Objective To investigate the current status of pelvic floor muscle training(PFMT)adherence for preventing low anterior resection syndrome(LARS)in rectal cancer patients with prophylactic ostomy and analyze its influencing factors.Methods A total of 247 patients who underwent preventive stoma reversal surgery after sphincter-preserving rectal cancer resection between January 2024 and February 2025 at 22 tertiary hospitals in the Beijing-Tianjin-Hebei region were recruited in this study.Their clinical data were collected through a general information questionnaire,a LARS Knowledge-Attitude-Practice and Needs questionnaire,a PFMT Self-Efficacy Scale,and a PFMT Adherence Questionnaire.Univariate analysis,correlation analysis,LASSO regression,and random forest importance ranking were applied to screen the variables,and multiple linear regression analysis was conducted to analyze the significant variables.Results The overall PFMT adherence score was 14.52±4.18 among the 247 patients.The random forest algorithm identified 7 key predictors when the minimum error was achieved at a λ value of 2.293.The top 7 variables in importance ranking were PFMT self-efficacy,total knowledge-attitude-practice(KAP)score,education level,primary caregiver,tumor location,stoma reversal time,and chemoradiotherapy.Multiple linear regression analysis revealed that PFMT self-efficacy(P<0.001,β=0.007,95%CI:0.004～0.009),total KAP score(P<0.001,β=0.052,95%CI:0.035～0.070),stoma reversal time(P<0.030,β=-0.539,95%CI:-1.025～-0.053),and chemoradiotherapy(P<0.045,β=-0.451,95%CI:0.010～0.892)were significant related factors of PFMT adherence(P<0.05).Conclusion PFMT adherence for LARS prevention is at a moderate level in rectal cancer patients with prophylactic ostomy.Key factors such as PFMT self-efficacy,total KAP score,stoma reversal time,and chemoradiotherapy are significantly correlated with PFMT adherence.

Objective:To explore the development trends, frontiers, and hotspots of research on early rehabilitation for patients with severe neurological diseases at home and abroad in the past 10 years, with a view to providing reference for the development of early rehabilitation for patients with severe neurological diseases in China.Methods:The article on early rehabilitation for patients with severe neurological diseases was systematically searched in the Web of Science and China National Knowledge Infrastructure (CNKI) . The search period was from January 1, 2012 to June 1, 2022. CiteSpace software was used to construct a visual graph of early rehabilitation for patients with severe neurological diseases in authoritative databases in both Chinese and English, for agency cooperation, author cooperation, keyword co-occurrence, and keyword clustering analysis.Results:A total of 349 articles were included, including 237 Chinese articles and 112 English articles. According to the search results of CNKI, there were 161 institutions publishing article related to early rehabilitation for patients with severe neurological diseases in China, among which the Nursing Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medicine School had the highest number of publications (4 articles) . The search results of the Web of Science showed that there were 160 institutions publishing article in this field, among which the Florey Institute of Neuroscience and Mental Health in Australia in Australia had the highest number of publications (16 articles) . Foreign researchers mainly focused on the safety assessment and timing of early rehabilitation for patients with severe neurological diseases, while domestic research mainly focused on the evaluation of the effectiveness of different rehabilitation methods on early rehabilitation for patients with severe neurological diseases.Conclusions:The research on early rehabilitation of patients with severe neurological diseases in foreign countries is more in-depth and comprehensive than in China, and there are more multi-center clinical studies, providing a high-level evidence for clinical decision-making. On the basis of existing research results, domestic scholars should focus on strengthening interdisciplinary and inter institutional cooperation, improving the quality and effectiveness of rehabilitation, and fully leveraging the leading role of nurses while collaborating across multiple disciplines.

The theoretical domains framework provides systematic guidance for research protocol design, which can be used by researchers when designing research protocols based on behavior change. This paper introduces the overview of theoretical domains framework, the research implementation steps based on theoretical domains framework, the application of theoretical domains framework in nursing research, the shortcomings and prospects of theoretical domains framework in application, and probes into its guiding significance in nursing research, aiming to increase the understanding of researchers in theoretical domains framework and broaden the research vision of theoretical domains framework in nursing field.

