Objective:To construct a management program for postoperative home exercise rehabilitation in patients undergoing liver cancer surgery, and to provide guidance for improving home exercise capacity after liver cancer surgery.Methods:A mixed study design was used to summarize the best evidence for a postoperative home exercise rehabilitation program for patients with liver cancer based on a literature review from January to June 2022, and the first draft of a postoperative home exercise rehabilitation program for liver cancer patients was formed after discussion in the research team, and discussed in an expert validation meeting, and the first draft of the program was revised and improved according to the expert′s opinion in combination with clinical practice.Results:This study included 14 articles, including 4 clinical guidelines, 3 systematic evaluations, 2 randomized controlled studies, 3 class experimental research and 2 expert consensuses. And 22 pieces of evidence were included in the summary of evidence, including the principle of exercise, supervision of exercise, type of exercise, time and frequency of exercise, and intensity of exercise. A total of 10 experts participated in the expert validation meeting, with 6 males and 4 females, aged (53.31 ± 10.23) years, with an expert authority coefficient of 0.944, and the final home exercise rehabilitation program for postoperative patients with liver cancer was formed to include six aspects, including pre-exercise assessment, warm-up exercise, whole-body exercise, stretching exercise, organizing exercise, and exercise detection and follow-up.Conclusions:The home exercise rehabilitation program for postoperative liver cancer surgery patients is scientific, practical and feasible, and it is a systematic, standardized and safe exercise management model, which can be used for home guidance of postoperative exercise rehabilitation for liver cancer patients.

Objective:To summarize the evidence for the application and management of continuous glucose monitoring, providing evidence-based support for the clinical application and management.Methods:BMJ Best Clinical Practice, UpToDate, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang and other databases, Yimaitong and and other guide networks, and diabetes related association websites were searched for the application and management of continuous glucose monitoring, the search time limit was from the establishment of the database to July 7, 2024. Researchers evaluated the quality of the included literature, extracted and summarized the evidence based on the topic.Results:A total of 13 articles were included, including 5 guidelines, 5 expert consensuses, 1 systematic review and 2 randomized controlled trials. The best evidences for the application and management of continuous glucose monitoring were summarized, including 3 themes and 13 aspects, practice norms (before, during, and after wearing), application norms, management norms (personnel, systems, information, materials, methods), with 31 pieces of evidence.Conclusions:This study summarized the evidences for the application management of continuous glucose monitoring, which could standardize the operation process of continuous glucose monitoring, provide response strategies for related nursing issues, and ensure that there were unified and clear management standards to follow.

Objective:To observe the application effect of nursing risk management based on PDCA (plan, do, check, action) cycle quality control concept on patients with diabetic ketoacidosis, and provide reference for improving the nursing quality of diabetic ketoacidosis.Methods:A historical control study was adopted. Using simple random sampling method, patients with diabetic ketoacidosis admitted to Emergency Intensive Care Unit of Lishui Central Hospital from January 2019 to March 2020 were selected as the research subjects, patients admitted from January to September 2019 were treated as the control group and received routine care, while patients admitted from October 2019 to March 2020 were treated as the experimental group and received nursing risk management based on PDCA cycle quality control concept. Blood glucose control time, urine ketone negative conversion time, acidosis correction time, hospital stay, occurrence of complications, depression and anxiety scores, nursing quality and nursing satisfaction were compared between the two groups after intervention.Results:A total of 89 patients were included. There were 43 patients in the control group, including 16 males and 27 females, aged (64.37 ± 15.85) years old; 46 patients in the experimental group, including 23 males and 23 females, aged (59.28 ± 13.66) years old. Before intervention, there were no significant differences in depression and anxiety scores between 2 groups (both P<0.05). After intervention, the blood glucose control time, urine ketone negative conversion time, acidosis correction time and hospital stay were (9.24 ± 1.26), (38.39 ± 3.28), (12.23 ± 1.39) h and (11.34 ± 2.28) d in the experimental group, shorter than (9.94 ± 1.40), (40.12 ± 3.67), (13.66 ± 2.47) h and (13.62 ± 3.40) d in the control group, the differences were statistically significant ( t values were 2.35-3.74, all P<0.05). The occurrence of complications, depression and anxiety scores in the experimental group were 13.04% (6/46), (3.18 ± 0.37) points, (4.69 ± 1.33) points, lower than 30.23% (13/43), (3.72 ± 0.96) points, (5.77 ± 1.60) points in the control group, the differences were statistically significant ( χ2=3.91, t=3.55, 3.47, all P<0.05). The total score of nursing quality and nursing satisfaction in the experimental group were (82.91 ± 4.22), (89.02 ± 4.95) points, higher than (76.86 ± 5.01), (81.14 ± 7.89) points in the control group, the differences were statistically significant ( t=6.18, 5.68, both P<0.05). Conclusions:Nursing risk management based on PDCA cycle quality control concept can shorten the treatment time of patients with diabetic ketoacidosis, reduce the risk of complications, ensure the nursing quality, relieve the negative emotions during hospitalization, and improve satisfaction of patients.

