Objective To investigate the status of fatigue and depression and their influencing factors in patients with acute coronary syndrome, and analyse the correlation of fatigue, depression and self-management behavior. Methods 113 patients were investigated by using Fatigue Symptom Inventory (FSI), Patient Health Questionnaire-9 (PHQ-9), Coronary artery disease Self-management Scale (CSMS). Results The score of fatigue was (4.59±1.93)points, while depression scored (5.05±1.48)points and self-management behavior scored (57.29 ±8.29)points; the score of fatigue, depression of female patients were higher than that of male patients, which had statistical difference(t=2.535-5.894, P<0.05);Regression analysis showed that gender, time of illness, number of other chronic diseases were major factors affecting fatigue while gender and treatment method were major factors affecting depression; there were negative ralationships between self-management and fatigue, self-management and depression (r=-0.855-0.682). Conclusions Fatigue, depression are common in patients with acute coronary syndrome, and can affect their self-management behavior, and the female patients are more susceptible to fatigue and depression.

Objective To estimate the prevalence of iron deficiency and its influencing factors in 6 to 12-month-old infants,then more effective community nursing intervention of prevention against iron deficiency can be made.Methods Three hundred and thirty-one 6 to 12-month-old infants had been enrolled by convenience sampling method to complete the investigation.Variables associated with iron deficiency in bivariate analysis were evaluated in Logistic regression models.Results The prevalence rates of iron deficiency in 6 to 12-month-old infants was 34.74％.Anemia,age,feeding patterns and zinc deficiency were independently associated with increased risk for iron deficiency.Conclusions Iron deficiency was common and associated with anemia,low age,feeding patterns and zinc deficiency in a certain community in Tianjin.So effective nursing measures must be made to reduce the prevalence rates of iron deficiency in 6 to 12-month-old infants.

Objective The study aimed to evaluate the effects of web-problem-based learning (WPBL) in the application of Fundamental Nursing.Methods The sample was purposively selected.172 students in School of Nursing in Tianjin were recruited as the control group (n=83) and the intervention group (n=89).Traditional teaching method and WPBL was implemented in the control group and the intervention group,respectively.The teaching effectiveness of the two groups was measured by the examination and learning initiative evaluation scale and the teaching effect evaluation questionnaire,and the teaching satisfaction questionnaire was implemented among the intervention group.SPSS 18.0 was used and t test was performed to analyze the comparison between groups.Results In the theoretical examination,the scores of comprehensive analysis of the nursing students in the intervention group were better than those in the control group,and the difference was statistically significant (P＜0.05).In the evaluation of active learning after school,the scores of control learning in the intervention group were higher than those in the control group,and the difference was statistically significant ([14.78 ± 2.16),vs.(13.58 ± 2.16),t=-3.58,P=0.000].83 effective questionnaires of intervention group nursing students' teaching satisfaction were recovered.73 of them (88％) thought that WPBL could improve the students' ability of independent learning,71 students (85.5％) found that WPBL could enhance the ability of information processing,73 students (88％) thought they could communicate well with their classmates in WPBL and cooperate well to complete the task.Conclusion WPBL which is on the basis of PBL and make full use of the network,could promote the ability of autonomous learning,information processing and communication with classmates and good cooperation,but in the application process,it needs teachers to organize reasonably,perfect the supervision mechanism,and reduce taking up students' spare time.

Objective To understand the experience of women with heroin dependence in compulsory detoxification before the society-return.Methods A semi-structured interview was conducted with 15 women with heroin dependence in compulsory detoxification.Data were analyzed based on Colaizzi phenomenological research method.Results The feelings of women with heroin dependence in compulsory detoxification were classified into 3 themes,including negative self-concept,loneliness and helplessness,uncertainty about the future.Conclusions Nurses should pay attention to problems about women with heroin dependence in compulsory detoxification and provide effective measures to improve their physical and psychological health and help them to return to the society.

