Objective: To investigate the dyadic coping level and and its influencing factors among patients with chronic obstructive pulmonary disease (COPD), so as to provide the basis for reinforcing their self-management. Methods: Patients with COPD visiting the Hangzhou First People's Hospital from January to December 2024 were selected using a convenience sampling method. The demographic information was collected by questionnaire survey. The dyadic coping level, self-efficacy, and intimate relationship satisfaction were evaluated using the Dyadic Coping Inventory, Self-Efficacy for Managing Chronic Disease Scale, and Quality of Relationship Index, respectively. Factors affecting dyadic coping level among patients with COPD were analyzed using multiple linear regression model. Results: A total of 129 (54.66%) male patients and 107 (45.34%) female patients were investigated. Among them, 175 (74.15%) patients aged 60 to 84 years. The mean dyadic coping score was (124.10±8.95) points, self-efficacy score was (39.22±5.18) points, and intimate relationship satisfaction score was (5.16±1.08) points among patients with COPD. Multiple linear regression analysis identified that dyadic coping level was higher among patients with COPD who aged 41-<60 years (β'=0.182), had high school/secondary specialized educational level (β'=0.201) or college degree or above educational level (β'=0.325), had monthly household income per capita of 3 000-6 000 yuan (β'=0.196) or >6 000 yuan (β'=0.308), had disease duration ≥5 years (β'=0.214), scored high in self-efficacy (β'=0.209) and intimate satisfaction (β'=0.231). Conclusion The dyadic coping level among patients with COPD was related to age, educational level, monthly household income per capita, disease duration, self-efficacy and intimacy satisfaction.

Objective To retrieve, evaluate, and summarize evidence on preventive management of high output and dehydration in ileostomy patients from both domestic and international sources. Methods Based on the "6S" evidence model, a top-down approach was employed to retrieve evidence on prevention and management of high output and dehydration in ileostomy patients. Databases searched included BMJ best practice, UpToDate, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), Wound Ostomy and Continence Nurses Society (WOCNS), World Council of Enterostomal Therapists (WCET), Medlive Clinical Guidelines website, Joanna Briggs Institute (JBI), Cochrane Library, Embase, PubMed, Web of Science, CNKI, Wanfang Data, China Biology Medicine (CBM), and VIP Database. The search period was from January 2019 to April 2024. Results A total of 13 articles were included after retrieval and screening, comprising 2 guidelines, 2 expert consensuses, 4 systematic reviews, 4 evidence summaries, and 1 clinical decision aid. After translation, summarization, and organization of the included articles, 19 pieces of evidence across 11 categories were formulated, focusing on four items: definition and risk factors of high output in ileostomy, prevention and management strategies related to high output in ileostomy, prevention and management strategies related to dehydration in high-output ileostomy, and follow-up strategies for prevention of high output and dehydration after ileostomy surgery. Conclusion The evidence summarized based on the "6S" evidence model for prevention and management of high output and dehydration in ileostomy patients can provide a reference for clinical practice among healthcare professionals and medical decision-makers, thereby enhancing nursing quality and reducing patient rehospitalization rates.

Objective To explore the clinical characteristics,drug resistance and prognosis of Klebsiella pneumoniae bloodstream infection (KP-BSI),and to analyze the risk factors of death and drug resistance.Methods The clinical data of hospitalized patients with KP-BSI from April 2015 to April 2017 in Huashan Hospital were retrospectively analyzed.Continuous variables were compared using t test.Categorical variables were compared using x2 test or Fisher exact test.The independent risk factors for death were determined by logistic regression model.Results The majority of the 74 patients with KP-BSI were male (67.6％) and elderly patients (78.4％).Nosocomial infection occurred in 58 cases (78.4％) and a total of 24 (32.4％) cases died.The patients were widely distributed in various departments of the hospital.The first was the Department of Infectious Diseases (29.7％),followed by the intensive care unit (23.0％).The patients were often complicated with various underlying diseases and the most common was pulmonary infection (56.8％).There were 45 (60.8％) multiple drug resistance (MDR) strains and 29 (39.2％) Carbapenems resistant Klebsiella pneumoniae (CRKP) strains.There were significant differences of nosocomial infections (x2 =4.655,P =0.031),deep venous catheters (x2 =5.432,P-0.02),and invasive mechanical ventilation (x2 =7.630,P =0.006) between MDR and non-MDR patients.Deep venous catheters (x2 =5.923,P=0.015),invasive mechanical ventilation (x2 =16.845,P=0.000),other catheters (x2 =4.009,P=0.045) and surgery (x2 =3.910,P=0.048) were all significantly different between CRKP and non-CRKP patients.APACHE Ⅱ scores were performed in all patients.The average APACHE Ⅱ score was 8.74-±5.32 of the 50 cases (67.6％) in the survival group and that was 16.46 ± 6.62 of the 24 cases (32.4％) in the death group.The APACHE Ⅱ score in the survival group was significantly lower than that in the death group.The difference was statistically significant (t=5.091,P=0.000).APACHE Ⅱ ≥15 was the independent factor of death (B =-2.708,P=0.000).Conclusions The situation of drug-resistant KP-BSI is severe in the clinic.According to the clinical data,nosocomial infections,invasive mechanical ventilation and deep venous catheters may be the risk factors for MDR bloodstream infection.Deep venous catheters,invasive mechanical ventilation,other catheters and surgery may be the risk factors for bloodstream infection with CRKP.APACHE Ⅱ ≥15 is the independent risk factor for death.The evaluation of APACHE Ⅱ score may predict the prognosis of patients with bloodstream infection.