Objective:To explore the categories and influencing factors of depression in mild cognitive impairment (MCI) patients, so as to provide a reference for formulating precise interventions for depression in MCI patients.Methods:A cross-sectional investigation was conducted. Patients with MCI admitted to the Department of Neurology, The First Affiliated Hospital of Nanchang University from December 2022 to December 2023 were selected as the investigation objects by convenience sampling method. The general data questionnaire, Hamilton Depression Rating Scale-17, Montreal Cognitive Assessment Scale and Lubben Social Network Scale-6 were used to conduct a survey. Latent profile analysis and multiple Logistic regression analysis were used to explore the categories and influencing factors of depression.Results:A total of 537 patients with MCI were included, including 335 females and 202 males, aged (65.72 ± 9.53) years old. MCI patients scored (22.67 ± 4.68) points on the Montreal Cognitive Assessment Scale, (13.27 ± 5.73) points on the Lubben Social Network Scale-6, and 9.00 (5.00, 13.00) points on the Hamilton Depression Rating Scale-17. The depression in MCI patients could be divided into three categories: low risk depression (67.8%, 364/537), low depression-sleep disorder (20.1%, 108/537), and high depression-anxiety (12.1%, 65/537). The multiple Logistic regression analysis showed that gender, education, living style, social isolation and cognitive function were the influencing factors for different categories of depression ( OR values were 0.443-2.921, all P<0.05). Conclusions:There are individual differences in depression in patients with MCI, and precise intervention should be implemented according to the characteristics of different categories of depression.

