Objective To explore the influencing factors of family participation in medication safety of aged patients with multi-morbidity,and to provide references for clinical practice.Methods Based on capability,opportunity and motivation-behavior model,17 family caregivers of aged patients with multi-morbidity at 8 communities of Zhengzhou,Henan Province from September to November 2024 were selected for semi-structured interviews using purposive sampling method.The data were analyzed using directed content analysis.Results Facilitators of family participation behavior included ability factors(strong self-reflection and emotional regulation ability),opportunity factors(family and peer support,professional support from medical staff),motivational factors(par-ticipation in medication safety importance perception,high level of participation self-efficacy,strong sense of responsibility).Barriers of family participation behavior included ability factors(the family caregivers'own aging and disease limitations,and the family caregivers'medication safety management ability is insufficient),opportunity factors(the excessive physical and mental independence of the patients,the multiple role conflict of the family caregivers).Conclusion There are some facilitators and barriers in the process of family participation in medication safety of elderly patients with multi-morbidity.Medical staff should attach importance to family participation experience,adopt targeted strategies to promote family participation in medication safety of elderly patients with multi-morbidity,so as to promote disease recovery.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To explore the influencing factors of family participation in medication safety of aged patients with multi-morbidity,and to provide references for clinical practice.Methods Based on capability,opportunity and motivation-behavior model,17 family caregivers of aged patients with multi-morbidity at 8 communities of Zhengzhou,Henan Province from September to November 2024 were selected for semi-structured interviews using purposive sampling method.The data were analyzed using directed content analysis.Results Facilitators of family participation behavior included ability factors(strong self-reflection and emotional regulation ability),opportunity factors(family and peer support,professional support from medical staff),motivational factors(par-ticipation in medication safety importance perception,high level of participation self-efficacy,strong sense of responsibility).Barriers of family participation behavior included ability factors(the family caregivers'own aging and disease limitations,and the family caregivers'medication safety management ability is insufficient),opportunity factors(the excessive physical and mental independence of the patients,the multiple role conflict of the family caregivers).Conclusion There are some facilitators and barriers in the process of family participation in medication safety of elderly patients with multi-morbidity.Medical staff should attach importance to family participation experience,adopt targeted strategies to promote family participation in medication safety of elderly patients with multi-morbidity,so as to promote disease recovery.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

OBJECTIVE To systematically evaluate the risk factors for ineffective eradication therapy of adult Helicobacter pylori(Hp)infection.METHODS Retrieved from PubMed,Web of Science,the Cochrane Library,Embase,CNKI,VIP and Wanfang Data,cohort studies and case-control studies on the eradication therapy for Hp infection in adult patients were searched from Jan.2000 to Jul.2024.After screening literature,extracting data,and evaluating the quality of literature,RevMan 5.3 software was used for meta-analysis,and sensitivity analysis and publication bias analysis were also performed.RESULTS A total of 19 articles were included,all of which were cohort studies,involving 9 931 patients in total.Among them,1 929 patients were ineffective in eradication therapy,with the ineffective rates ranging from 8.02%to 33.33%.Meta-analysis showed that age＜50 years[OR=1.33,95%CI(1.12,1.57),P＜0.001],body mass index(BMI)＞25 kg/m2[OR=1.87,95%CI(1.35,2.59),P=0.000 2],a history of smoking[OR=1.62,95%CI(1.35,1.95),P＜0.001],a history of drinking[OR=1.93,95%CI(1.47,2.54),P＜0.001],living in a rural area[OR=1.74,95%CI(1.41,2.15),P＜0.001],having non-peptic ulcer[OR=3.45,95%CI(1.75,6.67),P=0.000 3],a family members'infection history[OR=4.72,95%CI(3.32,6.74),P＜0.001],poor treatment compliance[OR=4.89,95%CI(3.07,7.79),P＜0.001],amoxicillin resistance[OR=3.42,95%CI(1.95,6.00),P＜0.001]and clarithromycin resistance[OR=8.14,95%CI(5.00,13.24),P＜0.001]had significant impacts on ineffective eradication therapy of Hp infection in adults.Sensitivity analysis and publication bias analysis showed that the result of this study was robust and reliable.CONCLUSIONS Age＜50 years,BMI＞25 kg/m2,a history of smoking,a history of drinking,living in a rural area,having non-peptic ulcer,a family members'infection history,poor treatment compliance,amoxicillin resistance and clarithromycin resistance are risk factors for failure of Hp infection eradication therapy in adults.

