Objective To explore the relationship between alexithymia and sense of coherence in breast cancer patients based on a network analysis model,to accurately identify core and bridge nodes in the network,and to provide key targets for precise interventions from a network perspective.Meth-ods A total of 324 breast cancer patients were selected as survey subjects by the convenience sam-pling method.The patients were investigated by using the General Information Questionnaire,the To-ronto Alexithymia Scale and the Sense of Coherence-13.Network model construction and related index calculation based on R language were performed.Results Difficulty in describing feelings(strength=0.80)had the highest strength node in the network,followed by manageability(strength=0.59)and comprehensibility(strength=0.54).The node with the highest strength of bridges in the network was meaningfulness(bridge strength=0.37),followed by externally oriented thinking(bridge strength=0.33).Conclusion Network analysis not only reveals the relationships among variables,but also pinpoints key nodes in the network.In the network of alexithymia and sense of coherence in breast cancer patients,descriptive affective disorder is the core node,while sense of meaning and ex-troverted thinking are the bridge nodes.Healthcare professionals can develop precise interventions for the core and bridge nodes to improve the mental health of breast cancer patients.

Objective: To develop the Family-School-Community Cooperation Dilemma Scale for Nutritional Education in Primary Schools Students, and to determine its reliability and validity, in order to provide a basis for developing targeted strategies to promote family-school-community cooperation in the area of nutritional education. Methods: Based on overlapping spheres of influence theory, the initial scale was developed through a qualitative and literature review, discussion with Delphi experts and a pilot survey from July 2022 to July 2023. From July to September 2023, a total of 125 primary school parents, 118 primary school teachers and 113 community personnel were selected from six cities in Jiangsu Province by convenient sampling methods, who were investigated to test the reliability and validity of the scale and to develop a formal scale. Results: The final Family-School-Community Cooperation Dilemma Scale for Nutritional Education in Primary School students consisted of 3 dimensions and 19 items. The exploratory analysis extracted three metric factors, with a contribution ratio of 69.07% to the accumulated variance. The mean scale component effectiveness was 0.94, and the coefficient of association between the respective dimensions and the scale ranged from 0.80 to 0.91.The overall Cronbach α coefficient for the scale was 0.95, the folded half reliability was 0.87, and the retest reliability was 0.98. Conclusion The Family-School-Community Cooperation Dilemma Scale for Nutritional Education in Primary School Students has good reliability and validity, and can be used to measure the degree of the family-school-community cooperation dilemma regarding nutritional education in primary school students.

Objective To explore latent class of psychological distress among the elderly with multiple chronic conditions in the community and to analyze differences in demographic and alexithymia characteristics across class.Methods A total of 685 urban and rural elderly with chronic disease co-morbidities in 6 prefecture-level cities in Jiangsu Province were selected for the study using the General Information Questionnaire,the Depression Anxiety and Stress Scales-21,and the Toronto Alexithymia scale from November 2022 to March 2023 using a convenience sampling method.Results A total of 662 older adults with multiple chronic conditions were finally investigated with a total psychological distress score 30.00(16.00,52.00).Psychological distress manifested itself in 4 different potential categories named"stress-depressive"(19.9%),"low distress"(26.0%),"stress-anxiety"(23.4%),and"overall high distress"(30.7%).The comparison of the different psychological distress categories with respect to age group,marital status,residential status,financial stress of illness,acute events within 1 year,and self-perceived health status showed statistically significant differences(P＜0.05).The comparison of alexithymia scores for the 4 potential categories showed statistically significant differences(F=136.544,P＜0.001).Conclusion Psychological distress in older adults with multiple chronic diseases has distinct categorical features,and alexithymia varies across different categories of psychological distress.Healthcare professionals can adopt targeted interventions according to different categories of chronic disease co-morbidities in order to reduce their psychological distress,and at the same time they should focus on older adults with the alexithymia of"stress-depressive"and"overall high distress".

