Objective To study the effect of comprehensive interventions on anxiety of nursing students at internship. Methods Comprehensive educational interventions were practiced at the beginning,middle-term and end of their internship. The Self-Rating Anxiety Scale(SAS)was adopted to assess their level of anxiety.Results There were differences in SAS scores between the three phases(F=2.680,P<0.05).The scores were decreased from the beginning to the end.Conclusion Targeted comprehensive educational interventions can reduce anxiety and stress of nursing students.

Objective To explore the effect of multimodal analgesia methods on postoperative pain in patients with calcaneal fracture. Methods Totally 96 cases of the patients with calcaneal fracture were divided into the control group and the observation group, there were 48 cases in each group. The control group was treated with conventional methods of postoperative analgesia, the observation group was given with the multimodal analgesia method. The VAS scores,functional exercises compliance and the incidence of adverse reaction for patients between the two group were observed and compared. Results The scores of pain at different time points in the observation group was 3.40 ± 0.41, 2.50 ± 0.75, 2.10 ± 0.84, 2.00 ± 0.52 respectively, while in the control group was 5.50 ± 0.35, 4.50 ± 0.55, 3.60 ± 0.62, 3.10 ± 0.45 respectively, the difference between the two groups was significant, t=6.85-11.62, P < 0.01. The good functional exercises compliance in the observation group was 87.5%(42/48), which was higher than the 68.8%(33/48) in the control group, the difference between the two groups was significant (χ2=7.571, P<0.05). The occurrence of nausea and vomiting was lower than the control group (χ2=4.800 and 4.360, P<0.05). Conclusion Multimodal analgesia method can improve analgesia effect obviously, improve functional exercises compliance, reduce the incidence of adverse reaction.

Neurogenic bowel dysfunction is a common complication after spinal cord injury mainly on abdominal distension, constipation and fecal incontinence which has serious negative influences on patients' lives. Transanal irrigation is a novel intervention method which has been widely used at home and abroad. Clinical practice results showed that transanal irrigation can improve the intestinal function as well as quality of life of patients. A total of five aspects were reviewed in this article, the summary of neurogenic bowel dysfunction, summary of transanal irrigation, intervention strategies, complications and continuous nursing.

Objective? To investigate the current situation of the first aid capability of operating room nurses and analyze the influencing factors of their first aid capability, so as to provide reference for operating room nursing managers to carry out first aid training. Methods? Using cluster random sampling method, from February to March of 2018, 432 operating room nurses from 4 operating room nurse competency certificate training base hospitals in Shanghai were selected as the research participants. The Self-Designed General Information Questionnaire was used to collect the nurses' clinical data, and the Operating Room Nurses First Aid capability Assessment Scale was used for the operating room nurses in self-evaluation about their first aid capability. Univariate analysis was used to analyze the differences of first aid capability among the operating room nurses with different characteristics, and multivariate linear regression was used to analyze the influencing factors of the operating room nurses' first aid capability. Results? The score of operating room nurses' first aid capability was (110.95±13.09), which was at a high level. Univariate analysis showed that there were statistically significant differences in the overall score of first aid capability among nurses with different professional levels, nursing ages, emergency working experience, first aid experience, first aid training participating experience and first aid drill participating experience (P＜ 0.05). Nurses with different ages, educational backgrounds and professional titles achieved different scores in the 5 sub-dimensions of Operating Room Nurses First Aid capability Assessment Scale with statistical significance(P＜ 0.05), but showed no statistical difference in the total score (P＞ 0.05). Multivariate linear regression analysis indicated that, "whether had participated in first aid training", "professional level", "whether had emergency working experience", "nursing age"were the influencing factors on the operating room nurses' first aid capability (P＜0.05). Conclusions? Operating room nurses with high professional levels, long nursing ages, emergency working experience, and have participated first aid training have high levels of first aid capability, therefore the operating room managers should carry out individualized, professional, staged training and education targeting the nurses with low professional levels, short nursing ages, lacking in emergency working experience and first aid training, so as to improve their first aid capability and success rate of rescue for patients.

Objective:To investigate the risk factors of postoperative delirium in elderly patients with hip fracture.Methods:Using the convenient sampling method, a total of 141 elderly patients with hip fractures who were admitted to Trauma Department of Shanghai Sixth People's Hospital from November 2018 to April 2019 were selected as the research objects. The incidence of postoperative delirium was assessed by Confusion Assessment Method (CAM) , and patients were divided into the delirium group ( n=40) and the non-delirium group ( n=101) . Binomial Logistic regression analysis was used to analyze the risk factors of postoperative delirium in elderly patients with hip fracture. Results:Postoperative delirium occurred in 40 of 141 patients (28.37%) . Binomial logistic regression analysis showed that age, history of stroke, preoperative serum albumin level, intraoperative hypoxemia, and ICU stay were influencing factors for postoperative delirium in elderly patients with hip fracture ( P<0.05) . Conclusions:Postoperative delirium is more common in elderly patients with hip fractures. In addition, advanced age, history of stroke, high preoperative serum albumin level, intraoperative hypoxemia, long ICU stay were risk factors of postoperative delirium occurrence.

