ObjectiveTo evaluate the effects of lumber and back muscle exercise training program based on the theory of protective motivation on nurses＇ chronic low back pain and improving effect on the fear-avoid belief. MethodsBy convenience sampling, a total of 40 nurses in Intensive Care Unit(ICU) in a Class Ⅲgeneral hospital were selected from April to June of 2017, based on the theory of protective motivation, the back muscle exercise training program was designed and the intervention was carried out. Before intervention and 8 weeks after intervention, Visual Assimilation Scale(VAS), Roland Morris Dysfunction Questionnaire (RMDQ), the Chinese Version of the Fear-Avoidance Beliefs Questionnaire(FABQ-CHI) were used to evaluate the implementation effects of the training program. Results8 weeks after intervention, the nurses＇ score of chronic low back pain in VAS dropped from (4.60±1.17) to (2.58±0.96), RMDQ score dropped from (10.05±4.03) to (4.40±1.46), and FABQ score dropped from (65.63±10.49)to (49.28±7.54),all with statistical differences (P＜0.05). ConclusionsThe training program based on the theory of protective motivation can alleviate the symptoms of chronic low back pain and reduce the fear-avoidance belief level of nurses when facing operation or behavior that may potentially cause chronic low back pain.

Objective To evaluate the effects of the training program based on the competency of new nurses in neurology department.Methods Competency concept was used to analyze the needs,insure the objective,establish the training plan,and organize training for new nurses in neurology department from August 2015 to March 2016. Training program with the combination of group psychological counselling,scenario simulation training and assessment were performed. Observation indexes were analyzed using the Six-Dimension Scale of Nursing Performance (6-D Scale).Results Group psychological counselling played a crucial role in the elimination of new nurses′ strangeness so as to help them to adapt to clinical competence. Statistically significant differences in new nurses′ ability of planning and evaluation,ability of interpersonal relationship and communication,ability of education and training were observed before and after training based on 6-D scale (P<0.05).Conclusions The training program based on the competency can improve the planning and evaluation ability,interpersonal relationship and communication ability,education and training ability in new nurses,and play a positive role in the growth of new nurses to qualified nurses.

ObjectiveTo explore the effects of extended care on compliance of anticoagulant therapy in patients with lower limb deep venous thrombosis.Methods A total of 91 patients with lower limb deep veous thrombosis discharged from a tertiary hospital of Hebei Province from March to May 2015 were selected and divided into two groups according to odd and even numbers of discharging date. The control group (n=48) was conducted by conventional mode of care. Patients in the intervention group (n=43) were not only received conventional care,but also received extended care intervention,which included founding an extended care team,established anticoagulation files,providing brochure and follow up by phone. Level of anticoagulant knowledge,compliance of anticoagulation therapy and target rate of anticoagulation were evaluated and compared between two groups after three months' intervention.ResultsAfter three months' intervention,the score median of anticoagulation knowledge in the patients of observation group was 10,while that of the control group was 6 (Z=-8.397,P<0.01). Patients with good compliance of anticoagulation therapy in the observation group accounted for 77.1%,while patients with good compliance in the control group accounted for 39.5% (x2=13.254,P<0.05). The target rate of anticoagulation after discharge in the observation group was 85.4%, while that of the control group was 67.4% (x2=4.131,P<0.05).Conclusions Extended care for patients with deep venous thrombosis can improve the level of anticoagulation knowledge,the compliance of anticoagulation therapy and the target rate of anticoagulation,so as to provide individualized anticoagulation management for patients and improve their prognosis.

Objective To discuss the effects of combined exercise training on the glucolipid metabolism of type 2 diabetic adolescent patients. Methods A total of 41 cases of type 2 diabetic adolescent patients hospitalized in the Department of Endocrinology in the Second Hospital of Hebei Medical University from August 2015 to July 2016 were randomly divided into the intervention group (n=20) and the control group (n=21). The control group adopted the aerobic exercise, and the intervention group adopted the aerobic combined with resistance exercises. The blood glucose and lipid levels of two groups were compared before and after the intervention. Results After intervention for 12 weeks, levels of fasting blood glucose, 2-hour plasma glucose and glycosylated hemoglobin significantly decreased compared with those before intervention in both intervention and control groups (P<0.05). After intervention, levels of fasting blood glucose, 2-hour plasma glucose and glycosylated hemoglobin of the intervention group were statistically lower than those of the control group (P< 0.05); the total cholesterol (TC), triglyceride (TG), and high-density lipoprotein (HDL) in the two groups were significantly better than those before intervention (P< 0.05); levels of TC, TG and low-density lipoprotein (LDL) in the intervention group were lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusions Combined exercise training can improve the metabolic capability of glucose and lipid to enhance the health conditions of type 2 diabetic adolescent patients.

Objective To explore the current status of the stress and coping styles of emergency room nurses in Class Ⅲ Grade A hospitals, to discuss the correlation between stress and coping styles, and to provide a basis for formulating targeted training plans. Methods Totally 178 emergency room nurses from 9 Class ⅢGrade A hospitals in Hebei Province were randomly selected as the study subject from April to May 2016 and investigated with the General Information Questionnaire, Nurse's Working Stress Source Scale and Coping Style Questionnaire. Results The total average stress score of the nurses was (1.88±0.56); and the scores for each dimension of coping styles were: (0.84±0.12) for problem-solving, (0.71±0.20) for fantasy, (0.68±0.22) for rationalization, (0.67±0.24) for avoidance, (0.67±0.14) for asking for help, and (0.60±0.29) for self-accusation. Nursing and working stress was positively correlated with the coping styles such as fantasy and rationalization (P<0.05), and negatively correlated with self-accusation (P<0.05). Conclusions Emergency room nurses' stress generally remains at a medium and high level. Therefore, nursing managers should formulate proper nursing management measures and take necessary measures to alleviate nurses' stress.

