Objective:To explore the dilemmas in skin management of patients undergoing bariatric metabolic surgery, so as to provide a reference for constructing a skin management program.Methods:This study was a phenomenological study. Using purposive sampling method, 18 patients who underwent bariatric metabolic surgery and had follow-up visits at Nanyang Central Hospital from March to May 2024 were selected for face-to-face semi-structured in-depth interviews. The interview data were organized and analyzed using the Colaizzi seven-step analysis of phenomenological data.Results:A total of three themes and ten sub-themes were extracted, namely, difficulties in self-coping (difficulties in coping with physical discomfort, life distress and negative emotional distress caused by skin symptoms), insufficient social support (experiencing cold violence from family members, suffering from social isolation, insufficient support from professionals, and limited information sharing), and difficulties in decision-making for weight loss and body contouring (cognitive deficits, concerns about complications, and financial difficulties) .Conclusions:Patients undergoing bariatric metabolic surgery face multiple dilemmas during skin management. Healthcare professionals should develop targeted skin management programs based on the specific problems faced by patients to increase patients' attention to skin management and their ability to self-manage and maintain their physical and mental health.

Objective:To explore the dilemmas in skin management of patients undergoing bariatric metabolic surgery, so as to provide a reference for constructing a skin management program.Methods:This study was a phenomenological study. Using purposive sampling method, 18 patients who underwent bariatric metabolic surgery and had follow-up visits at Nanyang Central Hospital from March to May 2024 were selected for face-to-face semi-structured in-depth interviews. The interview data were organized and analyzed using the Colaizzi seven-step analysis of phenomenological data.Results:A total of three themes and ten sub-themes were extracted, namely, difficulties in self-coping (difficulties in coping with physical discomfort, life distress and negative emotional distress caused by skin symptoms), insufficient social support (experiencing cold violence from family members, suffering from social isolation, insufficient support from professionals, and limited information sharing), and difficulties in decision-making for weight loss and body contouring (cognitive deficits, concerns about complications, and financial difficulties) .Conclusions:Patients undergoing bariatric metabolic surgery face multiple dilemmas during skin management. Healthcare professionals should develop targeted skin management programs based on the specific problems faced by patients to increase patients' attention to skin management and their ability to self-manage and maintain their physical and mental health.

Objective:To develop a nomogram model for predicting the risk of medication deviation in ischemic stroke patients after hospital discharge, providing insights for clinical nursing strategies.Methods:A convenience sampling method was used to select 440 ischemic stroke patients hospitalized in the Neurology Department of Nanyang Central Hospital from March 2022 to September 2023. Data on basic patient information and post-discharge medication deviation were collected using the medication deviation assessment tool eight weeks after discharge. Patients were categorized into a no medication deviation group and a medication deviation group. Univariate and binomial logistic regression analyses were conducted to identify independent risk factors for post-discharge medication deviation, and a nomogram prediction model was developed.Results:Data were successfully collected from 424 patients, with a response rate of 96.36% (424/440). The incidence of medication deviation was 58.02% (246/424). Binomial logistic regression analysis identified the absence of a fixed caregiver ( OR=2.113, P=0.001), large number of comorbid chronic diseases ( OR=1.773, P<0.001), medication non-adherence ( OR=2.443, P=0.003), and negative coping ( OR=2.255, P<0.001) as independent risk factors for medication deviation. A nomogram prediction model based on these four risk factors was constructed. The Hosmer-Lemeshow goodness-of-fit test indicated good calibration (χ 2=10.569, P=0.227), with calibration curve closely approximating the ideal line. The area under the receiver operating characteristic curve was 0.770 (95% CI: 0.584-0.866) . Conclusions:The absence of a fixed caregiver, medication non-adherence, negative coping, and large number of comorbid chronic diseases are independent risk factors for medication deviation in ischemic stroke patients. The nomogram model developed in this study demonstrates good discrimination and accuracy, providing a basis for formulating targeted nursing strategies.

