Objectives Using the theory and method of feedforward control management to control the blind spot of nursing safety of preoperative fasting time for children,so that the actual preoperative fasting time for children is close to the standard preoperative fasting time.Methods We established preoperative fasting nursing procedure according to feedforward control based on reasons for common long preoperative fasting time of infants facing expected operation from September 2005 to September 2006.Children facing expected operation were divided into the experimental group(66 cases)and the control group(58 cases).They adopted preoperative fasting nursing procedure after feedforward control and the traditional nursing procedure respectively.Preoperative fasting time between the two groups was compared and analyzed.Results There was significant difference about the preoperative fasting time between the two groups,P＜0.01.The actual preoperative fasting time for infants in the experimental group was close to the standard fasting time.Conclusions Using preoperative fasting nursing procedure with feedforward control,the blind spot of nursing can be partially emilinated,and the actual preoperative fasting time for infants is close to the standard.

As to evaluating the medical compliance of patients with chronic hepatitis B (CHB) and the influence factors, information of 163 patients with CHB treated with lamivudine were collected by using the self-designed questionnaire, and the medical compliance and influencing factors of the patients were acquired by the research followed, and the prognosis and allocation were also observed. The results showed the medical compliance in 77.3% of patients with CHB was good, and in 22.7% patients was poor. After following-up for 2 years, the negative rates of HBV DNA and HBeAg shown in patients with good medical compliance were 78.6% and 46.0%, respectively,showing a significantly higher rate than in those with poor medical compliance, which having the rate of 37.8% and 21.6%, respectively (P<0.01). We suggested that there should be a correlation between the medical compliance of patients with CHB and the prognosis.

Objective To explore the influence of whole-course individualized nursing intervention on treatment compliance among intractable epilepsy children with ketogenic diet therapy.Methods 80 intractable epilepsy patients with ketogenic diet therapy were divided into the control group and the experimental group with 40 cases in each group.The routine nursing was given to the control group.On basis of routine nursing,whole-course individualized nursing intervention was given to the experimental group.The investigation was carried out before and after intervention in two groups by using self-designed questionnaire.The treatment compliance and therapeutic effect were compared between two groups.Results The treatment compliance and therapeutic effect were significantly alleviated in the experimental group compared with the control group in the third,sixth and twelfth months.Conclusions The whole-course individualized nursing intervention can improve the parental awareness of the disease,enhance their confidence and determination to adhere to the treatment,improve their treatment compliance,thereby improve the effect of treatment.

Objective To analyze the changes of benign and malignant thyroid nodules during followup and to increase the diagnostic accuracy.Methods The ultrasonographic changes of 161 thyroid nodules confirmed by pathology were retrospectively analyzed,including size,internal components,echogenicity,margin,microcalcification,anteroposterior to transverse dimension ratio(A/T) and the relationships with thyroid capsule,and the change of cervical lymph nodes.Results Ninety-three benign thyroid nodules and 68 malignant thyroid nodules were enrolled in this study,the changes in size,internal components,microcalcification,the relationships with glandular capsule,and cervical lymph nodes were significantly different (P ＜ 0.05),while the echogenicity,margin,and A/T were not significantly different,benign nodules changed more easily in size and internal components,while malignant nodules changed more easily in microcalcification.Both the nodules broken the thyroid capsule or cervical lymph nodes exhibited malignant signs suggest probable malignancy.Conclusions Analyzing the ultrasonographic changes during follow-up contributes to identify benign and malignant thyroid nodules.

Objective:To explore the influencing factors and mechanism of job satisfaction of medical staff based on grounded theory.Methods:A total of 33 literatures published in CNKI from January 1, 2015 to December 31, 2019 were retrieved with the theme of " job satisfaction of medical staff" . By using NVivo 11.0 software, the 33 literatures were qualitatively analyzed, and the main categories influencing the job satisfaction of medical staff were obtained, and the action mechanism model was integrated on this basis.Results:The influencing factors of medical staff′s job satisfaction were summarized into 6 first-class nodes: work ecology, hospital management, basic health care, occupational cognition, individual characteristics and external environment. Among them, work ecology was the direct influence factor; hospital management was the key influencing factor, which played an important role in the work ecology; basic health care was the safeguard factor, which was affected by the work ecology; occupation cognition was the internal driving factor, individual characteristic was the internal uncontrollable factor, external environment was the external uncontrollable factor.Conclusions:In order to improve the job satisfaction of medical staff, we should optimize the work ecology, promote the innovation of hospital management, ensure the health and safety, and pay attention to the internalization of professional values.

