Objective:To apply the ORTCC (objective, rule, training, check, and culture) refined management model for the systematic management and overall construction of a specialty nurse team in a tertiary grade A general hospital, and to promote the cultivation and development of specialty nurses.Methods:The management framework of specialty nurses was investigated and a survey on their work was conducted. The ORTCC model was used to implement fine management of specialty nurses, including determining the integrated objective of "training, use, and management"(objective):, improving the rule system (rule), building a hierarchical training platform (training), streamlining the whole process check (check), and shaping the specialty nursing culture (culture). The effects were evaluated after one year of implementation.Results:After the implementation of ORTCC refined management, the number of specialty nurses increased to 367 in 2023, and a three-level progressive specialty nurse team was formed. The total and dimensional scores of perceived professional benefits ( P<0.001) and clinical competence ( P<0.001 or P<0.05) were higher than the scores in 2022. Additionally, 12 specialized nursing techniques were established, and six provincial or higher-level specialized quality improvement awards were obtained, further enhancing the capacity for specialized nursing services. Conclusions:The refined management practice of specialty nurses based on the ORTCC model provides a theoretical and practical basis for the hierarchical cultivation, effective use, and scientific management of specialty nurses in tertiary hospitals, thereby promoting specialty nurse team development and enhancing specialized service capacity.

Objective To explore the application effects of a discharge planning service program based on King's Goal Attainment Theory in patients undergoing transcatheter heart valve surgery.Methods Using convenience sampling method,80 patients who underwent transcatheter heart valve surgery at a tertiary comprehensive hospital in Zhejiang Province from August 2023 to January 2024 were selected as the research subjects.Among them,40 patients from November 2023 to January 2024 were selected as an experimental group.A discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory was adopted.Totally 40 patients who underwent transcatheter heart valve surgery from August to October 2023 were selected as a control group and underwent routine measures for discharge preparation.The differences in the scores of the discharge preparation scale,discharge guidance quality scale,self-management scale for patients after mechanical heart valve replacement surgery,and unplanned readmission rate were compared between 2 groups before and after intervention.Results During the application of the plan,a total of 2 cases were excluded,and 38 cases were included in the experimental group and 40 cases were included in the control group.After intervention,the experimental group had higher scores in discharge readiness,discharge guidance quality,and self-management ability than the control group,and the differences were statistically significant(P＜0.001).The unplanned readmission rate within 30 days in the experimental group(2.63％)was lower than that in the control group(7.50％),and the difference was not statistically significant(P＞0.05).Conclusion The discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory can improve the discharge preparation,discharge guidance quality,and self-management ability of patients undergoing transcatheter heart valve surgery,and has a positive effect on improving their quality of life.

Objective To understand the changing trend of nutritional status of children undergoing liver transplantation within 6 months after discharge,and to explore its influencing factors,in order to provide guidance for the clinical formulation of personalized nutritional intervention programs.Methods By the convenient sampling method,153 children undergoing liver transplantation admitted to the liver transplantation center of a tertiary A hospital in Hangzhou from January 2023 to January 2024 were selected as the research subjects.Their basic and clinical data were collected.The nutritional status at the 1 day before surgery and 1 month,3 months,and 6 months after discharge was evaluated by the standard deviation evaluation method of children's nutritional status.According to the changing trend of their nutritional status,they were grouped.Univariate and multivariate Logistic regression were used to analyze the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation.Results A total of 144 children who underwent liver transplantation were ultimately included in the study.The incidence of malnutrition at 1 month,3 months,and 6 months after discharge was 66.0％,54.9％,and 53.5％,respectively.According to the changing trend of nutritional status of children undergoing liver transplantation,they were divided into 3 groups:54 cases(37.5％)in the good nutritional status group,24 cases(16.7％)in the fluctuating nutritional status group,and 66 cases(45.8％)in the poor nutritional status group.The results of multivariate Logistic regression analysis showed that birth weight,feeding method within 6 months after birth,age of caregivers and learning situation of nutritional knowledge were the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation(P＜0.05).Conclusion The incidence of malnutrition in children undergoing liver transplantation is high within 6 months after discharge;medical staff should closely collaborate with families to formulate and implement staged personalized nutritional intervention measures based on the specific conditions and influencing factors of the children to effectively improve the nutritional status of the children after transplantation.

