Digital health technologies (DHT) not only enhance patient engagement in healthcare but also enable personalized treatment and care services, empowering patients to manage their own health well. This paper reviews the composition and characteristics of digital vulnerable groups, as well as the current application status, influencing factors, intervention measures, and insights of DHT in their care. This paper aims to provide theoretical and practical references for enhancing the quality of DHT care for digital vulnerable groups, thereby promoting targeted and effective development of DHT within the nursing field.

Objective:To deeply understand the psychological experiences and needs of ward nurses caring for elderly patients with postoperative delirium, providing insights for improving their care capabilities.Methods:A descriptive qualitative study was conducted using purposive sampling to select nurses from the surgical wards of the Second Affiliated Hospital of Zhejiang University School of Medicine who had cared for elderly patients with postoperative delirium between January and March 2024. Semi-structured interviews were conducted, and traditional content analysis was used to extract themes.Results:Sixteen surgical ward nurses, aged 26-48 years old and all female, were interviewed. Four themes and nine sub-themes were identified: internal stress in caring for elderly patients with postoperative delirium (concerns about failing to recognize changes in condition, leading to delayed treatment; physical and psychological stress overwhelming nursing work); external challenges in caring for elderly patients with postoperative delirium (uncontrollable patient behavior; lack of close collaboration between medical staff; lack of awareness among patient families about postoperative delirium); lack of knowledge about postoperative delirium (difficulty in identifying subtypes of postoperative delirium; lack of knowledge about postoperative delirium management); and a desire for systematic professional support (urgent need for operational guidelines on postoperative delirium management in elderly patients; expectation for the establishment of a multidisciplinary team for postoperative delirium management in elderly patients).Conclusions:Nursing managers should pay attention to the physical and mental health of ward nurses, provide multifaceted support, strengthen their knowledge about postoperative delirium in elderly patients, optimize postoperative delirium management, and improve their care capabilities.

Objective:To construct the symptom network of patients after hepatectomy, analyze the core symptoms and bridge symptoms in the network, and provide evidence for symptom management of patients after hepatectomy.Methods:A cross-sectional study was conducted to select the patients after hepatectomy in the Second Affiliated Hospital of Zhejiang University from January to July 2024 by convenient sampling method. M.D. Anderson Sympotom Inventory and the Symptom Module Specific to Primary Liver Cancer were used to investigate the composition of symptoms. Symptom clusters were extracted by exploratory factor analysis, and simultaneous network layout was constructed by R language to describe the relationship between symptoms and analyze the central indicators.Results:A total of 228 questionnaires were distributed and 220 valid questionnaires were collected. There were 174 males and 46 females, aged (60.31 ± 10.69) years old. The four symptom groups were neuroaffective symptom group, gastrointestinal symptom group, fatigue-related symptom group and pain-related symptom group, and the cumulative variance contribution rate was 54.592%.In the concurrent symptom network analysis, distress was the core symptom of node centrality index, and the top 3 bridge symptoms were pain (r bs=2.40), decreased appetite (r bs=2.10) and nausea (r bs=2.00), the correlation stability coefficients of network strength centrality, compact centrality and expected influence values were 0.595, 0.595 and 0.673, the symptom group network was stable. Conclusions:Distress is the core symptom of patients after hepatectomy, and pain, decreased appetite and nausea are bridge symptoms. It is recommended that medical staff construct intervention programs based on core symptoms and bridge symptoms, implement precise symptom management, and improve the outcome of symptom management of patients.

Objective:To deeply understand the psychological experiences and needs of ward nurses caring for elderly patients with postoperative delirium, providing insights for improving their care capabilities.Methods:A descriptive qualitative study was conducted using purposive sampling to select nurses from the surgical wards of the Second Affiliated Hospital of Zhejiang University School of Medicine who had cared for elderly patients with postoperative delirium between January and March 2024. Semi-structured interviews were conducted, and traditional content analysis was used to extract themes.Results:Sixteen surgical ward nurses, aged 26-48 years old and all female, were interviewed. Four themes and nine sub-themes were identified: internal stress in caring for elderly patients with postoperative delirium (concerns about failing to recognize changes in condition, leading to delayed treatment; physical and psychological stress overwhelming nursing work); external challenges in caring for elderly patients with postoperative delirium (uncontrollable patient behavior; lack of close collaboration between medical staff; lack of awareness among patient families about postoperative delirium); lack of knowledge about postoperative delirium (difficulty in identifying subtypes of postoperative delirium; lack of knowledge about postoperative delirium management); and a desire for systematic professional support (urgent need for operational guidelines on postoperative delirium management in elderly patients; expectation for the establishment of a multidisciplinary team for postoperative delirium management in elderly patients).Conclusions:Nursing managers should pay attention to the physical and mental health of ward nurses, provide multifaceted support, strengthen their knowledge about postoperative delirium in elderly patients, optimize postoperative delirium management, and improve their care capabilities.