Objective To investigate hand hygiene awareness and performance for caretakers of children with chemotherapy, and explore effective intervention measures. Methods For 60 caretakers of children with chemotherapy in Hematology Department, we carried out a questionnaire survey of hand hygiene, and tracked the hand washing implementation. Also we carried on a six steps hand washing technique training for the caretakers, then compared and analyzed the hand washing qualified rate before and after the technique training. Results The hand washing cognitive rate of the caretakers when they directly contacting with sick children and before feeding food or medicine for sick children were 88. 33% and 93. 33% , and the implementation rate of those situation were 76. 67% and 89. 13% respectively. In addition, the hand washing cognitive rates of before contacting sick children′s objects and after contacting other people (including other sick children) were just 21. 67% and 41. 67% , and the implementation rates were 14. 89% and 28. 95%respectively. Before and after the six steps hand washing technique training, the bacterial colony count of the caretakers hands were (82. 36 ± 53. 32)cfu/ cm2 and (16. 21 ± 18. 83)cfu/ cm2 (t = 9. 061,P < 0. 01), but after training, the pathogenic bacteria detection rate was 31. 67% and the qualified rates 61. 67% with statistical difference (χ2 = 28. 420,27. 638, respectively; P < 0. 01). Conclusions The hand hygiene cognition for caretakers of children with chemotherapy is relatively low, and the implementation and hand washing qualified rate are unacceptable. The health education propaganda of hand hygiene and hand washing technique training for caretakers should be further strengthen. Hospital should supervise and urge the hand hygiene implementation, in order to improve the hand washing qualified rate of caretakers, reduce the nosocomial infection through hand contact, and protect the health and safety of children with chemotherapy.

Objective:To explore the effect of comprehensive gastrointestinal training on the recovery of gastrointestinal function after radical cystectomy (Bricker′s operation).Methods:Seventy-one elderly bladder cancer patients who had undergone Bricker′s operation were randomly divided into a control group of 34 and an observation group of 37. Both groups were given routine treatment, while the observation group was additionally provided with comprehensive gastrointestinal training immediately after the operation. Plasma gastrin was measured before the operation and on the 1st and 3rd day afterward. The return of peristaltic sounds, the exhausting and defecation time, the incidence of intestinal obstruction and the average hospital stay were recorded. On the 7th, 14th, 21st and 28th day after the operation, both groups′ gastrointestinal functioning was scored by using Gastrointestinal Symptom Rating Scale (GSRS).Results:The levels of plasma gastrin in the observation group were significantly higher than before the surgery and significantly higher than those in the control group on the 1st and 3rd day after the surgery, though there had been no significant difference between the two groups before the operation. Compared with the control group, peristaltic sounds returned significantly earlier in the observation group (after 1.22±0.15d), and the group′s exhaust time (1.88±0.22d) and first defecation time (2.95±0.19d) were also better. The incidence of intestinal obstruction (23.53%) was significantly lower in the observation group as well. The observation group recorded lower average GSRS values than the control group throughout the observation and follow-up periods, and their average hospital stay was significantly shorter.Conclusion:Comprehensive gastrointestinal training can effectively promote recovery after radical bladder cystectomy.

