Objective To investigate the reliability and validity of Hospice care quality assessment scale. Methods Eight experts in the field of hospice revised the Scale after Chinese localization. The scale data were analyzed after collation of 181 families fulfill the scale. Results The total scale Cronbach′s a coefficient was 0.851. The first dimension′s coefficient was 0.796. The second dimension′s coefficient was 0.622 and the third dimension′s coefficient was 0.827. In factor analysis of the scale, after varimax rotation, the number of characteristic roots>1 was 10 and made up of 70.88%of the total variance. Conclusions The hospice care quality assessment scale after Chinese localization has good reliability and validity and could be a tool to evaluate the clinical quality of care for dying patients.

Objective To explore what symptoms which the medical staff judged from determination of agonal symptoms in cancer patients. Methods Focus group interview was conducted by 3 groups, 5 people in each group in appropriate time and place at May 2015. The interview was conducted around the theme of"how to judge the advanced cancer patients in dying". Results Agonal patients often showed changes in 7 aspects by content analyzing included pain, "the last radiance of the setting sun", consciousness, breathing patterns, blood circulation, intake and output volume and functional status. Besides, the instinct and experience of medical staff was another determinant. Conclusions Medical staff members have their qualitative understanding on evaluating when cancer patients are agonal. Changes in some symptoms before death can provide references for evaluating survival time.

Objective To cultivate specialist nurses to perform preoperative stoma site marking in patients to receive enterostomy and improve the rate of preoperative stoma site marking and the ability of preoperative stoma site marking in specialist nurses. Methods The rate of preoperative stoma site marking in 148 patients from July 2016 to October 2016 was investigated and the reason of not receiving preoperative stoma site marking was analyzed. Nineteen primary nurses were trained to perform preoperative stoma site marking instead of the traditional pattern which was performed by enterostomy therapist and physician. The training included the criteria of preoperative stoma site marking, difficult preoperative stoma site marking, demonstration, group exercises, theoretical and operational assessment. The preoperative stoma site marking of 156 patients were performed by specialist nurses from November 2016 to February 2017.Then,the rate of preoperative stoma site marking,accuracy of stoma location,and knowledge of preoperative stoma site marking were compared between the traditional and new management pattern. Results The preoperative stoma site marking rate was 91.89%(136/148)and the accuracy rate was 94.12%(127/136)in traditional management pattern.The lack of enterostomy therapist, surgery performed on weekends and emergency surgery were the reasons that preoperative stoma site marking was not performed.After changing the management pattern,the preoperative stoma site marking rate was increased to 98.72%(154/156) and there was a significant difference between them (χ2=8.06, P <0.05).The accuracy of localization was decreased to 92.86%(143/154),but there was no significant difference between them(χ2=0.03,P>0.05).The rate of acquiring preoperative stoma site marking knowledge in nurses was increased from 8/19 to 18/19 with a significant difference(χ2=12.18,P<0.01). Conclusions The pattern of preoperative stoma site marking was changed and the new pattern improved the rate of preoperative stoma site marking,and didn′t affect the accuracy of preoperative stoma site marking.Meanwhile,we also improved the nurses′level of preoperative stoma site marking in our department.

Objective To investigate application effects of the pain nursing operation flowchart in the management of cancer pain patients .Methods Eighty-two patients were divided into the control group (40 patients) and the study group (42 patients) according to the admission time using the convenience sampling method.The patients in the control group received routine nursing .In the study group the pain nursing operation flowchart was designed based on the adult cancer pain guideline and the establishment standard of cancer pain standardized treatment example wards .The nursing form was designed corresponding to the flowchart .The standardized training was carried out in all nurses in the department for the improvement of their operation standardization . The comprehensiveness and the dynamics of the pain assessment , the timeliness of communicating with doctors , the comprehensiveness of pain propaganda and education , the timeliness of the management of adverse reactions and the satisfaction degree of discharged patients in the two treatment groups were evaluated .Results For the quality inspection of pain nursing of the patients in the study group , after using the flowchart , the qualified rates of the comprehensiveness and the dynamics of the pain assessment , the timeliness of communicating with doctors , the comprehensiveness of pain propaganda and education , the timeliness of the management of adverse reactions were 100.0%, 100.0%, 95.2%, 100.0%, 97.6%, respectively;the satisfaction degree of discharged patients was 97.6%, all of which were significantly higher than those in the control group (χ2 =9.31,6.80,4.44,8.04,7.74,4.18;P<0.05).Conclusions The application of the pain nursing operation flowchart in standardized wards of cancer pain can significantly improve the quality of pain management , which achieves good social benefits and worthy of promotion .

Objective To investigate the analgesic effects of inhaling 50% nitrous oxide on burn pediatric patients during and after dressing change. Methods A total of 120 burn pediatric patients received outpatient dressing and hospitalized from September 2012 to September 2014 were enrolled in our study, and they were all in accordance with the inclusion criteria. The 120 pediatric patients were divided into control group (n=30) treated with inhalation of oxygen during dressing change) and treatment group (n=90) treated with inhalation of 50% nitrous oxide during dressing change ) according to the computer-generated list of random number. The other treatments in control group and treatment group were the same. Before, during and after dressing change, degree of pain, heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation and adverse effects were observed at the same time points. Data were processed with analysis of chi-square test, covariance and Student′s t test. Results There were no significant differences between the two groups in levels of HR, SBP, DBP, and SpO2 before dressing change (t=0. 34, 0. 57, 0. 11, 0. 98, respectively;P>0. 05). Compared with those of control group, levels of HR, SBP, DBP, and SpO2 in treatment group were significantly ameliorated during dressing change (t=25. 96, 24. 11, 8. 37, 20. 29, respectively;P<0. 01). After dressing change, the levels of DBP in the two groups were close (t=1. 57,P>0. 05), but the levels of HR, SBP, and SpO2 showed statistical differences (t=5. 20, 8. 64, 3. 37, respectively;P<0. 01). Before dressing change, the pain scores were approximate between control group and treatment group (t=0. 18,P>0. 05). Compared with those in control group, the pain scores in treatment group during and after dressing change were (2. 82 ± 0.8) and (1.2 ±0. 84), which were significantly lower than those in the control group (t =23. 00, 4. 30, respectively;P<0. 01). There were no obvious adverse effects in two groups during and after dressing change. The results of the covariance analysis of pain scores during dressing change showed statistical differences ( F=867. 956,P <0. 01). Conclusions 50% nitrous oxide seems to have obvious analgesic effects on burns pediatric patients during dressing change, and it can be widely used.