Objective:To explore the effects of online supportive disclosure therapy on the self-expression level, professional identity, dimission intention, and turnover rate of pre-dimission nurses, in order to provide a reference for nursing managers to stabilize the nursing team.Methods:A quasi experimental research method was used, and a convenient sampling method was used to select 192 pre resigned nurses from Shandong Provincial Third Hospital, the First Affiliated Hospital of Shandong First Medical University, and Shandong First Medical University Affiliated Provincial Hospital from October 2021 to December 2022 as the research subjects. They were divided into a control group and an experimental group by random number table method, with 96 nurses in each group. The control group received routine exit interviews, while the experimental group received online supportive disclosure therapy intervention based on this. The self-expression level, professional identity, dimission intention, and turnover rate of two groups of nurses before and 1, 2 months after the intervention were evaluated.Results:Finally, 94 nurses in the control group and 92 nurses in the experimental group completed the study. There were no significant differences in the self-expression level, professional identity, dimission intention before the intervention between the two groups ( P>0.05). After 1 and 2 months of the intervention, the scores of the Pain Self Disclosure Index, Nurse Professional Identity Rating Scale, and Resignation Intention Scale of the experimental group were 36.33 ± 5.13, 73.88 ± 8.72, 14.18 ± 1.12 and 34.22 ± 6.78, 98.26 ± 11.29, 6.16 ± 1.19, respectively,and the control group were 28.06 ± 8.23, 64.72 ± 10.39, 17.82 ± 1.37 and 44.26 ± 7.62, 79.82 ± 8.66, 9.18 ± 1.06, there were statistically significant differences between the two groups ( t values were -13.54 to -2.11, all P<0.05); there were statistically significant differences in the inter group effects, time effects, and interaction effects of the scores on the Pain Self Disclosure Index, Professional Identity Rating Scale, and Resignation Intention Scale between the two groups ( F values were 5.12 to 14.82, all P<0.05). The turnover rate of nurses in the experimental group was 1.09% (1/92), lower than 8.51% (8/94) in the control group, and the difference between the two groups was statistically significant ( χ2=1.59, P<0.05). Conclusions:Online supportive disclosure therapy can improve the self-expression level and professional identity of pre-dimission nurses, and reduce their willingness to resign and turnover rate.

Objective:To investigate the effects of Satir model group intervention on stress coping style, self-consistency and congruence and subjective well-being of re-employment nurses, in order to provide evidence for nursing managers to take targeted intervention measures.Methods:This was a quasi-experimental study. Convenience sampling was used to select 63 re-employment nurses from Shandong Provincial Third Hospital in 2021 as the research objects. The re-employment nurses were divided into control group (32 cases) and observation group (31 cases) by random number table method. The control group received humanistic care including heart-to-heart talk, group discussion and psychological lecture, and the observation group received Satir model group intervention for 6 weeks. Simplified Coping Style Questionnaire, Self Consistency and Congruence Scale and General Well-Being Scale were used to evaluate the intervention effect before intervention, immediately after intervention, 3 months after intervention, and 6 months after intervention.Results:There was no significant difference in coping style, self-consistency and congruence and subjective well-being between the two groups before intervention ( P>0.05). The positive coping scores of the observation group immediately after intervention, 3 months after intervention and 6 months after intervention were (28.94 ± 2.99), (28.71 ± 4.70) and (29.16 ± 3.23) points, significantly higher than the control group (23.38 ± 5.50), (24.72 ± 5.91), (24.65 ± 5.65) points, the differences were statistically significant ( t=4.96, 2.96, 3.87, all P<0.01); the total self-consistency and congruence scores were (94.52 ± 14.00), (99.87 ± 16.82), (91.84 ± 10.36) points, significantly lower than the control group (105.72 ± 10.75), (114.23 ± 20.10), (107.41 ± 13.39) points, the differences were statistically significant ( t=-3.57, -3.07, -5.15, all P<0.01); the total subjective well-being scores were (84.97 ± 7.37), (84.58 ± 10.33), (91.84 ± 7.01) points, which were higher than the control group (75.69 ± 7.94), (77.28 ± 8.27), (77.00 ± 8.48) points, and the differences were statistically significant ( t=4.80, 3.69, 7.56, all P<0.01). Conclusions:Satir model group intervention can improve the coping style, enhance the level of self-consistency and congruence and subjective well-being among re-employment nurses.

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.