Objective:To build a systematic and standardized nutrition management plan for patients with chronic kidney disease.Methods:Based on the nutrition care procedure and model, a preliminary draft of a nutrition management plan for chronic kidney disease patients was developed through a literature search, quality evaluation, and group discussions. After two rounds of expert consultation and revision of the preliminary draft of the nutrition management plan, the final plan was formed.Results:A total of 32 experts were invited to complete two rounds of consultation. In two rounds of expert consultation, 32 questionnaires were distributed, and 32 and 31 valid questionnaires were collected, with valid response rates of 100.0% and 96.9%, respectively. The expert authority coefficients were 0.853 and 0.871, respectively. The final nutrition management plan for chronic kidney disease patients included six first-level items of nutrition management personnel: nutrition risk screening, nutrition assessment, nutrition treatment, nutrition monitoring, and nutrition health education, with 23 second-level and 52 third-level items.Conclusions:The constructed nutrition management plan for chronic kidney disease patients is scientific and can provide a reference for nutrition guidance.

Objective To investigate the level of benefit finding and positive psychological capital of stroke patients and their spouses,and to analyse the dyadic interaction between benefit finding and positive psychological capital of patients and their spouses.Methods From March to August 2023,235 stroke patients and their spouses were conveniently selected from the neurology wards of 3 tertiary hospitals in Henan Province,and were surveyed using a general information questionnaire,the positive psychological capital questionnaire,revised version of benefit finding scale,and caregiver benefit finding scale.Results The positive psychological capital scores of stroke patients and their spouses were(4.29±0.75)and(4.56±0.71);benefit finding scores of the dyads were(2.85±0.69)and(3.64±0.68).The results of actor-partner interdependence model showed that positive psychological capital of stroke patients and their spouses positively predicted their benefit finding;positive psychological capital of patients positively predicted benefit finding of spouses,and positive psychological capital of spouses positively predicted benefit finding of patients(all P＜0.05).In particular,spousal self-efficacy and resilience positively predicted their benefit finding;their optimism positively predicted the patient's benefit finding;their hopefulness negatively predicted the patient's benefit finding(all P＜0.05).Conclusion There was a dyadic interaction between benefit finding and positive psychological capital for stroke patients and their spouses.The role of spouses on patients'positive psychological capital should not be overlooked,and nurses should develop positive psychological capital intervention strategies centered on couples of stroke patients to enhance positive couple experiences.

Objective To investigate the current status of health behavioral decision-making in ischemic stroke patients and analyze its influencing factors.Methods Totally 250 ischemic stroke patients were selected from 2 hospitals in Zhengzhou and Anyang from February to May 2023.A general information questionnaire,Behavioral Decision-Making Scale for Stroke Patients,Recurrence Risk Perception Scale for Patients with Stroke,and Stroke Self-Efficacy Questionnaire were used to conduct the questionnaire survey.Results The Behavioral Decision-Making Scale for Stroke Patients score of 229 ischemic stroke patients was(117.83±7.15)scores.The results of multiple linear regression analysis showed that occupational status,glycemic compliance,primary caregiver,current symptoms,stroke self-efficacy,and recurrence risk perception were the influencing factors of health behavioral decision making in ischemic stroke patients(P＜0.05).Conclusion The health behavioral decision making of ischemic stroke patients is at an upper-middle level.Individualized interventions can be carried out for patients with different characteristics to promote the patients'ability to behavior decision making and the formation of preventive behaviors.

Objective To explore the categories of dyadic mental health literacy among stroke patients and their caregivers,and to analyze the differences in the characteristics of different classes of stroke patients and their caregivers.Methods A convenient sampling method was used to select 287 dyads of stroke patients and their caregivers who were treated at a tertiary general hospital in Henan province from July to October 2020.The general information questionnaire,Multicomponent Mental Health Literacy and Social Support Rating Scale were used for investigation.Latent profile analysis was adopted to explore the categories of dyadic mental health literacy,and multiple logistic regression was used to analyze the influencing factors of each category.Results Stroke patients and their caregivers were divided into 4 categories based on scores of mental health literacy:dyadic low resource group(19.86％),dyadic low literacy group(54.36％),dyadic low belief group(11.15％),dyadic high literacy group(14.63％).The patient's age,average monthly household income,the caregiver's age,the caregiver's Social Support Rating Scale score,the caregiver's educational level,daily care time and total time length of care were the factors influencing the categories of dyadic mental health literacy among stroke patients and their caregivers(P＜0.05).Conclusion Stroke patients and their caregivers were divided into 4 categories based on scores of mental health literacy.Medical staff should carry out comprehensive psychological interventions for stroke patients and their caregivers with different dyadic mental health literacy characteristics,so as to improve dyadic mental health literacy.

Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01). Conclusion Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.

Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01). Conclusion Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.

Objective:To investigate the role of HMGB1-TLR4-NF-κB signaling pathway in cerebral ischemia-reperfusion in-jury and the effect of adenosine preconditioning on the signaling pathway.Methods:Total 80 adult male Sprague-Dawley rats weighing 220～270 g were selected from the Animal Center of Xinxiang Medical University.The rats were randomly divided into F group(sham operation group),I/R group(ischemia reperfusion group)and AP group(adenosine preconditioning group).The MCAO model of rats was established by wire embolization.Quantitative analysis of neural function in successfully modeled rats using animal behavior scor-ing method,the morphological changes of brain cells were observed by HE staining,TTC staining was used to observe cerebral infarc-tion and cerebral infarction volume was calculated;Immunohistochemical staining was used to detect HMGB1,TLR4 and NF-κB pro-tein expression levels in brain tissues of each group.The data were statistically analyzed by one-way ANOVA in SPSS26.0 software.Results:After ischemia reperfusion,the neurological function of I/R group and AP group showed different degrees of impairment,and the neurological function scores of the two groups were significantly higher than that of F group,the difference was statistically signifi-cant(P<0.05),and the neurological function of the AP group was significantly less than that of I/R group,the difference was also sta-tistically significant(P<0.05).TTC staining showed that AP group,I/R group rat cerebral infarction volume was significantly more than F group[(93.670±4.509)mm3,(123.670±7.234)mm3 vs(0.000±0.000)mm3],and AP group rats infarction volume was signifi-cantly reduced than that in I/R group,the difference had statistical significance(P<0.05).Immunohistochemistry showed that HMGB1,TLR4,NF-κB protein in F group with a small amount of expressions in rats,while significantly expressed in AP group and I/R group relatively,and the AP group of each subgroup rat HMGB1,TLR4,NF-κB protein expressions significantly lower than the amount of I/R group,the difference had statistical significance(P<0.05).Conclusion:Adenosine preconditioning can reduce the expressions of HMGB1,TLR4 and NF-κB protein,and then protect the rats with cerebral ischemia-reperfusion injury.

Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01). Conclusion Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.

Objective:To explore the mediating effect of empathy between personality traits and death attitude in nursing students.Methods:From April to May 2022, a total of 237 undergraduate nursing students were surveyed by general information questionnaire, big five inventory, Jefferson scale of empathy for nursing students, and death attitude profile-revised. Common method bias test, correlation analysis and descriptive analysis were conducted by SPSS 26.0 software.PROCESS macro program was used to test the mediating effect.Results:Agreeableness(32.78±4.92), empathy(110.03±16.83)were positively correlated with positive death attitude(57.95±12.35)( r=0.274, 0.571, both P<0.01), neuroticism(23.00±4.78)was positively correlated with negative death attitude(31.81±10.04)( r=0.199, P<0.01), empathy was negatively correlated with negative death attitude ( r=-0.226, P<0.01). Empathy partially mediated the relationship between neuroticism and negative death attitude, the mediating effect accounted for 16.08%(0.032/0.199) of the total effect, and empathy played a completely mediating role between the agreeableness and positive death attitude. Conclusion:The death attitude of undergraduate nursing students is mainly natural acceptance. Personality traits can directly affect death attitude and also indirectly affect death attitude through empathy.

Objective:To systematically evaluate the factors that promote and hinder exercise in patients with chronic kidney disease, and to provide reference for exercise intervention.Methods:The Cochrane Library,Web of Science, PubMed, Embase, CNKI, Wanfang, VIP and China Biomedical Literature Database were searched for qualitative researches on the promoting and hindering factors of exercise in patients with chronic kidney disease.The retrieval period was from the establishment of the database to January 2022. Qualitative Research Authenticity Evaluation Tool (version 2016) from JBI Evidence-Based Health Care Center was used to evaluate the quality of the literatures, and Meta-integration was used to analyze the results.Results:A total of 10 articles were included and 60 results were extracted, which were grouped into 8 new categories and integrated into 2 results:the promoting factors included personal exercise motivation,exercise self-efficacy stimulation,physical and psychological benefits and good social support;the hindering factors included disease and treatment factors,low exercise self-efficacy,fear of exercise risk and weak social support.Conclusions:Exercise of patients with chronic kidney disease is affected by many factors, so we should deeply understand the actual situation of patients,pay attention to the core factors affecting exercise, and improve the health of patients.