Objective:To construct a shared decision-making scheme for early activities of ICU patients, so as to provide guidance for carrying out early activities of ICU patients and improving patient activity compliance.Methods:From July to December 2021, a total of 16 medical and nursing experts engaged in shared decision-making research were selected as correspondence experts using the purposive sampling method, and the Delphi expert correspondence method was used to construct a shared decision-making plan for early activities of ICU patients.Results:A total of 2 rounds of expert correspondence were conducted. The effective recovery rates of the questionnaires were 100%, the expert authority coefficients were 0.94 and the Kendall's harmony coefficients were 0.254 and 0.393, respectively ( P<0.01) . Finally, a shared decision-making plan for early activities of ICU patients with 3 stages (preparation stage, decision-making and execution stage and evaluation stage) , 12 basic steps and 65 specific contents was formed. Conclusions:The shared decision-making scheme for early activities of ICU patients constructed in this study is scientific and feasible, which can provide a reference for improving the activity compliance of ICU patients.

The correct thoughts and principles of diagnosis and treatment of chronic refractory wounds need to be formulated. Through the relevant domestic and international consensus and based on clinical experience, the Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China is proposed. It is considered that in the diagnosis and treatment of chronic refractory wounds, in the case of fully understanding the patient′s medical history, the following thoughts and principles should be complied in order. (1) Pay attention to the cleanliness of the wound after being cleaned. (2) Reasonably perform debridement to avoid being " excessive" or " not thorough". (3) Reasonably perform examination, diagnosis, and differential diagnosis of pathogenic factors. (4) Treat according to etiology. (5) Find comorbidities and prevent adverse outcomes. (6) Select the correct wound treatment method reasonably and timely. When the conservative wound care treatment is considered, pay attention to embodying the concept of etiological treatment, treat the wound according to the principles of safety, phase, selectivity, and effectiveness, and make a reasonable choice of continuing conservative treatment or surgical treatment in time after completing the preparation of the wound bed. When surgical treatment is considered, pay attention to the selection of reasonable surgical method and donor site, pay attention to the healing rate of surgical wound site and the outcome of donor site, and give reasonable protection to the wound site after surgery. (7) Carry out rehabilitation treatment after wound healing and related health education.