Objective: To investigate patients' satisfaction rate towards referral in a class A tertiary hospital, so as to provide the evidence for promoting the highly efficient implementation of referral. Methods : The gender, age, type of referral, referral efficiency and referral cost of patients receiving referral services in 2021 were collected through the interconnected intelligent hierarchical diagnosis and treatment collaborative platform of Henan Provincial People's Hospital. Patients' awareness and recognition of the two-way referral system were investigated using questionnaire surveys, and factors affecting patients' satisfaction with referral were identified using a multivariable logistic regression model. Results: A total of 1 268 patients receiving referral services were surveyed, including 576 men (45.43%) and 692 women (54.57%), and the respondents were predominant at ages of 18 years and older (935 cases, 73.74%). There were 535 cases with overdue referral (42.19%) and 1 157 cases with free referrals (91.25%). There were 749 cases that were aware of the two-way referral system (59.07%), and 587 cases recognized the two-way referral system (46.29%). There were 975 patients with a satisfactory attitude towards referral, with a satisfaction rate of 76.89%. There were 1 030 cases (81.23%) that considered fluent communication of referral information, with a 78.54% satisfaction rate towards referral; 569 cases (44.87%) that considered simple referral procedures, with an 81.37% satisfaction rate towards referral, and 797 cases that were satisfied with the services provided by the referred medical staff (62.85%), with a 79.42% satisfaction rate towards referral. Multivariable logistic regression analysis showed that non-overdue referrals (OR=1.846, 95%CI: 1.411-2.414), free referrals (OR=1.815, 95%CI: 1.188-2.773), awareness of the two-way referral system (OR=0.624, 95%CI: 0.472-0.826), recognition of the two-way referral system (OR=1.621, 95%CI: 1.235-2.129) were factors affecting the satisfaction with referral. Conclusions The satisfaction rate towards referral was 76.89% among the study patients, and the awareness and recognition of the two-way referral system, referral efficiency and convenience are factors affecting the satisfaction with referral.

With the increasing number of food safety problems caused by the abusing and misusing of plant hormones, it will be increasingly important to strengthen the trace detection of plant hormones in foods. In this study, benzyl methacrylate_methyl methacrylate_based amphiphilic polymer micelles were prepared, and a method for trace determination of five plant hormones was established by using these micelles. This method was rapid, sensitive and reproducible. Through optimization, the best experimental conditions were obtained as follows: 2 g/L polymer micelles, 50 mmol/L NaOH_H3BO3 buffer (pH 9. 2), 15 kV running voltage. Based on this novel method, naphthalene acetic acid in the solution of rooting powder was determined.

Objective To study influencing factors for giving up chemotherapy during initial treatment in elderly patients with multiple myeloma.Methods A total of 156 elderly patients diagnosed as multiple myeloma from 2000-2010 were retrospectively analyzed.And 123 young patients with multiple myeloma were selected as control group.The causes for giving up the chemotherapy and its related factors were recorded and analyzed.Results The rate of giving up the initial chemotherapy was higher in the elderly than in young patients [58.3％ (91/156) vs.35.0％ (43/123),P＜0.05].51.7％ of the elderly patients did not accept chemotherapy after diagnosis.The main factors for giving up the initial chemotherapy in elderly patients were critically ill,economic difficult and the low tolerance.However,the economic difficulty was the first cause in the young group.Conclusions The rate of giving up the chemotherapy in the elderly patients is high.Old age,severe conditions,economic difficulty,and low tolerance are the independent factors.

0bjective To explore the effects of narrative nursing on posttraumatic growth for patients with amputation. Methods From December 2016 to March 2018,a total of 62 hospitalized patients with amputation were randomly assigned into the control group and the intervention group by random number table.The control group received routine nursing,the intervention group received narrative nursing on the basis of control group.Two groups were evaluated by Posttraumatic Growth Inventory(PTGI) before and after intervention. Results Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the control group were (19.87 ± 5.22), (7.90 ± 2.53), (8.83 ± 3.62), (9.73 ± 3.13), (10.63 ± 3.01), (56.97 ± 17.21) points, respectively. After intervention,the scores were (20.80±5.89), (8.80±2.17), (8.90±3.39), (10.27± 2.75), (11.07 ± 3.12), (59.83 ± 16.91) points, respectively, except new possibilities, the scores of each dimension and total scores of posttraumatic growth in the the control group were higher than before,the differences were statistically significant(t=3.00- 5.34, P＜0.05).Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the intervention group were (20.28±4.94), (8.17±2.58), (8.59±3.48), (9.55± 2.90), (11.07±2.83), (57.66±16.42) points, respectively. After intervention, the scores were (23.79±4.70), (10.10±2.17), (10.72±3.34), (11.69±2.22), (12.79±3.28),(69.10±14.92) points, respectively, the scores of each dimension and total scores of posttraumatic growth in the intervention group were statistically higher than those in the control group and before intervention,the differences were statistically significant (t=10.61-16.75, P＜0.05). Conclusion Narrative nursing can effectively improve the level of posttraumatic growth and psychological state for patients with amputation.