Objective:To explore the role of continuous renal replacement therapy (CRRT) combined with extracorporeal carbon dioxide removal (ECCO 2R) in the treatment of children with respiratory failure. Methods:The clinical data of 12 children with respiratory failure who were treated with CRRT+ECCO 2R in PICU of Jinan Children's Hospital from July 2020 to August 2022 were collected and analyzed retrospectively. The outcomes and the external pipeline usage of the patients were observed, and the blood gas analysis and ventilator parameters before 1 h and after 1, 6, 12 and 24 h of the treatment were compared by one-way ANOVA with LSD post hoc correction. Results:Six patients successfully withdrew from CRRT+ECCO 2R and mechanical ventilation, three patients were transferred to ECMO treatment. Three cases died after voluntary withdrawal of treatment, and two cases died due to treatment failure. The mortality rate was 41.7%. After continuous treatment of CRRT+ECCO 2R for 15 to 112 h, two cases experienced extracorporeal circuit obstruction. After 1 h of treatment, PaCO 2 decreased from (64.67±24.4) mmHg to (49.42±15.54) mmHg, pH increased from (7.28±0.20) to (7.38±0.11), FiO 2 decreased from (0.85±0.13) to (0.78±0.15), PC decreased from (19.42±4.34) cmH 2O to (17.75±4.00) cmH 2O. After 24 h of treatment, PaCO 2 decreased to (39.2±5.55) mmHg, pH increased to (7.41±0.04), FiO 2 decreased to (0.46±0.11), and PC decreased to (13.8±3.36) cmH 2O, and the differences were statistically significant compared with before treatment ( P < 0.05). Conclusions:The combination of CRRT and ECCO 2R therapy can safely substitute for partial lung ventilation/perfusion function, and play a role in protecting right heart function and improving lung-kidney interaction. It can be considered as an option for extracorporeal respiratory, circulatory, and renal support, and consequently has broad prospects.

Objective:To translate the Intermittent Catheterization Difficulty Questionnaire (ICDQ) into Chinese, and to test its reliability and validity in neurogenic bladder patients.Methods:After translation, back-translation, cross-cultural debugging, expert consultation and pre-investigation, a Chinese version of ICDQ was formed. A total of 248 patients with neurogenic bladder clean intermittent self-catheterization who were treated and followed up in the First Hospital of Shanxi Medical University in October 2022 were selected as research objects by the convenient sampling method, and the Chinese version of ICDQ was used for investigation. The critical ratio method was used for project analysis. Content validity and structure validity were used to test the validity of the questionnaire. Cronbach's α coefficient, split half reliability coefficient and retest reliability coefficient were used to test the reliability of the questionnaire. A total of 248 questionnaires were sent out in this study, and 238 were effectively collected, with a recovery rate of 95.97% (238/248) .Results:The Cronbach's α coefficient of the Chinese version of ICDQ was 0.857, the split half coefficient was 0.711, and the retest reliability coefficient was 0.954. The content validity index of the Chinese version of ICDQ item level was 0.860 to 1.000, and the content validity index of the scale level was 0.930. Seven common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 77.38%. The results of confirmatory factor analysis showed RMSEA < 0.080, GFI, AGFI, TLI, CFI > 0.800. Conclusions:Through confirmatory factor analysis, the Chinese version of ICDQ shows that the model fitting indicators of the scale meet the corresponding requirements, indicating that the scale has high structural validity and overall model fitting. It can be used as an evaluation tool for intermittent self catheterization difficulties in patients with neurogenic bladder.

Objective:To translate the Self-Confidence Scale for Clean Intermittent Self-Catheterization (SCSCISC) into Chinese and test its reliability and validity.Methods:Following the Brislin questionnaire translation principles, the English version of SCCSISC was translated, back translated, culturally adapted, consulted with experts, and pre-surveyed to form the Chinese version of SCCSISC. From June to September 2023, 237 patients with neurogenic bladder admitted to the First Hospital of Shanxi Medical University were selected as survey subjects by the convenient sampling method. The critical ratio method was used for project analysis, and Cronbach's α coefficient, split half reliability, and test-retest reliability were used to evaluate the reliability of the scale. Content validity and construct validity were used to test the validity of the scale.Results:The Cronbach's α coefficient of the Chinese version of SCCSISC was 0.976, the split half coefficient was 0.962, and the test-retest reliability was 0.876. The item-level content validity index ( I- CVI) of the Chinese version of SCCSISC was 0.86 to 1.00, and the scale-level content validity index ( S- CVI) was 0.93, with Kappa consistency coefficients above 0.74. Two common factors were extracted through exploratory factor analysis, with a cumulative variance contribution rate of 73.42%. Conclusions:The Chinese version of SCCSISC has good reliability and validity, and can be used as a tool for self-confidence measurement of clean intermittent self-catheterization among patients with neurogenic bladder in China.