Objective:To explore the application effect of a childlike cognition-empowered collaborative nursing model in pediatric burn patients aged 3 years and younger and their elderly caregivers, so as to provide reference for improving the cooperative nursing ability of elderly caregivers and improving the treatment and rehabilitation effect of burn children.Methods:This quasi-experimental study enrolled 80 pediatric burn patients aged 3 years and younger admitted to Children′s Hospital of Nanjing Medical University from January 2022 to December 2023 via convenience sampling, each paired with one elderly caregiver. Based on admission time, they were divided into the control group (40 patients and caregivers admitted from January to December in 2022) and the intervention group (40 patients and caregivers admitted from January to December in 2023). The control group received routine nursing, while the intervention group received a childlike cognition-empowered collaborative nursing model. Self-rating Anxiety Scale (SAS) and Chinese version of Positive Aspects of Caregiving (PAC) were used to evaluate the degree of anxiety and positive feelings of the elderly caregivers in the 2 groups. FLACC (F: face; L: legs; A: activity; C: cry; C: consol ability) Pain Assessment Scale, Child Medical Fear Scale (CMFS) and Vancouver Scar Scale (VSS) were used to evaluate dressing change pain, medical fear and scar status of the patients in the 2 groups.Results:A total of 80 pediatric burn patients and 80 elderly caregivers were included. The patients were (2.5 ± 0.2) years old in the control group, with 23 males and 17 females, and were (2.6 ± 0.1) years old in the intervention group, with 24 males and 16 females. The elderly caregivers were (62.0 ± 1.5) years old in the control group, with 9 males and 31 females, and were (61.0 ± 1.2) years old in the intervention group, with 8 males and 32 females. There were no significant differences in SAS and PAC scores between the 2 groups of elderly caregivers before intervention (both P>0.05). There were no significant differences in FLACC Pain Assessment Scale, CMFS before intervention and VSS scores within 1 week after wound healing between the 2 groups of patients (all P>0.05). After the intervention, the SAS score of the elderly caregivers in the intervention group was (45.80 ± 2.81) points, lower than (57.78 ± 4.63) points in the control group, the difference was statistically significant ( t=13.99, P<0.05), and the PAC score in the intervention group was (38.85 ± 3.03) points, higher than (30.15 ± 3.03) points in the control group, the difference was statistically significant ( t=-15.24, P<0.05). The FLACC Pain Assessment Scale, CMFS after intervention, VSS scores at 6 months of rehabilitation treatment of the patients in the intervention group were (3.35 ± 0.45), (22.20 ± 1.07), (6.50 ± 0.68) points, lower than (7.00 ± 0.45), (51.43 ± 2.26), (8.68 ± 0.76) points in the control group, the differences were statistically significant ( t=34.86, 73.87, 13.45, all P<0.05). Conclusions:The childlike cognition-empowered collaborative nursing model can enhance the caregiving enthusiasm of elderly caregivers, alleviate negative emotions among both elderly caregivers and pediatric burn patients aged 3 and younger, improve the collaborative nursing abilities of elderly caregivers, and enhance the treatment and rehabilitation outcomes of pediatric burn patients.

Objective:To explore the application effect of comfort-based light sedation strategy nursing model in early rehabilitation exercises for critically ill patients after gastrointestinal surgery, aiming to provide a reference for the recovery of patients after gastrointestinal surgery.Methods:A randomized controlled trial was conducted using purposive sampling to select 110 critically ill patients who underwent gastrointestinal surgery from July 2022 to December 2023 in the Department of Critical Care Medicine of Shantou Central Hospital. Patients were randomly assigned into the control group and the observation group, with 55 cases in each group. The control group received routine sedation care, while the observation group adopted a comfort-based light sedation strategy nursing model. The NRS (Digital Rating Scale for Pain), RASS (Rationalizing Self-Assessment Scale), SAS (Self-Rating Anxiety Scale), analgesic and sedative drug usage, postoperative bowel sounds, flatus, and defecation onset time, ICU length of stay, delirium incidence, postoperative 24-hour MRC muscle strength score, and discharge Modified Barthel Index (MBI) scores were compared between the two groups at 8 hours, 24 hours, 48 hours, 72 hours, and 96 hours postoperatively.Results:During the study, 5 cases dropped out from both the observation and control groups, leaving 50 cases each complete. The control group consisted of 32 males and 18 females, with an average age of (66.94 ± 14.39) years; the observation group consisted of 34 males and 16 females, with an average age of (68.01 ± 14.76) years. At 8, 24, 48, 72, 96 hours postoperatively, the NRS scores for the observation group were (3.11 ± 0.58), (3.14 ± 0.53), (3.09 ± 0.56), (2.97 ± 0.50), and (2.48 ± 0.45), respectively, were all lower than those of the control group (3.55 ± 0.61), (3.46 ± 0.59), (3.42 ± 0.62), (3.38 ± 0.54), (2.87 ± 0.53), with statistically significant differences ( t values were 2.80 - 3.97, all P<0.05). The RASS scores at postoperative 8, 24, 48, 72, 96 hours were (- 1.42 ± 0.43), (- 1.41 ± 0.42), (- 1.39 ± 0.44), (- 1.36 ± 0.41), (- 1.32 ± 0.40) respectively, compared to the control group (- 1.85 ± 0.47), (- 1.78 ± 0.44), (- 1.81 ± 0.50), (- 1.80 ± 0.48), (- 1.68 ± 0.45), with statistically significant differences ( t values were 4.23 - 4.93, all P<0.05). The SAS scores at postoperative 48, 72, 96 hours were (49.68 ± 4.55), (48.69 ± 4.41), (46.71 ± 4.33) respectively, compared to the control group (53.75 ± 4.76), (53.13 ± 4.69), (52.84 ± 4.51), with statistically significant differences ( t = 4.37, 4.89, 6.93, all P<0.05); the propofol dosage in the observation group (3 228.52 ± 587.78) mg and the dexmedetomidine dosage (1 205.58 ± 311.46) μg were all lower than those of the control group (4 056.77 ± 638.04) mg and (1 650.77 ± 432.69) μg, with statistically significant differences ( t = 6.75, 5.92, both P<0.05). The start time of bowel sounds in the observation group was (18.63 ± 5.96) hours, the start time of flatus was (1.42 ± 0.57) days, and the start time of defecation was (2.02 ± 1.25) days. The ICU hospitalization duration of the observation group (5.54 ± 1.51) days was shorter than that of the control group (7.36 ± 1.89) days, with differences being statistically significant ( t values were 2.71 - 5.32, all P<0.05). The postoperative delirium incidence rate of the observation group was 8.00% (4/50) lower than that of the control group 24.00% (12/50), with differences being statistically significant ( χ2 = 4.76, P<0.05). The postoperative 24-hour MRC muscle strength score (5.34 ± 0.58) and the discharge MBI score (77.56 ± 11.34) in the observation group were both significantly higher than those of the control group (4.79 ± 0.65) and (68.25 ± 10.47), respectively ( t = 4.46, 4.27, both P<0.05). Conclusions:The comfort-oriented light sedation strategy nursing model can improve the postoperative sedation and analgesia effects for ICU gastrointestinal surgery patients, promote gastrointestinal function recovery, shorten ICU hospital stay, reduce delirium incidence, and accelerate patient postoperative recovery.

