Objective To evaluate the predictive effect of Braden scale for the risk of development of pressure ulcers (PU) in the department of neurology bedridden patients and to explore subgroup preventive measures. Methods 400 cases newly hospitalized bedridden patients in the department of neurology were collected with no pressure ulcers at the first evaluation and pressure ulcer risk was continuously predicted by a Braden scale skin assessment. The high-risk, middle-risk and low-risk groups were randomized into the experimental group and the control group respectively. Routine preventive measures were taken for the control group while the air fluidized bed for the high-risk group, the sponge mattress for the middle-riskgroup, and turning the body over every 4 hours for low-risk group. Other preventive procedures were undertaken simultaneously in beth the experimental and the control groups. Results The area under the ROC curve (AUC)was 0.771 and 0.828 at the first and last time Braden scale scores respectively. Such vMues as sensitiveness, specificity, positive predictive value, negative predictive value were found in higher level,when the diagnosis value was 17. There was no significant difference of incidence rate of the subgroup pressure ulcers between the high-risk, middle-risk, low-risk groups compared to the control group. Conclusions The effect of predicting pressure ulcer risk for bedridden patients in the department of neurology with Braden scale was fairly good, while the score 17 as the diagnosis value was ideal. The air fluidized bed for the high-risk group and the sponge mattress for the middle-risk group resulted in no significant decrease of incidence rate of the pressure ulcer, while taming over the patients' body every 4 hours for low-risk groups showed acceptable and therefore saving medical resources.

Objective:To explore the effects of nurse as standardized patient (NSP) in clinical apprenticeship and objective structured clinical examination (OSCE) of psychiatric nursing.Methods:Totally 260 undergraduate nursing students admitted to the School of Nursing of a medical university in 2017 were selected into experimental group, who were taught in combination of real patients and NSP, and received assessment of clinical apprenticeship skills through OSCE involving NSP. Totally 286 undergraduate nursing students admitted in 2016 were selected into control group, who received conventional clinical apprenticeship teaching and assessment. The discrimination and difficulty of the assessment of the experimental group was considered, and the test scores, the degree of recognition of the assessment form by the nursing students, and the ability of critical thinking were compared between the two groups.Results:Totally 247 nursing students in the experimental group and 280 in the control group completed the study. The degree of difficulty and discrimination met the assessment requirements. There was a statistically significant difference in apprenticeship performance between the two groups ( P<0.01) . After OSCE, the recognition scores of the two groups for OSCE were (3.22±0.64) and (4.17±0.58) , respectively, and the difference was statistically significant ( P<0.01) . The total scores of Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) of the two groups were (278.29±25.66) and (289.53±35.43) , respectively, and the difference was statistically significant ( P<0.01) . There were statistically significant differences in the scores of CTDI-CV in 4 dimensions between the two groups, they are open-mindedness, analytical ability, systematic ability and self-confidence ( P<0.05) . Conclusions:The NSP-based clinical apprenticeship and OSCE for psychiatric nursing is feasible and practical, which can improve students' critical thinking ability, and is worth referencing and promoting.

Objective:To evaluate the feasibility of using Patient Health Questionnaire-4 (PHQ-4) to screen for depression and anxiety in inpatients in general hospitals.Methods:Using the convenient sampling method, a total of 695 inpatients from 10 ClassⅡ Grade A and above comprehensive hospitals in Nanjing from January to June 2021 were selected as the research objects. They were investigated by PHQ-4, Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) to compare the screening results of different measuring tools for depression and anxiety. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of PHQ-4, Kappa test was used to analyze the consistency, Cronbach's α coefficient was used to evaluate the internal consistency of the scale, and Pearson correlation analysis was used to evaluate the calibration correlation validity. A total of 695 questionnaires were sent out in this study, and 672 were effectively collected, with an effective recovery rate of 96.69% (672/695) .Results:Among 672 inpatients in general hospitals, the detection rate of depression and anxiety in patients using PHQ-4 was 38.39% (258/672), while that in patients using PHQ-9 and GAD-7 was 41.82% (281/672), and the difference showed no statistical significance (χ 2=1.64, P=0.20). Cronbachs'α coefficient of PHQ-4 was 0.913, and the half reliability coefficient was 0.888. The Kappa value of the consistency test between PHQ-4, PHQ-9, and GAD-7 for depression and anxiety screening results was 0.756 ( P<0.01). The correlation coefficients between the total scores of PHQ-4, PHQ-9 and GAD-7 in 672 inpatients from general hospitals were 0.822 and 0.802, respectively (both P<0.01). The area under the ROC curve of PHQ-4 was 0.936. With a critical score of 3, the sensitivity and specificity of PHQ-4 were 81.9% and 92.8%, respectively. Conclusions:The detection rate of PHQ-4 and PHQ-9 and GAD-7 on depression and anxiety state of inpatients in general hospital is similar, and has good reliability and validity, which is suitable for the screening of depression and anxiety of inpatients in general hospital.