Objective:To understand the present situation of self-acceptance of elderly in nursing home and explore its influencing factors, so as to provide basis for improving self-acceptance level of elderly in nursing home.Methods:Totally 415 elderly people in 3 Medical and nursing homes in Fuyang city of Anhui province were selected by Self-Acceptance Scale, and influencing factors were analyzed.Results:The total score of Self-Acceptance Scale of the elderly in nursing home was (44.11±7.25) points, the score rate was 67.86% (44.11/65), in the middle level; the results of multiple linear stepwise regression showed that the relationship with children, hobbies, number of children, length of stay in nursing home, frequency of visits and age were the main influencing factors ( F value was 48.228, P<0.001). Conclusion:The self-acceptance of the elderly in nursing home is in the middle level. The nursing home or social should pay attention to the higher age group and the newly admitted elderly in nursing home, give such people timely psychological guidance, help them to plan their later life, cultivate their interests and hobbies through recreational activities, and take corresponding measures to harmonize their relationship with their children in order to improve their self-acceptance level and promote mental health.

Objective:To investigate the resilience level and self-management status of patients with type 2 diabetes and analyze the mediating effect of mindfulness level between the resilience and self-management behavior.Methods:Totally 219 patients with type 2 diabetes from December 2019 to April 2020 were selected as the research subjects.The general information questionnaire, Mindful Attention Awareness Scale, Connor-Davidson Resilience Scale, and the Summary of Diabetes Self-Care Activities were used to investigate all patients.SPSS 22.0 was used for statistical analysis.Spearman correlation analysis was used to analyze the relationship among the variables, and multiple linear stepwise regression analysis was used to analyze the mediating effect.Results:The correlation analysis showed that resilience(45.0 (40.0, 50.0)) was positively related to self-management(14.0 (9.0, 22.0)) ( r=0.876, P<0.05), and mindfulness(46.0 (40.0, 57.0)) ( r=0.838, P<0.05). Mindfulness was positively related to self-management( r=0.821, P<0.05). The mediating effect test showed that mindfulness played a part of mediating role between resilience and self-management, with the mediation effect of 0.56, accounted for 69.80% of the total effect. Conclusion:The variables of mindfulness, mental resilience and self-management behavior in type 2 diabetic patients are positively correlated with each other.Mindfulness plays a partial mediating role between mental resilience and self-management behavior.

Objective:To investigate the effect of situational simulation drill in nurses training on prevention and treatment of venous thromboembolism (VTE).Methods:Totally 120 nurses in 1-3 years from a tertiary general hospital were selected to participate in the training for prevention and treatment of venous thromboembolism. They were divided into intervention group and control group according to the number of single and double packet ward. A total of 62 nurses in the single wards were selected as the intervention group, and a total of 58 nurses in the double wards were selected as the control group. The control group and the intervention group were trained on the prevention and treatment of venous thromboembolism by traditional teaching method and scenario simulation drill, and the effect was evaluated by Kirkpatrick Model.Results:After training, intervention group training object theory examination score, operation assessment score, clinical nursing work assessment score, and nurses ability to scale score (83.79±6.85), (87.00±4.57), (7.90±0.62), (79.03±8.24) respectively, were higher than the control group (80.67±7.90), (84.02±4.70), (7.21±0.72), (70.86±11.59), the score comparison difference was statistically significant ( t values were -3.660-5.670, P < 0.05); The satisfaction of the training object to the teaching plan, teaching content and teaching form in the intervention group was 88.71% (55/62), 87.10% (54/62) and 87.10% (54/62), which were all higher than the control group 74.14% (43/58), 72.41% (42/58) and 68.97% (40/58), with statistically significant differences ( χ2 values were 4.250, 4.038, 5.804, P<0.05). Conclusion:The application of situational simulation drill in the nursing training of prevention and treatment of VTE is helpful to improve the theoretical skills and clinical work ability of nurses in the prevention and treatment of VTE, and to increase the satisfaction of nurses with the training.