To improve the current situation of multiple preoperative visits and evaluations for elderly patients and other patients with complex conditions, in December 2022, Peking Union Medical College Hospital established preoperative multidisciplinary evaluation clinic (shorted as joint clinic). The joint clinic established a multidisciplinary team, clarified service targets, and developed standardized clinic workflows to provide patients with a " one-stop" preoperative assessment(physical fitness assessment, nutritional assessment, and frailty assessment, etc.), nutritional optimization intervention, and prerehabilitation education and guidance services. This practice strengthened preoperative risk management, improved preoperative assessment efficiency, and ensured the safety of patients during the perioperative period. As of September 2023, the joint clinic had received a total of 128 patients, of which 86 underwent surgery after preoperative evaluation and prehabilitation optimization. The obesity rate, smoking rate, and number of frailty cases of these patients had decreased from 13.96%, 11.63%, and 18 at the time of visit to 9.30%, 4.65%, and 14 on the day before surgery, respectively. They had recovered well after surgery. This practice had improved the preoperative status of patients and created conditions for high-risk patients to undergo surgery smoothly, so as to provide references for other hospitals to carry out multidisciplinary collaborative preoperative evaluation works.

Objective:To construct a scientific and reasonable early warning evaluation index system for high-risk pregnancy during childbirth, so as to provide a content framework for the establishment of an information management platform.Methods:Convenience sampling was used to select 15 experts from 2 colleges and universities, 5 ClassⅢ Grade A general hospitals and 2 ClassⅢ Grade A maternal and child health hospitals in Henan Province as the subject of consultation. The early warning evaluation indicators of high-risk pregnancy during childbirth were determined through literature research, group discussion, and Delphi expert consultation method. Convenience sampling method was adopted to select 288 pregnant women admitted to the hospital for delivery from February to April 2020 in a ClassⅢ Grade A hospital in Henan Province as the research object. The early warning evaluation index system for high-risk pregnancy during childbirth was used to evaluate pregnant women.Results:The final early warning evaluation index system for high-risk pregnancy during childbirth included 7 first-level indicators and 27 second-level indicators. The expert authority coefficients of the two rounds of consultation were 0.91 and 0.93, respectively, and the Kendall harmony coefficients were 0.241 and 0.385, respectively ( P<0.001) . The area under the ROC curve predicted by the early warning evaluation index system for high-risk pregnancy during childbirth was> 0.85, and the best cut-off point was 9.98. Conclusions:The constructed early warning evaluation index system for high-risk pregnancy during childbirth has comprehensive content and high reliability, which will help midwives to identify high-risk pregnancy during childbirth.

The rapid development of aging has brought new challenges to the elderly nursing service.Traditional nursing education is difficult to meet the needs of elderly nursing personnel cultivation.The training experience of other countries will provide a reference for the training of elderly nursing talents in China,so as to meet the needs of the society.This paper analyzes the current status of the geriatric nursing personnel cultivation in the United States from three aspects:the elderly nursing education in the United States,the training of the senior practice nurses and the training of the elderly nursing teachers,and according to the national conditions of our country,it is pointed out that the training of elderly nursing personnel should pay attention to curriculum setting to cultivate senior nursing professionals,pay attention to professional qualification certification and train advanced specialist nurses in geriatric nursing,pay attention to evidence-based practice and train characteristic TCM nurses in geriatric nursing,pay attention to teachers' leadership and cultivate high-level talents especially elites in geriatric nursing.

Objective To evaluate the effects of mindfulness-based stress reduction(MBSR) on fatigue and sleep quality for breast cancer patients undergoing chemotherapy. Methods Totally 96 patients with breast cancer under-going chemotherapy were assigned into the intervention group and the control group with 48 cases in each group from a tertiary hospital in Zhengzhou city. Both groups received routine care,and the intervention group also received 8 weeks of MBSR. The Revised Piper Fatigue Scale(PFS-R) and Pittsburgh Sleep Quality Index(PSQI) were used to assess fatigue and sleep quality of two groups during chemotherapy before the intervention(T1),after the interven-tion(T2) and 3 months after the intervention (T3). Results There were significant differences in sensory,behav-ioral,emotional and total fatigue scores between the two groups(P<0.05);the time effect on fatigue of the various dimensions scores and total fatigue scores was significant(P<0.05);sensory aspects,emotional aspects,behavioral aspects,and total fatigue scores were interfered between intervention and time factors(P<0.05). There were signifi-cant differences in sleep quality,fall sleep time,sleep time,sleep efficiency and sleep scores between the two groups(P<0.05);the time effect on sleep quality,sleep time, fall sleep time was significant(P<0.05);there were interac-tion effects between intervention and time on sleep quality,sleep time,sleep disturbance and sleep total score(P<0.05). Conclusion MBSR can effectively relieve fatigue and improve sleep quality for breast cancer patients undergoing chemotherapy.