Objective:To explore the effect of the application of nursing decision support information system in the continuing nursing of stroke patients in convalescent period, and to provide guidance for the information-based whole process nursing of stroke patients in convalescent period.Methods:A total of 107 stroke patients in convalescent period admitted to 4 Grade Ⅲ Level A hospitals of Beijing city from March to November 2019 were selected. The patients were divided into control group (53 cases) and test group (54 cases) by coin tossing method. The control group followed uniformly formulated discharge health education manual for post-discharge management and follow-up, while the test group received health guidance and follow-up through the nursing decision support information system. Barthel Index and MOS SF-36 were used to evaluate the activities of daily living and quality of life of the two groups of patients before intervention and 3 and 6 months after the intervention, and the results were compared.Results:There was no significant difference in Barthel Index before the intervention between the two groups( P>0.05). After 3 months of intervention, the Barthel Index ≤ 49, 50-70 and ≥ 71 in the test group were 7, 17 and 27 cases respectively, and 16, 21 and 13 cases in the control group respectively, and the difference between the two groups was statistically significant ( Z=-2.95, P<0.01). After 6 months of intervention, the Barthel Index ≤ 49, 50-70 and ≥ 71 in the test group were 7, 12 and 32 cases respectively, and 10, 15 and 25 cases in the control group respectively,and the difference between the two groups was statistically significant ( Z=-2.21, P<0.05). There was no significant difference in MOS SF-36 before the intervention between the two groups( P>0.05). After 3 and 6 months of intervention, the total score of MOS SF-36 in the test group was (50.51 ± 14.57), (57.06 ± 14.85) respectively, and that in the control group was (42.02 ± 15.48), (45.58 ± 14.97) respectively, and the differences between the two groups were statistically significant ( t=2.84, 3.23, both P<0.05). Conclusions:The application of nursing decision support information system can effectively improve the daily life ability of patients, enhance the quality of life of patients.

Objective:To explore the predictive value of artificial intelligence algorithm model for venous thromboembolism（VTE）in lower extremities of trauma patients.Methods:The data of 15，856 orthopedic inpatients were retrospectively collected from the information system database in Chinese PLA General Hospital from December 1992 to November 2017. The patients were divided according to whether they had thrombosis or not. Data pretreatment and feature extraction were carried out. Four artificial intelligence algorithms including Random Forest（RF），Bayes（Bayes），Decision Tree（DTC）and Gradient Boosting Tree（GBDT）were constructed to evaluate their clinical diagnostic efficacy in VTE. The original data were divided into training set and test set according to the ratio of 8∶2 by random stratified sampling method. By comparing the area under receiver operating characteristic curve（ROC）（AUC），true positive rate（TPR）and accuracy in the above methods，the efficiency of different models in clinical diagnosis of VTE was evaluated. According to the contribution degree of the features in the model，the important features were ranked to screen the independent risk factors of VTE.Results:For RF，Bayes，DTC and GBDT algorithm models，the AUC was 0.89，0.86，0.68，0.71，with the TPR for 0.29，0.44，0.38，0.66 and the accuracy for 0.97，0.94，0.95，0.76，respectively. The RF algorithm model had the highest accuracy and the largest AUC. Analysis of important features of artificial intelligence prediction models for VTE showed that the history of thrombosis was the primary predictor of adverse outcomes. The ranking of important clinical features represented by the RF model showed that the history of thrombosis，enoxaparin sodium injection dose，last glucose measurement and first glucose measurement after surgery were important predictive characteristics of VTE.Conclusions:The RF model has the highest accuracy in risk prediction of VTE in trauma patients，which can provide a reference for the formulation of VTE prevention strategies.

Objective:To construct implementation plan of exercise training prescription for elderly patients with stable chronic obstructive pulmonary disease (COPD) and evaluate its application effect.Methods:The convenient sampling method was adopted to select patients with stable COPD in Department of Respiratory Medicine of a Class Ⅲ Grade A hospital in Beijing from February to May 2019 as the research objects. American Thoracic Society, European Respiratory Society, British Thoracic Society websites (ATS/ERS/BTS) , UpToDate, JBI evidence-based health care database, Cochrane, Pubmed, Embase were conducted computer retrieval to extract and summary the best evidence of exercise training prescription for COPD patients. Through expert discussion, exercise training prescription implementation plan for elderly COPD patients was constructed and implemented. Respiratory symptoms, quality of life, anxiety and depression were compared before and after intervention. SPSS 24.0 statistical software was used for statistical analysis.Results:The scores of COPD Assessment Test (CAT) , anxiety and depression in elderly patients with stable COPD after intervention were all lower than those before intervention, and scores of symptoms and activity dimensions in St George's Respiratory Questionnaire (SGRQ) were lower than those before intervention, and the differences were statistically significant ( P<0.05) . Conclusions:The implementation plan of exercise training prescriptions for elderly COPD patients can improve quality of life and emotional state of patients, which is safe and feasible.

