Objective:To systematically review and integrate the self-care experience of patients with chronic heart failure, so as to provide a reference for the construction of self-care plan for patients with chronic heart failure.Methods:Qualitative studies on the self-care experience of patients with chronic heart failure were retrieved by computer in Chinese and English databases such as PubMed, PsycINFO, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure (CNKI) , China Biomedical Literature Database, WanFang Med Database and VIP, and the retrieval time limit was from the establishment of the database to January 31, 2021. The quality of the studies were assessed using the Critical Appraisal Tool for qualitative studies of Joanna Briggs Institute Evidence-Based Health Care Centre in Australian. A pooled method was used to integrate the included articles.Results:A total of 13 articles were included. A total of 50 research results were extracted, and 7 new categories were obtained by integrating similar results, which were combined into 2 integrated results. Integrated result 1, that was, multiple factors affected the implementation of self-care in patients with chronic heart failure. Integrated result 2, that was, over time, the patient began to coexist with the disease, and realized self-worth by exploring positive psychological feelings and choosing positive responses using personal beliefs.Conclusions:Chronic heart failure patients are constrained by a variety of factors in the process of disease self-care. Medical and nursing staff should pay attention to the needs of patients in the process of self-care management, provide targeted support and help, and arouse their enthusiasm for self-management.

Objective:To analyze the distribution and drug resistance of wound pathogenic microorganisms in outpatients of wound healing center so as to provide a basis for the standardized construction of wound healing centers.Methods:A retrospective case series study was used to analyzed the data of 365 outpatients treated at Ruijin Hospital, Shanghai Jiaotong University School of Medicine from December 2017 to October 2019. There were 220 males and 145 females, aged (58.8±18.9)years (range, 18-98 years). The patients included 92 first-visit patients and 273 re-visit patients. The culture results (positive rate of pathogenic microorganisms, bacterial species, bacterial distribution) and drug sensitivity results of the wound secretions were compared and analyzed.Results:(1) Among 365 samples of wound secretions, 198 patients were positive for pathogenic microorganisms with a positive rate of 54.3%. A total of 107 strains (51.0%) of Gram-positive bacteria were detected, mainly Staphylococcus aureus (70 strains, 33.3%); 95 strains (45.2%) of Gram-negative bacteria were detected, mainly Escherichia coli (20 strains, 9.5%), followed by Pseudomonas aeruginosa (17 strains, 8.1%); 8 strains (3.8%) of fungi were detected. (2) A total of 26 (28.3%) first-visit patients were positive for pathogenic microorganisms, and 172 (63.0%) re-visit patients were positive for pathogenic microorganisms. The rate of positive microorganism detection had significant differences between first-visit and re-visit patients ( P<0.05). (3) A total of 29 strains were detected in first-visit patients, including 16 strains (55.2%) of Gram-positive bacteria, 11 strains (37.9%) of Gram-negative bacteria and 2 strains (6.9%) of fungi. A total of 181 strains were detected in re-visit patients, including 91 strains (50.3%) of Gram-positive bacteria, 84 strains (46.4%) of Gram-negative bacteria and 6 strains (3.3%) of fungi. The microbial distribution was significantly different between first-visit and re-visit patients ( P<0.05). (4) Compared with first-visit patients, the resistance of Staphylococcus aureus isolated from the re-visit patients to spenicillin, oxacillin, ciprofloxacin, tetracycline, clindamycin, moxifloxacin, erythromycin, and levofloxacin were increased variably. No vancomycin-resistant Staphylococcus aureus was detected, indicating that the staphylococcus aureus presented in the wound was highly sensitive to vancomycin. Conclusions:Staphylococcus aureus is the most common microorganism in wound secretions in outpatients of wound healing center. The rate of positive pathogenic microorganisms in wound secretions of re-visit patients is significantly higher than that of first-visit patients, and the distribution of pathogenic microorganisms of first-visited and revisited patients differs significantly. The Staphylococcus aureus detected in re-visit patients has a higher resistance to common antibiotics compared with first-visit patients. It is suggested that timely detection of pathogenic microorganisms in outpatients and effective control and supervision of outpatient infections are important contents that cannot be ignored in the construction of wound healing center.