Objective:To develop a nomogram model for predicting the risk of medication deviation in ischemic stroke patients after hospital discharge, providing insights for clinical nursing strategies.Methods:A convenience sampling method was used to select 440 ischemic stroke patients hospitalized in the Neurology Department of Nanyang Central Hospital from March 2022 to September 2023. Data on basic patient information and post-discharge medication deviation were collected using the medication deviation assessment tool eight weeks after discharge. Patients were categorized into a no medication deviation group and a medication deviation group. Univariate and binomial logistic regression analyses were conducted to identify independent risk factors for post-discharge medication deviation, and a nomogram prediction model was developed.Results:Data were successfully collected from 424 patients, with a response rate of 96.36% (424/440). The incidence of medication deviation was 58.02% (246/424). Binomial logistic regression analysis identified the absence of a fixed caregiver ( OR=2.113, P=0.001), large number of comorbid chronic diseases ( OR=1.773, P<0.001), medication non-adherence ( OR=2.443, P=0.003), and negative coping ( OR=2.255, P<0.001) as independent risk factors for medication deviation. A nomogram prediction model based on these four risk factors was constructed. The Hosmer-Lemeshow goodness-of-fit test indicated good calibration (χ 2=10.569, P=0.227), with calibration curve closely approximating the ideal line. The area under the receiver operating characteristic curve was 0.770 (95% CI: 0.584-0.866) . Conclusions:The absence of a fixed caregiver, medication non-adherence, negative coping, and large number of comorbid chronic diseases are independent risk factors for medication deviation in ischemic stroke patients. The nomogram model developed in this study demonstrates good discrimination and accuracy, providing a basis for formulating targeted nursing strategies.

Objective:To investigate gender measurement invariance of the Perceived Social Support Scale(PSSS)in people aged 50 years and older.Methods:A total of 1013 adults(50-96 years old)in Beijing, Hunan and Shandong were tested by using PSSS.The measurement invariance of PSSS between middle-aged and elderly males and females was analyzed.Differences in PSSS total scores and subscale scores between males and females were examined.Results:The equivalence test results of each item in the questionnaire met the requirements of the metrology(△CFI≥0.010, △TLI≥0.010, △RSMEA≤0.015), indicating that the hypotheses of morphological equivalence, weak equivalence, strong equivalence and strict equivalence of PSSS were all valid in the middle-aged and elderly population regardless of gender.In addition, middle-aged and elderly females had higher scores in family support, support from friends, support from other people and perceived social support than their male counterparts( P<0.05). Conclusions:PSSS has cross-gender equivalence in middle-aged and elderly people.Thus, differences in PSSS can reflect the perceived social support level in middle-aged and elderly people of different genders.

OBJECTIVE:To investigate the effects of application timing of carboporst tromethamine on postpartum hemor-rhage and hemodynamics of cesarean section women with centralplacenta previa. METHODS:Totally 138 parturient women with central placenta previa selected from our hospital during Jan.-Dec. 2015 were divided into observation group and control group ac-cording to random number table,with 69 cases in each group. Both groups received cesarean section. Control group was given Car-boporst tromethamine injection 250 μg on uterine body after the delivery of placenta. Observation group was given Carboporst tro-methamine injection 250 μg on corpora uteri immediately after umbilical cord cutting. The operation duration,intraoperative and postoperative blood loss were observed in 2 groups. The preoperative and postoperative 24 h hemodynamic index,coagulation func-tion and corpora uteri were compared between 2 groups. RESULTS:The operation duration of observation group was significantly shorter than control group;intraoperative blood loss and 24h blood loss of observation group were significantly less than control group,with statistical significance(P<0.05). There was no statistical significance in preoperative hemodynamic index and coagula-tion function index between 2 groups before surgery(P>0.05). 24 h after surgery,SBP,DBP,MAP,FIB and D-D of 2 groups were decreased significantly,while HR of them were increased significantly;the observation group was significantly better than the control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR (15.94% vs. 13.04%) between 2 groups (P>0.05). CONCLUSIONS:Carboporst tromethamine after omphalotomy via uterine body helps to shorten the operation time,reduce intraoperative blood loss,maintain hemodynamic indexes stable and improve coagulation func-tion of cesarean section women with central placenta previa ,with good safety.