Objective:To construct the symptom network of patients after hepatectomy, analyze the core symptoms and bridge symptoms in the network, and provide evidence for symptom management of patients after hepatectomy.Methods:A cross-sectional study was conducted to select the patients after hepatectomy in the Second Affiliated Hospital of Zhejiang University from January to July 2024 by convenient sampling method. M.D. Anderson Sympotom Inventory and the Symptom Module Specific to Primary Liver Cancer were used to investigate the composition of symptoms. Symptom clusters were extracted by exploratory factor analysis, and simultaneous network layout was constructed by R language to describe the relationship between symptoms and analyze the central indicators.Results:A total of 228 questionnaires were distributed and 220 valid questionnaires were collected. There were 174 males and 46 females, aged (60.31 ± 10.69) years old. The four symptom groups were neuroaffective symptom group, gastrointestinal symptom group, fatigue-related symptom group and pain-related symptom group, and the cumulative variance contribution rate was 54.592%.In the concurrent symptom network analysis, distress was the core symptom of node centrality index, and the top 3 bridge symptoms were pain (r bs=2.40), decreased appetite (r bs=2.10) and nausea (r bs=2.00), the correlation stability coefficients of network strength centrality, compact centrality and expected influence values were 0.595, 0.595 and 0.673, the symptom group network was stable. Conclusions:Distress is the core symptom of patients after hepatectomy, and pain, decreased appetite and nausea are bridge symptoms. It is recommended that medical staff construct intervention programs based on core symptoms and bridge symptoms, implement precise symptom management, and improve the outcome of symptom management of patients.

Digital health technologies (DHT) not only enhance patient engagement in healthcare but also enable personalized treatment and care services, empowering patients to manage their own health well. This paper reviews the composition and characteristics of digital vulnerable groups, as well as the current application status, influencing factors, intervention measures, and insights of DHT in their care. This paper aims to provide theoretical and practical references for enhancing the quality of DHT care for digital vulnerable groups, thereby promoting targeted and effective development of DHT within the nursing field.

Glaucoma is one of the most common optic neuropathies, featuring progressive retinal ganglion cell damage and visual field loss (Tham et al., 2014; Xu et al., 2020). Currently, the only effective treatment for this condition is the reduction of intraocular pressure (IOP) (Palmberg, 2001; Heijl et al., 2002). Canaloplasty is a proven bleb-independent surgery with good efficacy and safety profiles in primary open-angle glaucoma (POAG) (Gołaszewska et al., 2021). However, early transient postoperative IOP elevation has been reported in up to 30% of cases (Riva et al., 2019), similar to that commonly observed in other internal drainage glaucoma surgeries such as implantation using iStent (0%-21.0%), CyPass (10.8%), and Hydrus (4.8%-6.5%) (Lavia et al., 2017). This complication may be a predictor of poor reserve in the outflow system and is potentially associated with surgical failure. Nonetheless, the exact pathophysiology of glaucoma remains unknown, and studies clarifying the risk factors for postoperative IOP elevation have been scarce.
Humans ; Intraocular Pressure ; Glaucoma, Open-Angle/surgery* ; Incidence ; Treatment Outcome ; Risk Factors

From 1951 to 1980, stroke was the main cause of disability and death among middle-aged and elderly residents in Japan. Its mortality once stood in the first place among all the developed countries, with the mortality of hemorrhagic stroke significantly higher than that of the western countries. In 1965, the mortality of stroke in Japan reached a peak of 175.8 per 100 000. Since then, it began to decline rapidly with a range of 5%-7%, and dropped to 139.5 per 100 000 in 1980, and from the top cause of death to the third place. By 2010, the mortality had dropped to 97.7 per 100 000. The significant decline in stroke morbidity and mortality in Japan is mainly attributed to controlling important risk factors and the public health service system's improvement. Setting up related policies and regulations to ensure comprehensive interventions and using the existing monitoring systems and surveys to assess interventions' effectiveness also contributes. Given the similarities of epidemiological characteristics and risk factors on stroke in Japan and China, strategies and measures adopted in Japan will have certain positive significance for China.

Objective:To early identify and manage secondary malposition of peripherally inserted central catheter (PICC), and to reduce other PICC related complications.Methods:A total of 8 509 patients were included form January 2017 to December 2018 in intravenous therapy department in the Second Affiliated Hospital of Medical College of Zhejiang University. PICC was implanted and the original tip location was in the superior vena cava (SVC). The function and complications of the catheter were evaluated during the indwelling process. X-ray was taken for every abnormal patient to confirm the route and tip position of the catheter. Tip malposition were adjusted by external manipulation (pulling out part of the catheter, changing body position, external percussion, rapid flushing with 0.9% sodium chloride) when patients’ situation were allowed.Results:A total of 31 cases of PICC secondary malposition were early identified, 27 of them were treated with external manual reduction. Totally 19 cases succeeded, and 8 cases failed. The success rate was 70.4%. There was no other complication during the process. 3 cases were found venous thrombosis, and 1 case was unable to do external manipulation due to his poor situation.Conclusion:X-ray is a simple and easy method to identify secondary malposition of PICC. Using external manipulation to adjust the tip position back to SVC is effective, and the complications are few, which is worthy of clinical application.