Objective The study aimed to explore the reliability and validity of the Chinese version of the Nottingham Assessment of Functional Footcare (NAFF) in investigating the footcare behavior's level in patients with high risk of diabetic foot.Methods According to Bradley's principle,NAFF was converted into the Chinese version scale,then it was applied to 211 cases of patients with high risk of type 2 diabetic foot,and the reliability and validity of foot care be-havior scores were analyzed.Results In the Chinese version scale,the Cronbach's alpha coefficient was 0.77,test-retest reliability was 0.74.Content validity,ICVI was 0.80 to 1.00,S-CVI/Ave was 0.96,and the adjusted value of kappa was 0.75 to 1.00.Conclusions The questionnaire has been tested to have good reliability and validity.The NAFF possesses certain value in the clinical application and could be suitable for Chinese patients with high risk of type 2 diabetic foot.

Objective The purpose of the study was to evaluate the reliability and validity of the Chinese Version of Hypoglycemia Fear Survey Ⅱ-Worry Scale (CHFSⅡ-WS) and provide a psychological assessment tool for patients with type 2 diabetes mellitus.Methods The CHFSⅡ-WS was tested in 300 patients with type 2 diabetes mellitus for measuring the scale's reliability and validity.Results The itemlevel content validity index (Ⅰ-CVI) of the CHFSⅡ-WS was 0.78～1.00,the scale-level content validity index (S-CVI) was 0.928.Through the exploratory factor analysis two factors were extracted which accounted for 52.959％ of the total variance.The test-retested reliability of the CHFSⅡ-WS was 0.911,Cronbach'α coefficient was 0.904.Conclusions The CHFSⅡ-WS has excellent reliability and validity,which can be used as a valid tool for type 2 diabetes mellitus patients in China.

Objective To investigate the fatigue in patients with type 2 diabetes mellitus (T2DM),and analyze its related factors.Methods A total of 211 patients with type 2 diabetes were investigated with Chinese version of Multidimensional Fatigue Inventory-20 (MFI-20),Medical Outcomes Study Health Status Short Form-Vitality (SF-36-VT) and demographic survey questionnaire.T test,one-way AVOVA and multiple linear regression analysis were used to analyze the data.Results The fatigue incidence of 211cases of patients with type 2 diabetes was 63.5％ (134/211),the mean score of MFI-20 was 54.10±15.63,and women's score (57.89±15.32) was significantly higher than that of men (51.54±15.37)(t=2.949,P ＜ 0.01).Physical fatigue got the highest score of the three dimensions in MFI-20,which was 2.99±1.03,the mental fatigue scored 2.67±0.82.Multiple linear regression analysis showed that fatigue was related to the sports,2hPBG,rest situation,cerebrovascular complications and the number of complications,which could totally explain 30.7％ of the variance.Conclusions More attention should be paid to fatigue of T2DM patients.Effective interventions should be carried out to relieve the fatigue status of T2DM patients and improve their self-management ability and quality of life.

Objective To investigate the level of foot care behavior and analyse related influencing factors in patients with high risk of type 2 diabetic foot (DF).Methods Apply the Chinese version of the Nottingham Assessment of Functional Footcare to 300 cases of patients with high risk of DF and take oneway ANOVA and multiple stepwise linear regression analysis on the general information and current foot condition.Results The score of foot care behavior was (45.58 ±7.83) scores.52.3 percents patients' scores were less than 45.Gender,previous education of diabetic foot care and history of diabetic foot ulcer were influencing factors of foot care behavior in patients with high risk of type 2 diabetic foot (t=3.196,3.392,2.462,P＜0.05).Conclusions The current level of foot care behavior was relatively low in patients with high risk of type 2 DF.It was also approved that female patients with high risk of DF who had received diabetic foot care education and suffered from diabetic foot ulcer before score much higher on foot care behavior.

Objective Mining and exploring the positive experience of family caregivers of diabetic foot,aims to deepen the conceptual framework of positive aspects of caregiving and to provide a basis for interventions. Methods A qualitative study design was used guided by the conceptual framework of positive aspects of caregiving.Ten family caregivers of patients with diabetic foot were surveyed. The Colaizzi qualitative analysis method and the framework method were used to analysis the qualitative data. Results The caregivers′positive experience was described from 4 aspects:quality of caregiver/care receiver daily relationship, caregiver′s feeling of accomplishment, meaning of the caregiver′s role in daily life and the caregivers′gain. The caregivers′positive experience was influenced by the caregiver′s sense of self-efficacy and the enrichment events in daily life. Conclusions Family caregivers of diabetic foot get positive experiences in caregiving. The conceptual framework of positive aspects of caregiving explains the relationship between caregivers′positive experience and the determine factors, and it will be helpful to the designing and implementing of interventions. The positive experience should be considered when an intervention program will be conducted for supporting family caregivers.

Objective To explore the behaviors caused by fear of hypoglycemia in type 2 diabetic patients, and deeply analyze the causes of these behaviors, providing help for medical staff to fully understand the inner demands of diabetic patients with hypoglycemia, so as to manage the blood glucose effectively, laying the foundation of Hypoglycemia Fear Survey-behavior scale suitable for domestic type 2 diabetic patients. Methods The interpretative phenomenological analysis method was used guided by the knowledge-attitude-belief-practice and social cognitive theory, 33 patients with hypoglycemia from 5 hospitals with different levels were interviewed by semi-structured interview. Results Four themes were extracted, including excess sensitivity, caution, avoidance and compromise. The theme excess sensitivity contained three kinds of behaviors, that were meal with sensitive alertness, drug sensitivity and excessive response to the hypoglycemia, while the theme caution contained two kinds of behaviors, that were strive to blood sugar stable and must prepare food. Conclusions The results show that the fear of hypoglycemia is serious in type 2 diabetic patients, and they make many behavior change to avoid it, affecting their quality of life and glycemic management. Medical staff should attach importance to the inner feelings and behaviors of diabetic patients with hypoglycemia, and provide guidance and support after comprehensive assessment, working together with the patient to realize the effective management of blood glucose.