Objective To investigate the status and influencing factors of convalescent patients with heroin dependence in compulsory detoxification.Methods A total of 90 convalescent patients with heroin dependence in compulsory detoxification were recruited and investigated with a self-designed scale,General Self-efficacy Scale (GSES),Social Support Assessment Scale (SSRS) and Self-rating Depression Scale (SDS).Results The mean score of the self-efficacy was (20.97±2.26) points.Multiple regression analysis showed that depression,social support and daily dose of heroin use were influencing factors of the self-efficacy,which could explain 59.1％ of the variance.Conclusions Improving the self-efficacy of convalescent patients with heroin dependence in compulsory detoxification can enhance physical and psychological health and decrease the relapse.

The senile frailty has become the focus of social attention.It is urgent to improve the quality of life of the elderly.The recovery and improvement of the body function can delay the aging.Functional exercise, including the exercise of balance ability and walking ability, can effectively improve the physical function and the quality of daily life in the elderly.It is important to control exercise amount and quality.Combining functional exercise with science and technology, and formulating a scientific, multi-level and personalized functional exercise mode for the elderly can delay the senile frailty and promote the health of the elderly.

Objective:To explore the influencing factors of psychological distress in middle-aged and young stroke patients to provide evidence for improving the mental health of the patients and guiding clinical psychological nursing interventions.Methods:A cross-sectional survey was conducted on 447 middle-aged and young patients with stroke hospitalized in four hospitals in Tianjin from March 2022 to January 2023.Various assessment scales were employed, including a general data questionnaire, distress thermometer, numerical rating scale, family APGAR index, perceived social support scale, general self-efficacy scale, Herth hope index, self-rating anxiety scale and self-rating depression scale.Statistical analyses were performed using encompassing descriptive statistics, Wilcoxon Mann-Whitney test, Kruskal Wallis test, Spearman correlation analysis, and structural equation modeling of SPSS 25.0 and AMOS 24.0.Results:The psychological distress score of middle-aged and young stroke patients was 1(1, 2). Age( Z=-5.497), marital status( Z=-2.755), number of children( H=25.448), co-residents( H=14.389), occupation( H=34.889), per capita monthly family income( H=19.105), hospitalized caregivers( H=23.794), stroke type( H=23.308), course of disease( H=10.649), number of chronic diseases( H=8.021), daily self-care ability( H=128.439), eating status( H=41.904), physical status( H=49.786), excretion status( H=112.736), dressing ability( H=63.036), nutritional status( H=15.514), organ injury status ( H=23.797)and edema status( Z=-4.307)affected the psychological distress of middle-aged and young stroke patients, and the differences were statistically significant (all P<0.05). Correlation analysis showed that psychological distress were positively correlated with pain(1(1, 1)), anxiety(36(27, 53)) and depression(31(27, 58)) ( r=0.390, 0.525, 0.591, all P<0.001), while were negatively with family caring degree(10(10, 10)), perceptive social support(72(67, 74)), general self-efficacy(35(29, 38)) and hope level(41(36, 45)) ( r=-0.200, -0.464, -0.647, -0.675, all P<0.01). Results of the structural equation model of the influencing factors of psychological distress in middle-aged and young stroke patients showed that a total of 5 common factors were extracted, which were named support system, daily activities, disease condition, general condition and physical burden.Disease condition and physical burden had direct positive effects on psychological distress ( β=0.385, 0.204, both P<0.05). Support system, daily activities and general situation had direct negative effects on psychological distress ( β=-0.332, -0.262, -0.258, all P<0.05). Conclusions:The influencing factors of psychological distress in middle-aged and young stroke patients are disease status, support system, daily activities, general conditions and physical burden, which can provide theoretical basis for nurses to carry out active and effective prevention and nursing intervention on psychological distress in middle-aged and young stroke patients.