Objective:To develop and validate a knowledge-attitude-practice questionnaire for clinical nurses on postoperative thirst management.Methods:From July 2023 to May 2024, based on the theory of knowledge, belief and practice, a preliminary questionnaire was formed after literature review, Delphi expert consultation and pre-survey. A total of 243 clinical nurses were investigated, and the questionnaire was compiled and the reliability and validity were tested.Results:The questionnaire was composed of 31 items in three dimensions of knowledge, attitude and behavior. The cumulative variance contribution rate of the three factors in exploratory factor analysis was 76.130%. The overall Cronbach′s α coefficient was 0.965. The test-retest reliability was 0.913. The items of the questionnaire ranged from 0.857 to 1.000, and the questionnaire was 0.968. Conclusions:The questionnaire has good reliability and validity, which is suitable for clinical nurses to investigate the knowledge, attitude and behavior of postoperative thirst management.

Oral cancer is a malignant tumor with poor incidence and prognosis among primary head and neck tumors, and postoperative patients are often combined with surgical scar, dysphagia, mastication difficulties, and speech dysfunction, which bring heavy physiological and psychological burdens to the patients, and make their reintegration into the society after cancer generally poorly adapted. Factors such as patients′ role transition, swallowing function, life and social changes during treatment will affect their psychosocial adaptive function. The enhancement of psychosocial adaptive ability helps to stimulate patients′ intrinsic potential, improve their psychological state, and enable them to adapt to the changes brought by the disease, thus promoting their physical and mental health. In this paper, we review domestic and international nursing interventions such as perioperative nursing interventions, continuity nursing interventions, and cosmetic nursing to effectively improve patients′postoperative psychosocial adaptations, and provide a theoretical basis for the future development of a scientific and effective intervention program for psychosocial adaptations in oral cancer.