Impaired awareness of hypoglycemia is an acquired complication of insulin therapy, which affects people with type 1 and insulin-treated type 2 diabetes mellitus, whereby the ability to perceive the onset of hypoglycemia becomes diminished or absent, which not only affects life health, but also causes fear of hypoglycemia , and causing a serious burden on the quality of life. The paper reviews the concept,the assessment tools,the occurrence,the influencing factors and intervention strategies of impaired awareness of hypoglycemia.In order to provide suggestions for the researches of impaired awareness of hypoglycemia in China.

Objective:To explore the application effect of SBAR communication mode based on early warning hierarchical management in emergency observation room.Methods:Formulating the handover program of SBAR communication mode based on the early warning hierarchical management, systematically training the nurses of the observation room and put into effect.The 455 patients transferred by 18 nurses in the observation room from November to December 2018 were listed as the control group, and the traditional SBAR communication mode was implemented for the handover.A total of 443 patients with nurse handover from November to December 2019 were included in the observation group, and the SBAR communication mode based on early warning hierarchical management was implemented. The incidence of adverse nursing events, quality of nursing handover, doctors' and nurses' satisfaction with the handover were compared between the two groups.Results:The incidence of adverse events was 1.81%(8/443) in the observation group and 7.91%(36/455) in the control group, the difference between the two groups was statistically significant (χ 2 value was 17.96, P < 0.05).In the observation group, the nursing handover quality and nurse's knowledge of the patients’ condition were (91.37±2.73) points and (96.7%,58/60) respectively, while those in the control group were (89.07±2.76) points and (81.7%, 49/60).The difference between the two groups was statistically significant ( t value was -2.38, χ 2 value was 6.99,all P<0.05).The satisfaction of doctors and nurses on nursing handover was 95.0%(57/60) and 95.0%(57/60)in the observation group respectively, and that in the control group was 83.3%(50/60) and 81.7%(49/60) respectively.The difference between the two groups was statistically significant (χ 2 values were 4.23, 5.18, P < 0.05). Conclusions:SBAR communication mode based on early warning classification can significantly improve the early warning ability of nurses in emergency observation room during the shift, reduce the occurrence of adverse nursing events, improve the quality of nursing shift, and improve the satisfaction of doctors and nurses.

Objective:To develop a geriatric nursing core literacy evaluation scale and to test its validity and reliability.Methods:The scale item pool was constructed by referring to relevant literatures and expert consultation method was used to form initial scale. A preliminary investigation was conducted among 40 nurses to form the formal scale, and then 252 nurses were selected to test the validity and reliability of the formal scale.Results:The formal scale consisted of four dimensions and 37 items. The Cronbach α coefficient of the formal scale was 0.980, the content validity index was 0.912, exploratory factor analysis identified 4 principal factors (knowledge geriatric nursing core literacy, skill geriatric nursing core literacy, cognitive geriatric nursing core literacy, belief geriatric nursing core literacy) and explained 73.135% of the total variance.Conclusion:The geriatric nursing core literacy evaluation scale has good reliability and validity, which can be used to evaluate the geriatric nursing core literacy of nursing staffs.

Objective:To establish fluid intake compliance motivation scale for hemodialysis patients and to test its reliability and validity.Methods:With protection motivation theory as the basic framework, the initial scale was established by means of literature analysis, patient interview and expert consultation. From April 2019 to July 2019, a total of 170 patients with hemodialysis in 10 blood purification center in Jiangsu Province were selected for preliminary investigation by convenient sampling method, and the tentative scale was formed through project analysis and exploratory factor analysis. A total of 550 hemodialysis patients were selected for formal testing to evaluate the reliability and validity of the scale.Results:The final scale consisted of 22 items. 7 common factors are extracted by exploratory factor analysis and the cumulative variance contribution rate was 75.949%. The Cronbach's α coefficient of the total scale was 0.928, Spearman-Brown coefficient was 0.841 and the retest reliability coefficient was 0.899. The content validity index of the scale was 0.987. The confirmatory factor analysis model fitted well.Conclusions:Fluid intake compliance motivation scale for hemodialysis patients has good reliability and validity, which can be used to assess fluid intake compliance motivation of patients.