Objective:To develop a culturally adapted Advance Care Planning (ACP) Decision Balance Scale for Family Members of Patients with Advanced Cancer in China, and to test its reliability and validity.Methods:Based on the transtheoretical model-decisional balance framework, the item pool was established through literature analysis, qualitative interviews, and research team discussions. After expert panel meetings and semantic debugging pre-surveys among family members of patients with advanced cancer, item screening was conducted to form the pilot scale. From October to December 2024, the scale was administered to 310 family members of inpatients with advanced cancer in five Class Ⅲ Grade A hospitals in Chongqing. SPSS and AMOS software were used for item analysis and reliability and validity testing, and the final formal scale was developed.Results:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer consisted of 2 dimensions, perceived cost of choice and perceived benefit of choice, with a total of 12 items. The Cronbach's α coefficient of the scale was 0.875, the split-half reliability was 0.905, and the test-retest reliability was 0.856. The item-level content validity index ranged from 0.880 to 1.000, and the scale-level content validity index was 0.980. Exploratory factor analysis extracted 2 common factors, with a cumulative variance contribution rate of 65.365%. Confirmatory factor analysis showed χ 2/ df=1.743, and the model fit indices met the requirements. The scale also demonstrated good convergent validity and discriminant validity. Conclusions:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer developed in this study demonstrated good reliability and validity. It can be used as a tool to assess the level of ACP decision-making participation of family members of patients with advanced cancer, and to systematically, comprehensively, and effectively evaluate, collect, and analyze their behavioral intentions and barriers regarding ACP decision-making.

Objective:To develop a culturally adapted Advance Care Planning (ACP) Decision Balance Scale for Family Members of Patients with Advanced Cancer in China, and to test its reliability and validity.Methods:Based on the transtheoretical model-decisional balance framework, the item pool was established through literature analysis, qualitative interviews, and research team discussions. After expert panel meetings and semantic debugging pre-surveys among family members of patients with advanced cancer, item screening was conducted to form the pilot scale. From October to December 2024, the scale was administered to 310 family members of inpatients with advanced cancer in five Class Ⅲ Grade A hospitals in Chongqing. SPSS and AMOS software were used for item analysis and reliability and validity testing, and the final formal scale was developed.Results:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer consisted of 2 dimensions, perceived cost of choice and perceived benefit of choice, with a total of 12 items. The Cronbach's α coefficient of the scale was 0.875, the split-half reliability was 0.905, and the test-retest reliability was 0.856. The item-level content validity index ranged from 0.880 to 1.000, and the scale-level content validity index was 0.980. Exploratory factor analysis extracted 2 common factors, with a cumulative variance contribution rate of 65.365%. Confirmatory factor analysis showed χ 2/ df=1.743, and the model fit indices met the requirements. The scale also demonstrated good convergent validity and discriminant validity. Conclusions:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer developed in this study demonstrated good reliability and validity. It can be used as a tool to assess the level of ACP decision-making participation of family members of patients with advanced cancer, and to systematically, comprehensively, and effectively evaluate, collect, and analyze their behavioral intentions and barriers regarding ACP decision-making.

Objective:To investigate the current situation and influencing factors of knowledge, attitude and practice in terms of refeeding syndrome (RFS) in enteral nutrition among nurses in intensive care unit (ICU), and to inform the development of relevant training framework.Methods:A total of 1 332 ICU nurses were surveyed using a self-developed questionnaire on knowledge, attitude and practice towards refeeding syndrome in enteral nutrition. The questionnaire consists of 45 items covering three dimensions, namely knowledge, attitude and practice.Results:The subtotal scores of knowledge, attitude and practice were 60.00 (48.00, 66.75), 53.00 (48.00, 60.00) and 46.00 (39.00, 52.00), respectively. The total score was 156.78±23.03. Multiple linear regression analysis showed that the influencing factors for the total score included age, years of working in ICU, professional title, position, specialist nurses or not, experiences of relevant training ( P<0.05). Conclusions:ICU nurses had better attitude towards RFS, but the level of knowledge and practice still need to be improved. Nursing managers should develop and optimize the training system to enhance the knowledge and behavior concerning RFS in ICU nurses, so as to further improve the nursing quality in terms of RFS management.

