Objective:To investigate the effects of Bruner's constructivist theory on the critical thinking and practice performance of nursing students interning in internal medicine.Methods:One hundred and fifty-three undergraduate nursing students practicing in the department of internal medicine of a Beijing grade A tertiary hospital were selected by convenience sampling and divided into control group ( n=76) and experimental group ( n=77) according to the order of rotation time. The experimental group received teaching based on Bruner's constructivist theory, while the control group was given traditional teaching. SPSS 24.0 was used to perform the t test. Results:Compared with the control group, the experimental group showed a significantly higher critical thinking score [(306.13±33.00) vs. (325.03±32.09)], a significantly higher exit theory assessment score [(94.74±3.24) vs. (96.94±1.79)], a significantly higher exit skills assessment score [(86.68±11.95) vs. (90.23±9.17)], and a significantly higher degree of satisfaction with teaching [(180.08±13.35) vs. (187.91±14.50); all P<0.05]. Conclusions:Bruner's constructivist theory can help nurse students improve their critical thinking, theoretical and practical performance, and satisfaction with teaching, which enhances the effects of internal medicine nursing teaching.

Objective:To retrieve and summarize the evidence for postoperative observation time and bed rest time in patients undergoing percutaneous renal biopsy, so as to provide evidence-based basis for postoperative nursing of patients undergoing percutaneous renal biopsy.Methods:Using search terms such as "renal biopsy" and "renal puncture", based on the "6S" evidence resource pyramid model, evidence on postoperative observation time and bed rest time of percutaneous renal biopsy patients, including guidelines, best practice information books, evidence summaries, systematic reviews, expert consensus, and original research, was systematically searched on various guideline websites, evidence-based databases, original research databases, and professional association websites both domestically and internationally. The search period was from database establishment to July 1, 2023. After independent evaluation of the included literature by two researchers, evidence was extracted and summarized from the literature that met the quality standards.Results:A total of nine articles were included, including one guideline, five cohort studies, and three cross-sectional studies. This study summarized six best pieces of evidence from two aspects, namely postoperative observation time and postoperative bed rest time. For patients with low risk of complications after percutaneous renal biopsy, it was recommended to observe for 6 to 8 hours after surgery, but further shortening the observation time to 4 to 5 hours may also be safe and sufficient. For patients with high risk of complications after percutaneous renal biopsy, those living far from the hospital, those living alone, or those who may experience significant psychological stress after biopsy, it was recommended to extend the observation time to up to 24 hours.Conclusions:Based on existing evidence, it seems feasible to shorten the bed rest time after percutaneous renal biopsy. A large amount of high-quality research is still needed to explore the optimal postoperative bed rest time.

Objective:To explore the cognition and behavior of nurses in blood purification centers on the quality of death of patients undergoing maintenance hemodialysis.Methods:The descriptive phenomenological research method was adopted. From August to October 2022, a total of 14 nurses from blood purification centers in three hospitals, namely Beijing Union Medical College Hospital, Beijing Hospital and Beijing Chaoyang Hospital were selected as interview subjects by the purposive sampling method. Semi-structured in-depth interview method was used to collect data, and Colaizzi 7-step analysis method was used to analyze data.Results:The cognition and behavior of nurses in the blood purification center towards the quality of death of maintenance hemodialysis patients were analyzed into four themes, namely factors affecting the quality of death of patients, convenient conditions for nurses to carry out quality of death improvement work, proactive measures taken by nurses to improve the quality of death and obstacles in the process of improving the quality of death of patients.Conclusions:The nurses in the blood purification centers have special characteristics in their feelings about the death of patients with maintenance hemodialysis, and they have certain cognition and judgment about the quality of death of patients. Managers need to pay attention to the relevant needs and suggestions of the nurses in the blood purification centers and provide help and guidance, so as to continuously improve the quality of patient death and achieve the goal of optimal death of patients.

Objective:To search, review and summarize the best evidence on promoting maturation of autologous arteriovenous fistula (AVF) in patients undergoing maintenance hemodialysis (MHD) .Methods:In accordance with the relevant methods of evidence-based nursing, evidence was retrieved from relevant websites and databases according to the "6S" pyramid model, including clinical decision-making, guidelines, expert consensus, group standards, and systematic reviews. The search time limit was from April 20, 2012 to April 20, 2022. Two investigators assessed the quality of the evidence, and the evidence team extracted and summarized the evidence.Results:A total of 17 articles were included, including 1 clinical decision-making, 6 guidelines, 1 expert consensus, 1 group standard and 8 systematic reviews. Totally 28 best evidences were summarized from 6 aspects: team education, perioperative management, functional exercise, physical therapy, drug application, first puncture timing and scheme.Conclusions:The best evidence provides a reference for medical staff to standardize the management of AVF in MHD patients. It is recommended that medical staff develop individualized plans based on medical conditions, clinical judgment, and patient wishes when applying relevant evidence.

Objective:To investigate the correlation of illness uncertainty with anxiety and depression in perioperative patients with early gastric cancer.Methods:A cross-sectional survey was conducted among 107 patients with early gastric cancer who were admitted in Department of Gastroenterology of a Class A tertiary hospital in Beijing from April 2020 to August 2021. The demographic data questionnaire was used for survey, and the psychological status of patients was evaluated with Mishel′s Uncertainties in Illness Scales (MUIS), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Spearman correlation analysis was used to explore the correlation of disease uncertainty with anxiety and depression in patients with early gastric cancer.Results:The illness uncertainty in patients with early gastric cancer was at a moderate level (93.2±14.0). The total scores on the SAS and SDS were (46.5±9.7) and (47.7±10.2), respectively. And the incidence rate of anxiety and depression was 34.6% (37/107) and 31.8% (34/107) respectively. The illness uncertainty of patients with early gastric cancer was positively correlated with anxiety and depression ( r=0.40,0.31,all P<0.05). Conclusion:Some patients with early gastric cancer have illness uncertainty, anxiety and depression, and the illness uncertainty is related to anxiety and depression.