Objective:To explore the application effect of the attention and interpretation therapy based on Swanson′s caring theory in adolescents with epilepsy, aiming to reduce negative emotions and improve self-management levels in children.Methods:This study was a quasi-experimental research. A convenience sampling method was used to select 78 adolescents with epilepsy who were admitted to the Department of Neurology, the Affiliated Children′s Hospital of Xiangya School of Medicine, Central South University (Hunan Children′s Hospital) from March 1 to August 31, 2023. The participants were assigned into two groups, the control group ( n=39) and the intervention group ( n=39), using a random number table. The control group received standard anti-epileptic treatment and routine nursing care, while the intervention group received the same treatment and care with the addition of a caring team providing attention and interpretation therapy based on Swanson′s caring theory. Assessments were made at three time points: before the intervention, 4 weeks after the intervention, and 12 weeks after the intervention. The Depression-Anxiety-Stress Scale (DASS-21), Epilepsy Self-Management Scale (ESMS), and Pediaric Quality of Life Inventory Measurement Methods (PedsQL TM4.0) were used to assess the participants′ scores. Results:In the control group, 23 were male and 16 were female, with aged of (13.49 ± 1.43) years. In the intervention group, 24 were male and 15 were female, with aged of (13.51 ± 1.45) years. After 4 weeks of intervention, the scores of depression, anxiety, and stress on the DASS-21 for the intervention group were (9.32 ± 2.04), (6.79 ± 2.44), and (13.63 ± 2.67), respectively, which were lower than those of the control group: (10.43 ± 2.27), (8.43 ± 2.75) and (16.05 ± 3.32); the scores of ESMS and PedsQL TM4.0 in the intervention group were (66.66 ± 10.87) and (73.63 ± 9.85), respectively, which were higher than those of the control group: (60.70 ± 10.24) and (67.27 ± 12.33), the differences were statistically significant ( t values were -2.47 to 3.49, all P<0.05). After 12 weeks of intervention, the scores on the DASS-21 for the intervention group were (5.47 ± 1.66), (3.37 ± 1.68) and (8.42 ± 2.24) for depression, anxiety and stress, respectively, which were lower than those of the control group: (8.03 ± 1.98), (6.06 ± 2.64) and (11.28 ± 3.21) ;the scores for ESMS and PedsQL TM4.0 in the intervention group were (74.66 ± 9.15) and (85.24 ± 7.00), respectively, which were higher than those of the control group: (65.36 ± 10.86) and (75.67 ± 11.39), the differences were statistically significant ( t values were -4.33 to 6.03, all P<0.05). Additionally, there were statistically significant differences in the DASS-21 depression, anxiety, and stress scores, ESMS, and PedsQL TM4.0 scores across the different time points ( F values ranged from 4.65 to 1 134.03, all P<0.05). Conclusions:Attention and interpretation therapy based on Swanson′s caring theory can effectively reduce negative emotions in adolescents with epilepsy, improve their self-management skills, and further enhance their quality of life.

Objective:To explore the psychological experience of reproductive concerns in female patients of childbearing age with systemic lupus erythematosus (SLE), and to provide evidence for formulating targeted intervention measures.Methods:From April to May 2024, phenomenological research methods of qualitative study and purposive sampling were used to conduct semi-structured interviews with 13 female SLE patients of childbearing age who were outpatient or hospitalized in the Third Affiliated Hospital of Southern Medical University. Colaizzi′s seven-step method was used for data analysis.Results:A total of 13 female patients of childbearing age with SLE were interviewed, aged 21-36 (27.08 ± 3.88) years. Six themes were identified: concerns about fertility, concerns about one′s own health, concerns about the safety of the offspring, concerns about unmet fertility information, the need for positive emotional transmission, negative psychological experience caused by childbearing related problems ( inferiority and depression caused by difficulty in maintaining intimate relationships, anxiety and guilt caused by reproductive pressure, pain and panic caused by failure reproductive experience, and restlessness and anxiety caused by the burden of reproductive costs).Conclusions:Female patients of childbearing age with SLE have many concerns about fertility issues. Medical staff should pay attention to the psychological experience related to fertility among female patients of childbearing age with SLE, and give targeted scientific and effective intervention to alleviate the negative psychological experience of patients with reproductive.