Subclinical hypothyroidism is a common endocrine disease, and the clinical incidence rate has increased gradually in recent years. This disease has impacted on cardiovascular function, lipid metabolism, etc, which can leads diseases such as atherosclerosis, coronary heart disease. The screening and treatment for patients with subclinical hypothyroidism and the follow-up study have become a research hotspot in the field of endocrine at home and abroad in recent years. The consensus has not been reached about the outcome and prognosis of subclinical hypothyroidism. This article will conduct a literature review on the effects of subclinical hypothyroidism on the body, the intervention mode, the research progress and clinical follow-up to cause attention from endocrine professional medical staffs in patients with subclinical hypothyroidism, strengthening the management and follow-up of this group and improving the level of patients with subclinical hypothyroidism health and life quality, prolonging their life expectancy.

Objective:To explore experiential teaching to physical restraint training for intensive care nurses and its effects in reducing restraint actions.Methods:903 inpatients in ICU from January 2017 to October 2018 in a ClassⅢ Grade A hospital in Shijiazhuang were selected as the subjects by convenient sampling. 491 patients from January to October 2017 were set as the control group, and 412 patients who implemented the experiential teaching method from January to October 2018 were set as the test group. The control group was given routine restraint nursing, and the test group was given reduced restraint nursing. The physical restraint rates, qualified rates of physical restraint, writing quality of physical restraint nursing documents and patient satisfaction scores were compared between the two groups.Results:The restraint rate of patients in the test group was 62.14% (256/412) , which was lower than that 71.69% (352/491) in the control group, the qualified rate of restraint in the test group was 89.06% (228/256) , which was higher than that 80.68% (284/352) in the control group, the differences between the two groups were statistically significant ( P<0.05) . Quality score of writting quality of physical restraint nursing documents in the test group was (98.32±2.22) , and the patients satisfaction score was (98.11±2.53) , which were higher than those in the control group, there were statistically significant differences between the two groups ( P<0.05) . Conclusions:Reduced restraint nursing based on experiential teaching reduces the physical restraint rate of ICU patients, improves the quality of physical restraint and patient's satisfaction of nursing, and it is worthy of clinical promotion.

Objective To understand the present situation of occupational low back pain of clinical nurses, and analyze its influence factors.Methods A questionnaire survey was conducted among 1300 clinical nurses from 7 Class Ⅲ Grade A general hospitals in 5 provincial capital cities, in the region of north China, central China, southern China, southwest and northwest, from April to December 2016. The survey tools included general demographic characteristics questionnaire, Visual Analogue Scale (VAS) and Chinese version of Fear-Avoidance Belief Questionnaire (FABQ-CHI). A total of 1300 questionnaires were distributed, and 1279 valid were collected. SPSS 21.0 was applied for statistical analysis.Results In the 1279 nurses, 115 (8.99％) had no low back pain, and 1164 (91.01％) was positive. The majority of nurses suffered with mild pain, account for 64.69％. The average score of FABQ-CHI in negative nurses was (50.11±17.5), and that in positive nurses was (55.24±8.2), the difference was statistically significant (t=14.56,P< 0.001). Univariate analysis showed that there were significant differences in VAS scores among nurses of different ages, marital status, fertility status, professional titles, working years, and whether or not they participated in training (P<0.01). Multivariate analysis showed that age (OR=1.40) and professional title (OR=1.84) were the influencing factors of low back pain.Conclusions The incidence of occupational low back pain in nurses is high, and it is related to individual factors, work related factors and psychological factors. It is suggested that great attention should be paid to the popularization of knowledge on prevention and treatment of low back pain and the training of occupational protection skills for clinical nurses. Especially, we should pay attention to the correlation between psychological factors and nurses' occupational low back pain, gradually improve the working environment and bad living habits of nurses, reduce the occurrence of low back pain, and improve the job satisfaction of clinical nurses.

Objective To explore the effects of telephone follow-up on patients with sub-clinical hypothyroidism. Methods Of 120 patients who were diagnosed as sub-clinical hypothyroidism between January, 2014 and June,2014, 60 were included in control group and 60 were assigned in observation group by a random number table. Patients in control group received routine check-up and treatment protocols according to their condition, in contrast, patients in observation group had extra telephone follow-up. Patients′symptoms, the degree of goiter, thyroid ultrasound examination, thyroid function and thyroid peroxidase antibody (TPOAb), and other indicators were compared in the two groups after 12 weeks intervention. Results After the intervention, both groups had an improvement in slow reactions, chills, skin changes, body mass increase, etc. After invention, thyroid stimulating hormone and TPOAb in observation group were statistically different from those in control group [(1. 955 ± 1. 633) vs (2. 875 ± 3. 025) mIU/L, (204. 500 ± 825. 500) vs (438. 500 ± 1065. 250) IU/ml] (Z=2. 539,1. 451;P<0. 05). Patients with thyroid enlargementⅢdegrees reduced from 29 cases to 14 cases in observation group, which was better than that in control group (χ2 =2. 199, P<0. 05). Thyroid ultrasound results were similar between the two groups (χ2 =0. 043, P >0. 05). Conclusions Telephone follow-up intervention is helpful to improve the symptoms of patients with sub-clinical hypothyroidism, alleviate goiter and promote thyroid function back to normal.

Exercise therapy is the predominant treatment for type 2 diabetes mellitus, which can effectively restrict blood sugar level and decrease or delay the complication. Rational exercise prescriptions would enable the role of the exercise therapy fully realized. This review will summarize the development of exercise prescription.