Objective:To systematically evaluate the risk prediction models for refeeding syndrome in critically ill patients in China and abroad, with the aim of providing feasible risk assessment tools for clinical healthcare professionals.Methods:A computerized search of PubMed, Embase, Web of Science, Cochrane Library, CINAHL, Proquest, Scopous, China Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP was conducted for relevant literature from database inception to July 1, 2024. Two researchers independently reviewed the literature and extracted the relevant information. Quality assessment was performed using a risk of bias assessment tool specifically designed for predictive modeling.Results:A total of 8 papers were included, reporting 8 risk prediction models for refeeding syndrome in critically ill patients, with sample sizes ranging from 109 to 806 cases, outcome event rates from 22.5% to 69.8%, and area under the curve values from 0.74 to 0.95. The most frequently reported predictors included albumin (ALB), pre-albumin (PAB), blood potassium, use of diuretics, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores.Conclusions:The risk prediction models for refeeding syndrome in critically ill patients have good predictive performance but are still in the development stage. A high-quality, low-bias clinically applicable model should be established through multicenter, large-sample, and standardized studies.

Objective:To systematically evaluate the risk prediction models for refeeding syndrome in critically ill patients in China and abroad, with the aim of providing feasible risk assessment tools for clinical healthcare professionals.Methods:A computerized search of PubMed, Embase, Web of Science, Cochrane Library, CINAHL, Proquest, Scopous, China Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP was conducted for relevant literature from database inception to July 1, 2024. Two researchers independently reviewed the literature and extracted the relevant information. Quality assessment was performed using a risk of bias assessment tool specifically designed for predictive modeling.Results:A total of 8 papers were included, reporting 8 risk prediction models for refeeding syndrome in critically ill patients, with sample sizes ranging from 109 to 806 cases, outcome event rates from 22.5% to 69.8%, and area under the curve values from 0.74 to 0.95. The most frequently reported predictors included albumin (ALB), pre-albumin (PAB), blood potassium, use of diuretics, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores.Conclusions:The risk prediction models for refeeding syndrome in critically ill patients have good predictive performance but are still in the development stage. A high-quality, low-bias clinically applicable model should be established through multicenter, large-sample, and standardized studies.

Objective To systematically review the risk prediction models for intradialytic hypotension in maintenance hemodialysis patients,with a view to provide references for clinical practice.Methods PubMed,Embase,Web of Science,Cochrane Library,CINAHL,CNKI,VIP,Wanfang and CBM were searched from inception to May 29,2023.2 reviewers independently screened the literature,extracted information and assessed methodological quality using the Prediction Model Risk of Bias Assessment Tool.Results A total of 20 studies and 25 models were included with the sample size of 68～9 292 cases and the incidence of outcome events of 2.1～51％.Baseline systolic blood pressure,age,ultrafiltration rate,diabetes and dialysis duration were the top 5 predictors of repeated reporting of the models.20 models reported the area under the curve of ranging from 0.649 to 0.969,and 5 models reported calibration metrics.There were 9 internal validations and 4 combined internal and external validation models.The overall applicability of the 20 studies was good,but all had a high risk of bias,mainly in data analysis.Conclusion Research on risk prediction models for intradialytic hypotension in maintenance hemodialysis patients is still in the developmental stage.Future studies should improve the research design and reporting process,and validation studies of existing models should be carried out to further evaluate the effectiveness and feasibility in clinical practice.