Objective:To construct the evaluation index system of self-management quality for diabetic patients based on the information platform, so as to provide a reference for the development of diabetes management based on the information platform.Methods:From August to November 2018, the first draft of the index system was drawn up on the basis of literature review and expert meeting method. Through the Delphi method, two rounds of inquiries were conducted among 28 experts engaged in diabetes diagnosis and treatment, diabetes care, chronic disease management, nursing management, nursing education and so on, and the final index system was constructed. The activity and authority of experts, the consistency and coordination of experts' opinions were calculated.Results:The effective recovery rates of two rounds of consultation were 93.33% and 100.00%, and the expert authority coefficients were 0.911 and 0.945, respectively. In the second round of expert inquiry, the Kendall coordination coefficients of the first-level, second-level, and third-level indicators were 0.478, 0.478 and 0.537 respectively with statistical differences ( P<0.01) , and the coefficient of variation was all <0.25. The final evaluation index system of self-management quality for diabetic patients based on the information platform included 3 first-level indicators, 9 second-level indicators and 69 third-level indicators. Conclusions:The construction process of the evaluation index system of self-management quality for diabetic patients based on information platform is rigorous and scientific, and the indicator content is reasonable and reliable. It can provide a reference for perfecting the content of self-management intervention for diabetic patients supported by the information platform and improving the quality of comprehensive diabetes management.

Objective:To introduce evidence-based concepts into clinical nursing, and carry out perioperative nutritional risk screening for patients with primary liver cancer treated with Cyberknife, so as to enhance the overall nutritional management awareness and the level of nutritional nursing intervention of the nursing staff, and at the same time provide a basis and support for pushing nursing staff to multidisciplinary cooperation and broadening their professional horizons.Methods:From August 2019 to July 2020, in accordance with the practice model of the Australian Joanna Briggs Institute Evidence-based Health Care Center, we searched the evidence on nutritional risk screening of patients with primary liver cancer treated with Cyberknife in the European Society for Parenteral and Enteral Nutrition website and the Chinese Parenteral and Enteral Nutrition Society website, PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang Data. The evidence was evaluated by the team and applied to nurses and patients in the Liver Oncology Department of the Fifth Medical Center of the People's Liberation Army General Hospital. A total of 21 nurses were selected to conduct a survey with the Nutrition Knowledge Questionnaire of Primary Liver Cancer Patients undergoing Cyberknife Treatment designed by the research team before and after the application of evidence. A total of 41 patients treated with Cyberknife for primary liver cancer admitted from August to December 2019 (without the use of this evidence) were selected as the control group, and 39 patients treated with Cyberknife for primary liver cancer admitted from January to April 2020 (after the application of the evidence) were selected as the observation group. The nutrition-related indicators of the two groups of patients were collected and compared when the patients were admitted to the hospital and when they were discharged after the Cyberknife treatment was completed.Results:After the application of the evidence, 21 nurses' awareness rates of perioperative nutritional risk-related knowledge of patients treated with primary liver cancer Cyberknife, nutritional risk screening implementation rates, patients' nutritional screening knowledge awareness rates and nutritional screening implementation rates were higher than those before the application of the evidence, the differences were statistically significant ( P<0.05) . Conclusions:The evidence-based nursing practice based on the practice model of the Australian Joanna Briggs Institute Evidence-based Health Care Center is used to screen the nutritional risk of perioperative patients with primary liver cancer treated with Cyberknife treatment, which enriches the nurses' knowledge about nutrition risk screening, enhances the initiative of nurses in clinical work, and is also conducive to strengthening multidisciplinary cooperation, and improving the quality of perioperative nutritional nursing management for patients with primary liver cancer treated with Cyberknife.

Objective:To explore the relationship between anxiety, depression and various dimensions of cognitive function in patients with mild cognitive impairment (MCI) .Methods:The convenient sampling method was adopted to conduct memory screening for 727 elderly people who visited the multidisciplinary joint memory clinic of a Class Ⅲ Grade A hospital in Beijing from January to December 2019. With their consent, 247 MCI patients were investigated using Montreal Cognitive Assessment (MoCA) , Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) .Results:A total of 247 questionnaires were distributed and 233 valid questionnaires were returned. There were 67 cases (28.8%) of MCI patients with anxiety and depression, 11 cases (4.7%) with anxiety, 53 cases (22.7%) with depression and 102 cases (43.8%) without anxiety and depression. In MCI patients, anxiety was positively correlated with delayed recall ( P<0.05) , while depression was negatively correlated with language function ( P<0.05) . MCI patients with different emotional states had statistically significant differences in language function ( P<0.05) . Conclusions:MCI patients have a higher incidence of anxiety and depression, and anxiety and depression will affect different dimensions of cognitive function in MCI patients. Medical staff need to provide targeted interventions for MCI patients with different emotional characteristics.

With the improvement of people's living standard and the increasing demand of nursing care, the development of nursing specialty has a broad prospect. From the beginning of new China's nursing industry, the rapid development of nursing services after the reform and opening up to the major changes brought about by the "healthy China" strategy in the new era, the nursing service mode has been continuously innovated, the nursing specialty has been expanded rapidly, the nursing professional level has been improved significantly, and China's nursing industry has been developing vigorously. It is of great significance to review the 70 years' nursing development process since the founding of new China and summarize the development experience in planning of the development of nursing specialty in the future.