Objective To investigate the current situation of caregiver burden of relative caregivers of multiple myeloma patients, and to analyze its influencing factors. Methods Cross-section investigation method was used in the study. A total of 125 multiple myeloma patients and their relative caregivers, who accepted treatment in the hematology department of He'nan Provincial People's Hospital from December 2015 to March 2017 were selected by convenience sampling method. The general situation investigation questionnaire, Zarit Caregiver Burden Inventory (ZBI), Barthel Index (BI), Social Support Rating Scale (SSRS) and Connor-Davidson Resilience Scale (CD-RISC) were adopted in the investigation. PASW 18.0 software was adopted for statistical analysis of the data. Results The ZBI score of the relative caregivers of multiple myeloma patients was (57.01±15.36), and 86.4% of the caregivers' scored at a moderate level and over. The differences of ZBI scores of the caregivers with different educational background, family average monthly income, caring time and the different numbers of complications in patients were statistically significant (t/F/H=3.924,9.656,8.062,20.608;P< 0.05). The average score of BI in multiple myeloma patients was (53.56±8.30), with moderate dysfunction, which was negatively correlated with the total score of ZBI and the scores of its all dimensions (P< 0.01). The average score of SSRS in the caregivers was (48.18± 8.53), with a high level of social support, and the average score of CD-RISC was (64.50±9.41), the two of which were both negatively correlated with the total score of ZBI and the scores of its all dimensions (P<0.05). As indicated by the results of multiple linear regression analysis, the complication number and self-care ability of the patients as well as the average monthly family income, caregiving time, social support and mental elasticity of the relative caregivers could be included in the regression equation, which explained 40.1% of the variance. Conclusions The caregiver burden of patients with multiple myeloma is relatively heavy. The complication number and self-care ability of the patients as well as the average monthly family income, caregiving time, social support and mental elasticity of the relative caregivers are the influencing factors of caregiver burden.

Objective:To explore the application of psychological resilience intervention combined with prospective nursing in patients with free skin flap transplantation to repair skin and soft tissue defects of extremities.Methods:Using the convenient sampling method, a total of 65 patients with soft tissue injury in the skin of extremities after undergoing free skin flap transplantation who were admitted to Henan Provincial People's Hospital from October 2019 to October 2020 were selected. According to the admission time, they were divided into the observation group (34 cases) and the control group (31 cases) . Patients in the observation group received psychological resilience intervention combined with prospective nursing, while patients in the control group only received prospective nursing. The surgical success rate, flap necrosis rate, incidence of vascular crisis and complications were compared between the two groups. Symptom Checklist-90 (SCL-90) was used to evaluate treatment effects of patients in two groups before and after the intervention.Results:There was no statistically significant difference in the surgical success rate, flap necrosis rate and incidence of vascular crisis between the observation group (100.00%, 2.94%, 2.94%) and the control group (96.77%, 12.90%, 16.13%) ( P>0.05) . The observation group had 1 case of deep venous thrombosis (DVT) and 2 cases of other complications, and the control group had 3 cases of pressure injury, 1 case of infection, 2 cases of DVT and 3 cases of other complications. The complication rate in the observation group was 8.82%, which was lower than 29.03% in the control group, and the difference was statistically significant ( P<0.05) . After intervention, the scores of anxiety and paranoia in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Psychological resilience intervention combined with prospective nursing has a good application effect on patients with free skin flap transplantation to repair skin and soft tissue defects of extremities. The complication rate is reduced, and mental health of patients is good.

Objective:To explore the application effect of transitional care mode (CTM) based on protective motivation theory (PMT) in patients with urinary calculus.Methods:A total of 156 patients with urinary calculus who were admitted to Henan Provincial People's Hospital from January to December 2019 were selected by the convenient sampling method. According to random number table method, they were divided into the control group and the observation group, with 78 cases in each group. The control group received routine nursing, while the observation group received CTM nursing based on PMT. The two groups were followed up for 1 year. The self-care ability, self-management efficiency score and recurrence rate of calculus were compared between the two groups before and after nursing intervention.Results:After 1 year of follow-up, the recurrence rate of calculus in the observation group was 1.28% (1/78) , lower than 8.97% (7/78) in the control group, and the difference was statistically significant ( P<0.05) . After nursing intervention, the self-care ability and self-management efficacy of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The implementation of PMT based CTM in patients with urinary calculus can reduce the recurrence rate of calculus and improve the self-care ability and self-management efficiency of patients.