Objective To investigate the status quo of fear of disease progression(FoP)in patients after pituitary neuroendocrine tumour surgery and analyse the medication effects of positive coping style on disease perception and FoP.Methods Convenient sampling method was used to select 345 patients with pituitary neuroendocrine tumours who underwent surgical operations in the neurosurgery department of a Grade IIIA hospital in Shanxi Province from January 2022 to January 2023 as the research objects.A general data questionnaire,disease perception questionnaire,medical coping style questionnaire and fear of progression questionnaire-short form(FoP-Q-SF)were used in the investigation.Pearson correlation was employed to analyse the correlations of the disease perception,active coping style and FoP among the patients.Structural equation models were used to analyse the mediating effects of positive coping styles on disease perception and FoP.Results The FoP score of patients after pituitary neuroendocrine tumour surgery was found at(35.02±4.92).FoP was positively correlated with the disease perception(r=0.672,P<0.01),and negatively with the active coping style(r=-0.679,P<0.01).Positive coping styles were positively correlated with disease perception(r=-0.610,P<0.01).Disease perception not only had a direct effect on FoP,but also had an indirect effect on FoP via active coping style,with an intermediate effect value of 0.202(P<0.001),accounting for 25.5%of total effect.Conclusion Postoperative positive coping style in patients with pituitary neuroendocrine tumour is a mediating variable between the disease perception and FoP.Medical staff should dynamically assess and early identify coping styles of patients and adopt personalised guidance programs,therefore to guide the patients to actively cope with the disease,so as to reduce the negative disease perception and alleviate the fear of disease progression of the patients.

Illness acceptance is a key factor regulating the psychosocial adaptation of patients with end-stage renal disease receiving replacement therapy, which directly affects patients' medication adherence as well as their self-management behaviors, and also plays an important predictive role in patients' physical and mental health and quality of life. This article elaborates on the measurement tools, current situation, influencing factors and intervention measures of disease acceptance in ESRD replacement therapy patients, and proposes prospects for future research, in order to provide a basis for the development of related researches on illness acceptance.

Objective To analyze the current status and category characteristics of the nursing practice environment in tertiary hospitals in Shanxi province,and explore the influencing factors of different categories.Methods Using convenience sampling,from August 1st to September 10th,2023,nurses from 17 tertiary hospitals in Shanxi Province were selected as subjects for investigation.The demographic questionnaire and the Nursing Practice Environment Scales were used for investigation.A latent profile analysis(LPA)was performed on characteristics of nursing practice environment,and the influencing factors of the latent profile were identified by single-factor analysis and multinomial logistic regression analysis.Results A total of 13,048 nurses were incorporated,and the nursing practice environment in tertiary hospitals in Shanxi Province scored[84.93(68.19,96.35)]on the Practice Environment Measurement Scale,and their practice environments can be divided into 3 categories potential profiles,namely low perception type(13.99％),middle perception type(31.48％),and high perception type(54.52％).Logistic regression analysis revealed that gender,nature of hospital,whether it is a provincial hospital or not,type of hospital,department,position,and whether recruited with authorization were the influencing factors of the latent profile of the nursing practice environment in tertiary hospitals in Shanxi Province(P＜0.05).Conclusion There was heterogeneity in the characteristics of the nursing practice environment in tertiary hospitals in Shanxi Province,which can be categorized into 3 latent profiles.Nursing managers can conduct individualized interventions according to the influencing factors of these profiles to enhance the nursing practice environment.

Objective To analyze the current status and category characteristics of the nursing practice environment in tertiary hospitals in Shanxi province,and explore the influencing factors of different categories.Methods Using convenience sampling,from August 1st to September 10th,2023,nurses from 17 tertiary hospitals in Shanxi Province were selected as subjects for investigation.The demographic questionnaire and the Nursing Practice Environment Scales were used for investigation.A latent profile analysis(LPA)was performed on characteristics of nursing practice environment,and the influencing factors of the latent profile were identified by single-factor analysis and multinomial logistic regression analysis.Results A total of 13,048 nurses were incorporated,and the nursing practice environment in tertiary hospitals in Shanxi Province scored[84.93(68.19,96.35)]on the Practice Environment Measurement Scale,and their practice environments can be divided into 3 categories potential profiles,namely low perception type(13.99％),middle perception type(31.48％),and high perception type(54.52％).Logistic regression analysis revealed that gender,nature of hospital,whether it is a provincial hospital or not,type of hospital,department,position,and whether recruited with authorization were the influencing factors of the latent profile of the nursing practice environment in tertiary hospitals in Shanxi Province(P＜0.05).Conclusion There was heterogeneity in the characteristics of the nursing practice environment in tertiary hospitals in Shanxi Province,which can be categorized into 3 latent profiles.Nursing managers can conduct individualized interventions according to the influencing factors of these profiles to enhance the nursing practice environment.