Objective:To construct a prediction model of psychological distress risk in young and middle-aged patients with gynecologic malignancy based on random forest algorithm and validate its prediction effect, which provided a tool for healthcare professionals to detect patients′ psychological distress in early stage.Methods:This was a cross-sectional study, a total of 385 cases of young and middle-aged patients with gynecologic malignancies admitted to the gynecology and oncology departments of six tertiary hospitals in Tianjin from October 2021 to October 2022 were consecutively included, the study subjects were randomly divided into 270 cases in the training set and 115 cases in the testing set according to 7:3 by R-studio software. After grouping the training set patients according to the presence or absence of psychological distress (positive psychological distress 151 cases and negative psychological distress 119 cases), univariate analysis was performed on each influencing factor. A random forest model for the prediction of psychological distress in young and middle-aged gynecological malignancy patients using R-studio software on the training set, and the prediction effect was verified on the testing set.Results:The prediction accuracy was 94.78%, sensitivity was 96.88%, specificity was 92.16%, positive predictive value was 93.94%, negative predictive value was 95.92%, and AUC was 0.992 (95% CI 0.982-1.000). The top 5 significant predictor variables were ranked according to the average decrease in the Gini coefficient of each influencing factor in the random forest model: General Self-Efficacy Scale score, Herth Hope Index score, Perceived Social Support Scale score, Self-Rating Depression Scale score, Self-Rating Anxiety Scale score. Conclusions:In this study, the prediction model of psychological distress in young and middle-aged patients with gynecologic malignancy constructed by random forest algorithm has high predictive efficacy, which provides reference for healthcare professionals to identify patients′ psychological distress early and formulate interventions.

Objective To investigate the effect of enteral microecopharmaceutics nutrition supplement (EMN) on incidence of ventilator associated pneumonia complications,inflammatory responses,and prognoses in patients with severe traumatic brain injury (sTBI) undergoing ventilator therapy.Methods From January 2016 to September 2017,70 patients with sTBI were randomly divided into an experimental group (EMN supplement,n=35) and a control group (n=35).Early enteral nutrition was given to patients from both groups,and bifidobacterium viable capsule was given to patients from the experimental group.Glasgow Coma Scale (GCS) scores,acute physiological and chronic health evaluation (APACHE) II scores,number of white blood cells (WBC),proportion of neutrophil (N),and serum levels of procalcitonin (PCT) and C-reactive protein (CRP) were compared between the two groups on admission and 14 d after treatment.The incidence of VAP and clinical pulmonary infection scale (CPIS) scores,pulmonary function,mechanical ventilation time and hospital stays were compared 14 d after treatment.Results The incidence of VAP in the experimental group (n=17,51％) 14 d after EMN supplement was significantly lower as compared with that in the control group (n=22,63％,P＜0.05).Meanwhile,VAP patients from the experimental group had significantly lower CPIS scores as compared with patients from control group (P＜0.05).Ventilator weaning was achieved in 29 patients from experimental group (83％) and 24 patients from control group (69％),with significant difference (P＜0.05);ventilator weaning patients from the experimental group had significantly improved lung function as compared with ventilator weaning patients from control group (P＜0.05).WBC number,N proportion,and serum PCT and CRP levels in the experimental group were significantly smaller/decreased as compared with those in the control group (P＜0.05).As compared with patients from control group,patients from the experimental group had significantly higher GCS scores (8.35±0.51 vs.9.48±0.48,P＜0.05) and significantly lower APACHE II scores (12.58±0.78 vs.14.68±0.97,P＜0.05).Conclusion EMN supplement can effectively reduce the VAP incidence,alleviate the degree of infection and inflammatory response in patients with sTBI undergoing ventilator therapy,therefore,improve the prognosis;this method is worth of promotion.

Objective:To construct medical students' employment quality evaluation index system based on analytic hierarchy process (AHP), for providing basis to scientific and objective evaluation of medical students' employment quality.Methods:Two rounds of consultation with 21 experts were conducted to construct medical students' employment quality index and evaluation standard by Delphi method, and the weight of each index and evaluation standard determined by AHP. Excel 2007 and SPSS 21.0 were used to analyze the results of expert consultation. The enumeration data were expressed as frequency and percentage. The mean and coefficient of variation were used to describe the importance scores of experts on indicators at all levels. The positive coefficient, authority coefficient and coordination degree of experts were calculated, and the Kendall coordination coefficient ( W) test was carried out. Yaahp 6.0 is used to analyze the pairwise comparison matrix in the analytic hierarchy process to calculate the weight of the indicator. Results:The authority of expert consultation was ranged from 0.77 to 0.94, and the positive coefficient of experts was 100.00%. The evaluation system of medical students' employment quality was determined, which involved 3 first-class indexes, 9 second-class indexes and 35 third-class indexes, and the weight coefficients of each index were calculated by AHP.Conclusion:The evaluation index system of medical students' employment quality is reasonable, which can be used to provide reference standard for medical students' employment quality evaluation, and has certain application value.