning in life ranges from nothing to high, and some elderly had not explored it yet. Sources of meaning in life for elderly were quite different from when he was young: one valued work, earn money and self-improvement more when young, but as the growth of age, one would pay more attention to family and health. The sources of meaning in life included suffering, autonomy, family, make contributions and faith. Conclusion In the future, the sense of meaning in life of the elderly can be enhanced from the perspective of individuals, families and society by identifying the sources of meaning of the elderly.

Objective: To explore the effects of focused solving mode on the care preparedness and negative emotions of the main caregivers of patients with stroke. Methods: Totally 87 main caregivers of patients with stroke were enrolled from the department of Neurology,North Jiangsu People′s hospital in Yangzhou from January 2018 to October 2018. Forty-three caregivers were recruited in the control group from January to May 2018. From June to October in 2018, 44 caregivers were recruited in the intervention group. Both groups received routine care, and the intervention group also received focused solving mode. Applying Caregiver Preparedness Scale、Self-rating Anxiety and Depression Scale to evaluate the effects of intervention. Two cases in intervention group were lost to follow-up while one case in control group. Results: Before the intervention, there were no statistical differences in caregiver preparedness scores and anxiety and depression scores between two groups (P>0.05). After the implementation of the focused solving mode, the caregiver preparedness score was (24.14±3.25) points in the intervention group and (20.95±2.56) points in the control group, the difference was statistically significant (t=5.000, P<0.01); the anxiety and depression scores of caregivers were (47.64±6.54), (48.39 ±7.07) points in the intervention group, (50.33±4.68), (53.68±6.73) points in the control group, there were significant differences (t=-2.165,-3.511, P<0.05 or 0.01). Conclusion Focused solving mode can improve the care preparedness of the main caregivers of patients with stroke and alleviate anxiety and depression effectively.

Objective: To investigate the current status of uncertainty in illness and caregiving burden in family members of patients with chronic wounds, and to analyze the relationship between them. Methods: A total of 180 patients with chronic wounds admitted to the Department of Emergency of our hospital from October 2017 to March 2018, conforming to the study criteria, were selected by adopting the convenience sampling method. Then one family member who took care of the patients for the longest time and conformed to the study criteria were included in this cross-sectional survey. General Information Questionnaire made by the authors was conducted to investigate the demographic data and wounds of patients, and demographic data of family members. Chinese version of Parent Perception of Uncertainty Scale-Family Member (PPUS-FM) and Caregiver Burden Inventory (CBI) were used to investigate the uncertainty in illness and caregiving burden. Data were processed with multiple linear regression analysis and partial correlation analysis. Results: The effective recovery rate of questionnaire was 91.7% (165/180). (1) The ages of patients were (71±17) years. Among them, there were 89 males and 76 females. The course of chronic wounds was 0.5 to 120.0 months. The wounds were mainly primary occurrence (86.1%, 142 patients), and the main type of wound was pressure ulcer (43.6%, 72 patients). Fifty-seven patients (34.5%) had wound infection. The ages of family members were (56±13) years, and 61.8% (102 people) of them were female. Their daily time of taking care of patients was (10±8) h. (2) The total scores of PPUS-FM of family members were 33 to 125 (88±17) points, mainly in medium level, in which the item score of unpredictability dimension was the highest. (3) The total scores of CBI of family members were 7 to 79 (43±14) points, in which the item score of time-dependence burden dimension was the highest. (4) Uncertainty in PPUS-FM could independently influence 10% of the total variation of caregiving burden in family members of patients (t=3.18, P<0.01). (5) The total scores of PPUS-FM of family members were in significantly positive correlation with the total scores of CBI and scores of physical burden, emotional burden, and social burden, respectively (r=0.33, 0.32, 0.25, 0.36, P<0.05 or P<0.01), while there was no obvious correlation between total scores of PPUS-FM of family members and time-dependence burden/developmental burden (r=0.14, 0.16, P>0.05). Conclusion There is positive correlation between uncertainty in illness and caregiving burden.