Objective To develop an assessment scale of oropharyngeal candidiasis risks in HIV-infected patients,and to test its reliability and validity.Methods The draft of the assessment scale was constructed by the literature analysis method,Delphi consultations and analytic hierarchy process.Totally 231 HIV-infected patients in a tertiary A hospital of Hangzhou were recruited for questionnaire survey in October 2023 to January 2024.Results The scale includes 3 dimensions,including general factors,HIV related factors and oral related factors,12 first-level items and 21 second-level items.The Cronbach's α coefficient of the scale was 0.813;the content validity index was 0.98;the correlation of each dimension was 0.574～0.733(P＜0.05).Confirmatory factor analysis showed that the 3 factor models fitted the data well.The critical value(30.5 points)of the scale was determined by ROC curve;the area under the curve was 0.909;the sensitivity of index system was 0.962,and specificity was 0.697.Conclusion The assessment scale of oropharyngeal candidiasis risks in HIV-infected patients has good reliability and validity,and it can be used as an auxiliary tool for effective identification and prediction of oropharyngeal candidiasis risk.

Objective:To construct a comprehensive nursing evaluation indicator system for HIV infected patients with hematological malignancies receiving chimeric antigen receptor T cell therapy, and provide theoretical support for clinical nursing practice.Methods:From November 2023 to February 2024, the first draft of indicator system was developed through literature review and panel meeting, experts from 6 provinces and cities were interviewed by Delphi consultations, and the final draft were formed by revision.Results:A total of 18 experts took part in the expert consultation, included 4 males and 14 females, aged (44.00 ± 7.24) years. The effective recovery rates of questionnaire for both rounds were 18/18, and the authority coefficient were 0.894 and 0.900, respectively. The coordination coefficients of the third level items were 0.146 and 0.128 respectively (both P<0.05) regarding the importance, and 0.156 ( P<0.05) regarding the operability. The final comprehensive nursing evaluation indicator system for HIV infected patients with hematological malignancies receiving chimeric antigen receptor T cell therapy consisted of 5 first-level items, 28 second-level items and 89 third-level items. Conclusions:The comprehensive nursing evaluation indicator system of CAR-T therapy for HIV infected patients with hematological malignancies is scientific, reliable and comprehensive, which can provide reference for clinical nurses in nursing practice and training related to CAR-T and AIDS.

Objective To investigate the current status of rumination and professional grief among hospice nurses,and to explore the mediating effect of death attitude between the two.Methods A total of 323 nurses in hospitals with hospice services and hospice wards in Hangzhou City were surveyed from April to July 2024 by convenience sampling method.They were investigated with general information questionnaire,Event Related Rumination Inventory,Death Attitude Profile-Revised,and Grief State Scale for Nurses by convenience sampling method.The structural equation model was used to analyze the mediating effect of death attitude between rumination and professional grief among hospice nurses.Results A total of 331 questionnaires were collected,among which 8 invalid questionnaires were deleted,and 323 valid questionnaires were retrieved,with the valid questionnaire recovery rate of 97.58％.The score of intrusive rumination dimension for hospice nurses was 13.34(7.00,20.00),and the score of deliberate rumination dimension was 16.92(11.00,24.00).The negative attitude towards death scored 38.35(29.00,48.00),while the positive attitude towards death scored 62.88(49.00,78.00).The total score of Grief State Scale for Nurses was 47.05(40.00,53.00).Hospice nurses'intrusive rumination was positively correlated with negative attitudes toward death,professional grief,and negatively correlated with positive attitudes toward death(all P＜0.05);deliberate rumination was negatively correlated with negative attitudes toward death,professional grief,and positively correlated with positive attitudes toward death(all P＜0.05).Negative death attitudes and positive death attitudes partially mediated between intrusive rumination and professional grief,with mediation effects of 0.053 and 0.037,accounting for 12.70％and 9.25％of the total effect.Negative death attitudes and positive death attitudes similarly partially mediated between deliberate rumination and professional grief,with mediation effects of-0.033 and-0.080,accounting for 10.03％and 21.33％of the total effect.Conclusion Death attitudes are a mediating variable between hospice nurses'rumination and professional grief.Nursing managers can take effective measures to improve hospice nurses'ruminative contemplation ability and positively guide positive attitudes toward death,thereby reducing their professional grief levels.

Objective To conduct a scoping review of the current state of research on the application of virtual reality technology in psychological interventions for cancer patients,clarifying its types,forms,contents,intervention effects,and outcome indicators,and to provide the improvement of mental health in cancer patients.Methods A literature search was conducted on PubMed,Embase,Web of Science,Scopus,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Data up to October 11,2023.The selected literature was screened,included,and analyzed for content summary.Results A total of 22 studies were included,involving both non-immersive and immersive virtual reality technologies,with various systems or programs used for intervention.The primary interventions include virtual reality relaxation therapy,virtual reality exposure therapy,and virtual reality reminiscence therapy.The outcome indicators primarily include anxiety,depression,distress,pain,fatigue,sleep,quality of life,coping,and side effects of virtual reality.Conclusion The use of virtual reality technology for psychological interventions in cancer patients offers a variety of forms and rich content,which has a positive impact on improving the physical and mental health of cancer patients.However,there is significant heterogeneity in the content elements and outcome measure tools,leading to certain limitations in its application.In the future,the specific needs of cancer patients should be considered,and the procedural norms for virtual reality-based psychological interventions should be explored.