Objective To establish a systematic and scientific transitional care quality evaluation index for patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI), and to determine the weight of the index.Methods Using self management theory and Omaha effectiveness evaluation system as frameworks, the transitional care quality evaluation index for patients with CHD after PCI was basically formed on the basis of literature analysis and qualitative research. Totally 23 experts were consulted by Delphi method, and the weight of each index was determined by analytic hierarchy process (AHP).Results The quality evaluation index was finally determined after three rounds of expert consultation, composing of 4 first-class indexes, 16 second-class indexes and 42 third-class indexes. The questionnaire recovery rates of the three rounds of consultations were 91.3％, 81.0％ and 100.0％ respectively. And the authority coefficient of the experts were 0.87, 0.88 and 0.91 respectively. The index weight of various levels were determined by AHP. The weight of 4 first-class indexes were 0.489, 0.137, 0.304 and 0.070 respectively, and theCr value of indexes of various levels were all less than 0.10.Conclusions The transitional care quality evaluation index for patients with CHD after PCI is established to give feedback on the effects of transitional nursing and to promote the quality of transitional nursing.

Objective To develop an instrument for measuring family relocation stress scale during patient transferred from ICU. And to provide evidence for ICU health care personnel to assess and deal with the family member′s relocation stress. Methods A draft scale was developed based on the result of related scale abroad, literature review and semi-structured interviews. Delphi method and Classical test theory were used in item selection. Results The degree of experts′ authority in two rounds′consultation were 0.83. The Kendall′s coordination coefficients of importance were 0.36, 0.36 (P<0.05) in dimension and 0.35, 0.37 (P<0.05) in item. Five items were deleted by the statistical analysis with pilot investigation. 6 dimensions (transfer anxiety, environmental changes, disease severity, nursing model changes, the safety of transfer, self-efficacy of care ability) and 20 items consisted the scale. The Cronbach α coefficient was 0.882. Exploratory factor analysis extracted 6 items, accumulated variance contribution rate was 72.226%. Confirmative factor analysis showed χ2/df=1.677, comparative fit index=0.936, Tucker-Lewis index=0.921, root mean square error of approximation=0.061. Conclusions The scale is based on abundant theoretical evidence and reasonable design, with satisfactory reliability and validity. It can be used as the evaluation tool for family relocation stress during patient transferred from ICU.

Objective To discuss effect of fasting and taking food on hemostasis effect of patients with gastric ulcer and bleeding. Methods 160 patients with gastric ulcer and bleeding were divided in-to the experimental group and the control group, the experimental group was allowed to take lower ho-moiothermy water gruel (liquid), the control group was required absolute fasting (not medication), until bleeding stop. The two groups adopted identical treatment and nursing. The lienable stomach tube was placed respectively, everyday pH value monitor and occult blood test were carried out by taking out gas-tric juice when fasting and 2 hours after meals. Continuous monitoring tests continued till occult blood test of gastric liquid became negative for 3 times. Stool was kept for occult blood test, at the same time the gastrointestinal tract symptom and bleeding condition were observed, routine blood test was carried out one every other day. The data underwent statistical analysis with SPSS13.0 statistics software package, compari-son between two groups used t test. Results The inner stomach pH value of the experimental group in-creased obviously, the average pH value and percentage of pH above 4 was evidently higher than those of the control group. The time of occult blood test of gastric liquid and stool turning to negative in the experi-mental group was shorter than those of the control group. Conclusions Taking food can elevate pH of gastric liquid, reduce damage caused by gastric acid to gastric mucosa, thus hasten hemostasis process and promote healing.