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.

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 investigate the effects of cinnamic aldehyde(CA)on Bcl-2-associated X protein(Bax)and Bcl-2 homologous antagonist/killer(Bak)in vascular endothelial cells of diabetic ulcer wound tissues,as well as on cell apoptosis.Methods ① Forty-eight healthy SPF-grade male SD rats(5 weeks old,weighing 180～220 g)were randomly assigned to a control group(12 rats)and a diabetes group(36 rats).The diabetic model was established with an intraperitoneal injection of 50 mg/kg STZ-citrate sodium solution and high-fat diet feeding.The diabetes group was further randomly divided into Model group,CA group,and the rb-bFGF group,with 12 animals in each group.Wounds in the Con and Model groups were disinfected and topically treated with normal saline,CA group received topical application of 4 μmol/L CA in PEG 400 gel,and those of the rb-bFGF group were treated with bevacizumab gel.The wound healing rate of each group was calculated at 3,7 and 14 d after intervention.At 14 d after intervention,pathological changes in the wounds were observed with HE staining,and the expression levels of Bax and Bak were detected by Western blotting.② Human umbilical vein endothelial cell line EA.hy926 was treated with 175 mmol/L glucose for 48 h to establish a cell model of high glucose injury.The experimental cells were divided into control group,model group and CA treatment group.Cell scratch test and tube formation test were performed respectively to determine the migration ability and angiogenesis of the cells.The expression levels of Bax and Bak was detected with immunofluorescence assay,and cell apoptosis was detected by TUNEL staining.Results ①The diabetic rats in the Model group exhibited significantly higher blood glucose level(P<0.05),declined wound healing rate at 7 and 14 d after intervention(P<0.05),and enhanced expression levels of Bax and Bak(P<0.05)when compared with the control group.Pathological observation revealed that,at 14 d after intervention,accompanied with inflammatory reactions,dense infiltration of inflammatory cells,fewer new blood vessels,and continuous fluid exudation in the wound were observed in the Model group,but the control group presented complete epithelialization in full-thickness skin.Compared with the conditions in the Model group,both CA and rb-bFGF treatment improved the epithelialization process,with mature granulation tissues,showing good healing condition,promoted wound healing rate(P<0.05),and decreased the expression levels of Bax and Bak(P<0.05).② The results of cell experiments showed that the cells of the model group showed significantly reduced migration ability and tube formation ability(P<0.05),reduced protein levels of Bax and Bak(P<0.05),and lower apoptotic rate(P<0.05)when compared with the cells in the model group.Conclusion CA can inhibit the expression of apoptosis-related proteins Bax and Bak,promote the migration and tube formation of vascular endothelial cells,and inhibit the cell apoptosis under high glucose condition,which may be an important reason for its promoting wound healing in diabetic ulcer rats.

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 explore and analyze the application of smoking cessation intervention based on timing theory in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with tobacco dependence.Methods:A total of 120 elderly patients with COPD combined with tobacco dependence who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to March 2021 were selected by the convenient sampling method. They were divided the control group and the observation group according to the random number table method, with 60 cases in each group. The control group was given routine intervention, while the observation group was given smoking cessation intervention based on timing theory. The smoking cessation rate, nicotine dependence degree, clinical symptom score and lung function recovery were compared between the two groups.Results:Three months after discharge, the nicotine dependence degree of observation group was lower than that of control group, and the difference was statistically significant ( P<0.05). The smoking cessation rates of 1, 2 and 3 months after discharge in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05). Three months after discharge, PEF of observation group was higher than that of control group, and the difference was statistically significant ( P<0.05). The clinical symptom score of the observation group at 3 months after discharge was lower than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The application of smoking cessation intervention based on timing theory in elderly patients with COPD complicated with tobacco dependence can improve the smoking cessation rate, reduce the degree of nicotine dependence of patients and effectively alleviate COPD related clinical symptoms.

Objective:To observe the application value of virtual cognitive rehabilitation training in patients with mild cognitive impairment induced by transcatheter arterial chemoembolization (TACE) of liver neoplasms.Methods:By the convenience sampling method, a total of 126 liver neoplasms patients with mild cognitive impairment induced by TACE who were admitted and treated in the First Affiliated Hospital of Zhengzhou University from May 2015 to May 2019 were selected. They were randomly divided into the observation group and the control group, with 63 cases in each group. The control group was given routine cognitive intervention while the observation group was given virtual cognitive rehabilitation training, and the intervention lasted for 2 months. Montreal Cognitive Assessment Scale (MoCA) , Activities of Daily Living (ADL) Scale and Chinese version of Strategies Used by People to Promote Health (SUPPH) Scale were used to evaluate the cognitive function, ability of daily living and self-efficacy level of patients before and after intervention between two groups.Results:There was no statistically significant difference in MoCA, ADL, and SUPPH scale scores of patients between the two groups before the intervention ( P> 0.05) . After 2 months of intervention, the total score of the MoCA Scale (21.70 ± 5.27) and the total score of the SUPPH Scale (88.23 ± 21.43) in the observation group were higher than those in the control group, and the differences were statistically significant ( t=2.949, 4.509; P<0.05) . After intervention, the score of the ADL Scale in the observation group was (16.03±3.11) and that in the control group was (18.06±2.97) , and the difference was statistically significant ( t=3.747, P<0.05) . Conclusions:Virtual cognitive rehabilitation training can improve the cognitive function of liver neoplasms patients with mild cognitive impairment caused by TACE and improve the activity of daily living and self-efficacy.

Objective? To explore the effects of psychological flexibility intervention on the symptoms and self-management efficacy of patients after hepatic arterial infusion chemoembolization. Methods? By convenient sampling, a total of 90 patients with hepatocellular carcinoma who had undergone hepatic arterial transcatheter chemoembolization in the First Affiliated Hospital of Zhengzhou University from January to February 2018 were selected. By random number table method, they were divided into the observation group and the control group, with 45 participants in each group. The control group received routine nursing intervention, and the observation group received psychological flexibility intervention, both for 2 weeks. Before and after the intervention, the Memorial Symptom Assessment Scale (MSAS) and the Chinese version of the Strategies Used People to Promote Health (SUPPH) were used to assess the symptomatic distress and self-management efficacy of the two groups in order to evaluate the effects of the intervention. Results? There were no significant statistical differences in the average scores of physical symptoms, psychological symptoms, distressed index, and main clauses of MSAS before intervention between the two groups(P＞0.05). After intervention, the physical symptoms of the patients in both groups had no statistical difference compared with those pre-intervention (P＞0.05), while the average scores of psychological symptoms, distress index, main clauses of MSAS were all lower than those pre-intervention with statistical significance (P＜0.05). In the observation group, the average scores of psychological symptoms, distress index, and main clauses of MSAS were lower than the control group after intervention with statistical significance (P＜ 0.01). Before intervention, the total score of SUPPH and the score from each dimension in the scale between two groups had no statistical difference (P＞ 0.05). After intervention, the total score of SUPPH and the scores from each dimension increased with statistical significance (P＜0.05) while no statistical significance was found in the control group (P＞0.05). The total score of SUPPH and the scores from each dimension were all higher than the control group with statistical significance (P＜0.01). Conclusions? The psychological flexibility intervention can effectively reduce the patients' psychological distress after chemoembolization, and promote their self-management efficiency,therefore is worth promoting in the clinical practice.