To analyze and summary the setting of admission standards, training methods and certification and assessment methods of specialized nursing teachers, in order to lay the foundation for the homogenization training of specialized nursing teachers in China, and at the same time, provide guarantee for the improvement of the homogenization level of national specialized nursing training bases.

Objective To assess the effectiveness of a novel mobile health patient management system involving doctors, nurses, and patients ( TRIO mode) on glycemic control and self-monitoring of blood glucose (SMBG) compliance among the type 2 diabetes mellitus ( T2DM) patients using basal insulin standardization treatment in China. Methods From April 2014 to April 2015, 416 hospitals in 110 cities of 30 provinces, municipalities, and autonomous regions across China were selected to participate in the program. A Online-to-Offline ( O2O) integrated mobile health patients management system with mobile terminals for the doctors, nurses, and patients was applied in the program for patient education, follow-up, and data collection. For all the newly recruited patients, the baseline information was collected and a first-day patient education program were provided by a designated nurse. In the 12-week follow-up period, data of basal insulin doses and fasting plasma glucose ( FPG) values were collected from the patients by text messages or tracking phone call by the nurse. The patients also received timely standardized patients health education and glycemic control guidance by participating in thepatient education forum anddoctors' hotline in order to help them achieve the glycemic control goals. Results A total of 102 524 patients using basal insulin treatment were eligible and enrolled in the program. 64 420 patients completed the 12 weeks follow-up and provided at least one FPG value at all five follow-ups. In total, 62. 6% (40 334 / 64 420) of the patients reached the FPG control target(FPG≤7. 0 mmol/ L) at the end of follow-up period. The weekly average FPG for patients with complete SMBG data decreased from 10. 58 mmol/ L to 6. 91 mmol/ L while the FPG control rates increased from 13. 4% to 69. 2% . The weekly average FPG for the patients provided incomplete SMBG data decreased from 10. 54 mmol/ L to 7. 13 mmol/ L while the FPG control rates increased from 13. 6% to 62. 2% . The FPG control rates for the patients provided complete SMBG were 1. 74 times higher than those patients provided incomplete SMBG. Based on a GEE model, the average decline of the FPG and the increase of the FPG control rates were significantly better for patients who provided complete SMBG as compared to the patients with incomplete SMBG data. The results of the multivariate logistic regression analysis showed that factors such as receiving the first-day education, participating in the follow-up patient education forum, and the doctors' hotline were significantly associated with the improvement of the SMBG compliance, the treatment adherence, and the FPG control rates. The SMBG compliance and the treatment adherence for patients who completed first-day education were 1. 68 times and 1. 22 times higher, respectively. For the patients who participated in follow-up education activities, their SMBG compliance and treatment adherence were 3. 17 times and 3. 36 times higher, respectively. Conclusion The innovativeTRIOmobile health patient management mode was feasible and effective for better managing the type 2 diabetes patients initiated on basal insulin treatment in China. Active participation in the first-day education program and the follow-up patient education activities can effectively improve the SMBG compliance and the treatment adherence, and therefore play an important role in helping patient achieving FPG control in a faster manner.

Objective:To explore the application of grading nursing intervention program based on Munro scale for assessment in perioperative pressure injury prevention.Method:Convenience sampling method was used to extract the research object,the perioperative risk assessment was conducted with Munro scale, and grading nursing prevention measures based on the risk classification was performed in experimental group between Aug 2019 and Jan 2020, routine treatment in control group between Jan 2019 and Jul 2019. The incidence of pressure ulcers, recovery time of pressure red, patient satisfaction were observed.Results:The incidence of stress injury was 0.20% in the experimental group and 0.33% in the control group, without significant differences between the two groups. The red recovery time was (36.10 ± 11.94) min in the experimental group and (41.70 ± 11.26) min in the control group, with significant differences between the two groups ( t=7.99, P<0.01). Conclusion:The graded nursing intervention scheme based on Munro scale has significant effect on the prevention of stress injury.

Objective:To investigate the various factors that contribute to self-reported hypoglycemia in elderly patients with type 2 diabetes mellitus.Methods:This is a prospective cohort study that included 1, 010 elderly patients with type 2 diabetes mellitus who were hospitalized in Tianjin Medical University Chu Hsien-I Memorial Hospital from April to September 2019.Patients were selected using the convenient sampling method and were between the ages of 60-90(66.7±5.3)years with a disease course of 0.5-40.0 years.Baseline data was collected through questionnaires and patients were followed up for six months.The study observed self-reported hypoglycemia events and analyzed the influencing factors of self-reported hypoglycemia using logistic regression.Results:Out of the 1, 010 patients who participated in the study, 901(89.2%)completed it.Of those who completed the study, 321(35.6%)reported experiencing hypoglycemia.The median frequency of hypoglycemia was found to be 3(2, 4)times.Several factors were found to be influential in self-reported hypoglycemia in elderly patients with type 2 diabetes.These factors included waist circumference, HbA1c, thiazolidinediones combined with insulin therapy, frequency of hypoglycemia in the past year, blood glucose prevention education, and fear of hypoglycemia.All of these factors had a significant impact on self-reported hypoglycemia(all P<0.05). Conclusions:Medical professionals should prioritize patients who are undergoing thiazolidinediones combined with insulin therapy and frequently experience hypoglycemia.They should address the patients' fear of hypoglycemia and provide them with comprehensive education.