End-stage renal disease is the final stage of chronic kidney disease, and research on palliative care for end-stage renal disease patients in China is still in its infancy. The research content of palliative care for end-stage renal disease at home and abroad mainly includes identification and management of symptoms, advance care planning, psychosocial and spiritual support, and ethical issues in dialysis decision-making. However, practical experience is still insufficient. By focusing on the overview, development status, patient needs, as well as implementation forms and models of palliative care for endstage renal disease patients, this paper summarized the research progress and application status of related research, with a view to providing references for future domestic research and clinical practice in this field.

The aim of the present study is to explore the association between abdominal obesity and chronic kidney disease (CKD) through a systematic review of published studies. Databases including Wanfang data, CNKI, VIP, CBM, Cochrane Library, PubMed, Web of science and Embase were searched up to July 2021 to collect longitudinal studies published in Chinese and English on the association between abdominal obesity and CKD. In order to avoid omission, reference lists of related articles were also checked manually. After literature selection, data were extracted and study quality was evaluated by the Newcastle-Ottawa scale. Statistical analysis of this study was conducted using Stata 11.0 software. Finally, five studies were included in this study. The results showed that abdominal obesity defined by waist circumference was not associated with CKD (OR=1.17,95% CI:0.93-1.48). According to the results of subgroup analyses, whether adjusted body mass index might be part of the reason of heterogeneity. Based on results of this study, the association between abdominal obesity defined by waist hip ratio and CKD, as well as the association between abdominal obesity and CKD in different genders, remains unknown. In conclusion, abdominal obesity might not be associated with incident CKD. However, more studies are needed in the future to explore this association.

Objective:To explore the protective factors of psychological resilience in patients with inflammatory bowel disease (IBD) , so as to provide a basis for improving the psychological resilience of patients.Methods:From December 2020 to March 2021, 16 IBD patients in the Department of Gastroenterology of Peking Union Medical College Hospital were selected as the research object by purpose sampling, and the semi-structured in-depth interview was conducted with them. The interview data was organized and analyzed using the directed content analysis method.Results:A total of 3 themes and 10 sub-themes were extracted, including internal characteristics of individuals, social support network, environmental perception and active transformation. Among them, the internal characteristics of individuals included calm acceptance of the disease, positive disease cognition, appropriate emotion regulation, and clear goal motivation. Social support network consisted of solid family support, professional medical care, stable relationships, normal work status. Environmental perception and active transformation comprised selective perception of the environment and active behavioral coping.Conclusions:Medical and nursing staff should cooperate with the patient's family, friends and other parties to implement cognitive intervention, perfect the support system, and promote positive behaviors, thereby improving the patients' psychological resilience.

To analyze the lesion distribution situations and relationship of lesions detected by gastroscopy and colonoscopy in asymptomatic population in Beijing. Data of 1 663 patients who received gastroscopy and colonoscopy in the physical examination center of Peking Union Medical College Hospital and Beijing Hospital between January 2016 and December 2018 were analyzed retrospectively. Statistical analysis was conducted on the detection rate and relationship of different lesions based on the information of gender and ages. Gastroscopy data showed that chronic non-atrophic gastritis and chronic atrophic gastritis accounted for 1 240 (74.6%)and 423 (25.4%)cases respectively. Chronic atrophic gastritis was more common in population aged over 40. Other common diseases included erosions of gastric body and/or antrum, fundic gland polyps, reflux esophagitis, duodenitis, bile regurgitation and so on. Upper gastrointestinal tumors including esophagus cancer and gastric cancer were both early lesions. Colonoscopy results showed that colonic polyps were common lesions, among which there were 382 (23.0%)cases of colonic adenoma and 217 (13.0%)hyperplastic polyps. Incidence of colonic polyps increased with age. Colorectal cancer accounted for 0.7%. Colon diverticulum and melanosis coli were more common in population aged over 40. Colon adenoma was more common in male and melanosis coli was more common in female. The positive rate of HP was 32.2%. There was no positive relationship between HP infection and fundic gland polyps( P=0.329). There was no positive relationship between fundic gland polyps and colon adenomas as well as colorectal cancer( P=0.152, P=0.616). Gastroscopy and colonoscopy play important roles in different kinds of digestive diseases, especially in the early detection of tumors. More attention should be paid to the application of endoscopy in asymptomatic population.

Objective:To investigate the current situation with regard to a sense of coherence in major caregivers of enterostomy patients and analyze its relationship with self-efficacy and perceived social support.Methods:From July to December 2019, a total of 118 major caregivers of enterostomy patients were investigated using a general information questionnaire, a self-efficacy scale, and a perceived social support scale.Results:The score of sense of coherence in major caregivers of enterostomy patients was 58.40±9.17, and the average scores of all dimensions, from high to low, were “controllable sense，” “understandable sense，”and “meaningful sense.” Sense of coherence was positively correlated with self-efficacy and perceived social support ( r=0.457, P<0.01; r=0.369, P<0.01). Hierarchical multiple regression analysis showed that self-efficacy and perceived social support had a positive predictive effect on sense of coherence and explained 35.2% of the variance ( R′ 2=0.352, F=25.639, P<0.001). Conclusions:The main caregivers of enterostomy patients had a low level of sense of coherence. Self-efficacy and perceived social support have a positive effect on sense of coherence. Medical staff should take targeted measures to help caregivers improve their self-efficacy and social support system in order to improve their sense of coherence.