Objective:To apply the best evidence of pre-examination and triage management of patients with non-traumatic acute abdomen to clinical practice and evaluate its effects.Methods:Using convenience sampling method, 15 nurses and 237 patients with non-traumatic acute abdomen admitted in the emergency department of Shanxi Provincial People ′s Hospital from January to May 2021 were selected as the research objects, 114 cases as the baseline review group and 123 cases as the after-effect evaluation group. Following the clinical evidence practice application of JBI Evidence-Based Nursing Center Systematic standard procedures, using self before-after control study to compare the knowledge and behavior of triage nurses before and after evidence application, and compliance with each review index; using a non-contemporaneous controlled trial to compare the changes of pre-examination and triage time and triage accuracy between two groups. Results:After the application of evidence, the score of the triage nurses on the pre-examination and triage of non-traumatic acute abdomen increased from 98.00±6.56 in the after-effect evaluation group to 114.20±3.88 in the base-line review group, and the difference was statistically significant ( t=8.62, P<0.05); after the application of evidence, the compliance with indicators 1-9,12,13,15-17 was significantly improved and the difference was significant ( χ2 values were 11.46-123.06, all P <0.05). After the application of evidence, the compliance rate of those indicators <80% increased to more than 80% except indicator 6, the accuracy of patient triage rose from 84.21%(96/114) to 93.50%(115/123) with a statistically significant difference ( χ2=5.22, P<0.05); after the application of the evidence, the triage time was 2.00(1.00,4.00) min, shorter than 3.00(2.00,4.63) min in the base-line review group, and the difference was statistically significant ( Z=-3.18, P<0.05). Conclusions:The application of the best evidence of pre-examination and triage for non-traumatic acute abdomen can improve the nursing practice of non-traumatic acute abdomen triage, improve the accuracy of non-traumatic acute abdomen triage, and shorten the triage time.

Objective:To understand the current status of perioperative physical prevention of venous thrombosis in patients undergoing total knee and hip replacement and to analyze the barriers to clinical transformation of evidence and improve measures.Methods:Based on the evidence-based continued quality improvement model, then building a team, systematically searching, evaluating and summarizing evidences, establishing review indicators and review methods according to FAME principles (feasibility, appropriately, meanfulness, effectiveness), selecting patients undergoing total knee and hip replacement, nurses, and doctors who underwent total knee and hip replacement surgery from April 30 to August 31, 2020 in Shanxi Provincial People's Hospital as the review objects, and conducting a baseline review according to the review indicators one by one, and analyzing the obstacle factors and improvement measures based on the review results.Results:This study included 29 best evidences, and 17 review indicators were formulated based on the best evidences. Among them, the clinical compliance rate of 5 review indicators were greater than 80%, and the clinical compliance rate of 12 review indicators were less than 80%. The main obstacles were due to the imperfect venous thromboembolism (VTE) risk assessment and management process at the system level, and the low level of knowledge of VTE prevention and management among medical staff at the individual level.Conclusions:This study was based on the best evidences, scientifically and systematically developed clinical review indicators, rigorously and comprehensively analyzed obstacles, and constructed targeted improvement measures, not only for the future physical prevention of perioperative venous thrombosis in patients with total knee and hip replacement surgery transformation provides the basis but also can further promote clinical practice changes and continuous quality improvement.

Objective:To explore the symptom experience of patients with acute coronary syndrome before diagnosis, in order to improve their early recognition ability, timely medical treatment rate and formulate relevant measures to provide reference.Methods:Semi-structured interview was performed in 18 patients with acute coronary syndrome from August 12 2020 to September 8 in Shanxi Provincial people′s Hospital using phenomenological research, and the data were analyzed under the guidance of symptom experience model.Results:A total of four themes were summarized: symptom perception: diseases being easily predicted, symptom experiences being diverse and diseases being easily overlooked; symptom evaluation: correct evaluation and evaluation bias; symptom response: self-response and family-society support; reflection on the process of symptom experience:medical behaviour and lack of awareness of disease.Conclusions:At present, the identification of acutecoronary syndrome is still a challenge. Patients should enrich relevant knowledge, pay attention to their own symptom experience, make the correct evaluation and deal with it effectively. Medical workers should carry out relevant education to improve the ability of patients to identify diseases.