Objective To compare the effect of closed wet dressing and vaseline gauze applied in donor site.Methods A total of 60 patients with donor site wound (lateral thigh) underwent surgery were divided into wet dressing group (30 cases) and vaseline gauze group (30 cases),and the pain degree of donor area,exudation,healing time and incision scar were compared.Results Pain degree at 4,7 and 10 days after operation in wet dressing group was lighter than that of vaseline gauze group,the difference was statistically significant (P ＜ 0.05);but pain at 15 d showed no statistically significant difference (P ＞ 0.05).Exudate in wet dressing group was obviously less,wound healing time was shorter,and scar as well as pigmentation ratio was lower than that in vaseline gauze group,and the differences were statistically significant (P ＜ 0.05).Conclusion Application of closed wet dressing in the donor site can relieve the pain of patients with early postoperative pain,reduce the leakage of the wound,shorten the healing time,and has less pigmentation and scar hyperplasia.

Objective To investigate the compliance of the early functional exercise in the patients with lumbar disc herniation ( LDH) and analyze its influencing factors for exploring the methods to improve their compliance of the early functional exercise .Methods Through referencing literature and scales a postoperative functional exercise compliance questionnaire was designed for the patients with LDH .The compliance and its influencing factors of 147 LDH patients were analyzed.Results Among the 147 patients, the full compliance of the early functional exercise only accounted for 25.2%.The compliance significantly differed in the education level and the type of personalities ( P<0.05).The reasons of the poor compliance included fearing pain , worrying about healing , insufficient understanding of the importance of the postoperative functional exercise , and lack of social support ( P <0.05 ) .Conclusions The importance of rehabilitation knowledge should be propagated to patients in the early period , especially for the patients with a low education level , strong dependence , and fear of pain . Corresponding nursing measures are taken to improve the patient′s compliance of the postoperative functional exercise maximally , in order to recover and improve the ability in activities of daily living and the quality of life in LDH patients after the operation .

Objective To investigate the effect of the individualized nutritional support to hypoalbuminemia of elderly hip fracture patients after hip replacement.Methods A total of 100 elderly patients with hip replacement from February 2014 to May 2015 were included and divided into two groups randomly:control group (50 cases) and intervention group (50 cases). Patients in control group received routine care while patients in intervention group received individualized nutritional support in addition to the routine care. The serum albumin levels at 1st day and 3rd day, wound healing after surgery,start time of functional exercises, bed time and hospitalization days were analyzed and compared between two groups. Results The serum albumin levels at 1st day[(33.23±2.12)g/L] and 3rd day[(30.05±3.28)g/L] in intervention group were higher than those in control group, the differences were statistically significant (t=-5.82, -6.74; P<0.01). The first wound healing rate in intervention group (76.0%) was better than the rate in control group (64.0%), but the difference was not statistically significant (χ2=1.507,P=0.220). The start time of functional exercises, bed time and hospitalization days were shorter than those in control group, the differences were statistically significant (P<0.01).Conclusions Individualized nutrition support can effectively improve hypoalbuminemia in elderly hip fracture patients after hip replacement, improve postoperative wound healing, and encourage patients with functional exercise,shorten the time patients get out of bed for the first time and the hospital stay.

Objective To know the situation of postoperative pain and the satisfaction with pain management in patients who suffered osteonecrosis of the femoral head ( ONFH ) and accepted free vascularized fibular grafting ( FVFG ) , and analyze the influencing factors of satisfaction with pain management. Methods By convenience sampling method, 140 inpatients who underwent FVFG for 72 hours were recruited in this study. These patients were admitted in the orthopedic department of the Sixth People′s Hospital of Shanghai from January to October 2016, and were investigated by the general information questionnaire, the brief pain inventory, and the pain treatment satisfaction scale. The influencing factors of satisfaction with pain nursing were analyzed. Results The score of the most severe pain intensity of the 140 patients reached ( 4. 92 ± 1. 36 ) . The total score of patients′ satisfaction with pain management was (81. 81±9.09), among which, the dimension of professional skills earned the highest average score of (4.00± 0.61), followed by the dimension of trust, which was up to (3. 90±0.53). The dimension of the relation of education got the lowest score of (3.77±0.30). The analysis of single factor showed that the age and the education levels affected the satisfaction of pain management ( P<0. 05 ) . The stepwise multiple regression analysis reviewed that there were five factors having influences on the satisfaction of pain management, and they were: the most severe pain intensity after FVFG, the influences of pain on functional exercise, the degree of pain relief, the education level of patients, and the influences of pain on patients′sleeping. These can successfully explain 70.8% of the variation of the satisfaction ( R2=0.708) . Conclusions Patients are overall satisfied with postoperative pain treatment. Factors such as the most severe pain intensity after FVFG, the influences of pain on functional exercise, the degree of pain relief, the education level of patients, and the influences of pain on patients′sleeping will affect the degree of satisfaction.

Objective To explore the working stress feeling in clinical nursing teachers. Methods By phenomenological approach of qualitative research, a total of 20 clinical nursing teachers received deep interview, and the information was analyzed with phenomenological analysis method. Results 3 themes were distilled. Theme 1 was under pressure and pain including over workload, high comprehensive requirements of nursing students towards clinical teachers, insufficient support form colleagues, patients and families, struggling with different kinds of examination and test, restricted research capability and no energy for research. Theme 2 was self releasing pressure without systematic. Theme 3 was the suggestion of alleviating work pressure from hospital containing to carry out effective training activities for decompression, to perfect clinical nursing teachers decompression work from environment, organization, individual and so on factors. Conclusions Clinical nursing teachers confront multiple mental stress, nursing administrators should manage stress systematically according to clinical nursing teachers′feeling, stress sources and decompressive suggestions.