Objective To develop an assessment scale of oropharyngeal candidiasis risks in HIV-infected patients,and to test its reliability and validity.Methods The draft of the assessment scale was constructed by the literature analysis method,Delphi consultations and analytic hierarchy process.Totally 231 HIV-infected patients in a tertiary A hospital of Hangzhou were recruited for questionnaire survey in October 2023 to January 2024.Results The scale includes 3 dimensions,including general factors,HIV related factors and oral related factors,12 first-level items and 21 second-level items.The Cronbach's α coefficient of the scale was 0.813;the content validity index was 0.98;the correlation of each dimension was 0.574～0.733(P＜0.05).Confirmatory factor analysis showed that the 3 factor models fitted the data well.The critical value(30.5 points)of the scale was determined by ROC curve;the area under the curve was 0.909;the sensitivity of index system was 0.962,and specificity was 0.697.Conclusion The assessment scale of oropharyngeal candidiasis risks in HIV-infected patients has good reliability and validity,and it can be used as an auxiliary tool for effective identification and prediction of oropharyngeal candidiasis risk.

Objective:To apply the ORTCC (objective, rule, training, check, and culture) refined management model for the systematic management and overall construction of a specialty nurse team in a tertiary grade A general hospital, and to promote the cultivation and development of specialty nurses.Methods:The management framework of specialty nurses was investigated and a survey on their work was conducted. The ORTCC model was used to implement fine management of specialty nurses, including determining the integrated objective of "training, use, and management"(objective):, improving the rule system (rule), building a hierarchical training platform (training), streamlining the whole process check (check), and shaping the specialty nursing culture (culture). The effects were evaluated after one year of implementation.Results:After the implementation of ORTCC refined management, the number of specialty nurses increased to 367 in 2023, and a three-level progressive specialty nurse team was formed. The total and dimensional scores of perceived professional benefits ( P<0.001) and clinical competence ( P<0.001 or P<0.05) were higher than the scores in 2022. Additionally, 12 specialized nursing techniques were established, and six provincial or higher-level specialized quality improvement awards were obtained, further enhancing the capacity for specialized nursing services. Conclusions:The refined management practice of specialty nurses based on the ORTCC model provides a theoretical and practical basis for the hierarchical cultivation, effective use, and scientific management of specialty nurses in tertiary hospitals, thereby promoting specialty nurse team development and enhancing specialized service capacity.

Objective To investigate the current status of rumination and professional grief among hospice nurses,and to explore the mediating effect of death attitude between the two.Methods A total of 323 nurses in hospitals with hospice services and hospice wards in Hangzhou City were surveyed from April to July 2024 by convenience sampling method.They were investigated with general information questionnaire,Event Related Rumination Inventory,Death Attitude Profile-Revised,and Grief State Scale for Nurses by convenience sampling method.The structural equation model was used to analyze the mediating effect of death attitude between rumination and professional grief among hospice nurses.Results A total of 331 questionnaires were collected,among which 8 invalid questionnaires were deleted,and 323 valid questionnaires were retrieved,with the valid questionnaire recovery rate of 97.58％.The score of intrusive rumination dimension for hospice nurses was 13.34(7.00,20.00),and the score of deliberate rumination dimension was 16.92(11.00,24.00).The negative attitude towards death scored 38.35(29.00,48.00),while the positive attitude towards death scored 62.88(49.00,78.00).The total score of Grief State Scale for Nurses was 47.05(40.00,53.00).Hospice nurses'intrusive rumination was positively correlated with negative attitudes toward death,professional grief,and negatively correlated with positive attitudes toward death(all P＜0.05);deliberate rumination was negatively correlated with negative attitudes toward death,professional grief,and positively correlated with positive attitudes toward death(all P＜0.05).Negative death attitudes and positive death attitudes partially mediated between intrusive rumination and professional grief,with mediation effects of 0.053 and 0.037,accounting for 12.70％and 9.25％of the total effect.Negative death attitudes and positive death attitudes similarly partially mediated between deliberate rumination and professional grief,with mediation effects of-0.033 and-0.080,accounting for 10.03％and 21.33％of the total effect.Conclusion Death attitudes are a mediating variable between hospice nurses'rumination and professional grief.Nursing managers can take effective measures to improve hospice nurses'ruminative contemplation ability and positively guide positive attitudes toward death,thereby reducing their professional grief levels.