Renal transplant recipients have a high rate of unplanned readmission, which will seriously affect the quality of life of recipients and their families, increase medical costs and the medical burden. Unplanned readmission of renal transplant recipients is the result of multiple factors, which is difficult to be well intervened by a single measure. This article reviews the status quo, related reasons, influencing factors and interventions of unplanned readmission of renal transplant recipients for reference in clinical practice.

Objective:To investigate the current situation of perioperative nursing quality and nursing human resource allocation in 82 hospitals in Shanghai and analyze the correlation between them.Methods:The convenient sampling method was used to select surgical wards in 82 secondary and tertiary hospitals in Shanghai that underwent nursing quality supervision in September 2022 as the research objects. Perioperative nursing quality data (patients' condition, perioperative nursing routine and operation process, etc.) and nursing human resource allocation data (bed-to-nurse ratio, nurse-to-patient ratio, etc.) of inpatients in 82 hospitals were collected from the platform of Shanghai Nursing Quality Control Center. Pearson correlation analysis was used to investigate the correlation between perioperative nursing quality and nursing human resource allocation in inpatients.Results:The standard-reaching rate of perioperative nursing quality in 82 hospitals in Shanghai is 56.1% (46/82). The overall standard-reaching rate of perioperative nursing quality in secondary hospitals is 30.4% (7/23), which was lower than 66.1% (39/59) of tertiary hospitals, and the difference was statistically significant ( P<0.05). The total score of perioperative nursing quality in 82 hospitals was (79.67±1.89), among which the item with the lowest score was "perioperative complication predictive nursing", followed by "perioperative nursing routine and operation process" and "patient safety risk assessment". The bed-to-nurse ratio of surgical wards in 82 hospitals was 1∶ (0.47±0.21) and the nurse-to-patient ratio was 1∶ (12.20±6.44). The proportion of nurses with bachelor degree or above was (68±11) %, the proportion of nurses with intermediate title or above was (38±7) %, and the proportion of nurses with 5 years of work experience or above was (52±8) %. The total level of perioperative nursing quality was negatively correlated with the nurse-patient ratio ( r=-0.367, P<0.01), and positively correlated with the bed-to-nurse ratio, the proportion of nurses with bachelor's degree or above, the proportion of nurses with intermediate professional title or above, and the proportion of nurses with 5 years of work experience or above ( r=0.506, 0.631, 0.552, 0.636; P<0.01) . Conclusions:The overall level of perioperative nursing quality in 82 hospitals in Shanghai is average, and it is positively correlated with bed-to-nurse ratio and negatively correlated with nurse-to-patient ratio. Hospital managers should improve the scientific and refined level of perioperative nursing management, improve the perioperative nursing risk control mechanism, refine the perioperative nursing operation process, construct the risk forecasting, early-warning and pre-control mode of surgical complications and optimize the nursing human resource structure, so as to promote the high-quality development of perioperative nursing.

Objective:To systematically review and synthesize qualitative researches on self-management experience of home-based rehabilitation for patients with chronic diseases and focus on obstacles and promoting factors in the process of home self-management, so as to provide evidence for construction of self-management system of home rehabilitation for chronic diseases.Methods:Cochrane Library, Embase, Medline, PsycINFO, Scopus, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI) , Wanfang Database, VIP and China Biology Medicine disc (CBMdisc) were searched by computer to collect qualitative studies related to self-management experience of home rehabilitation for patients with chronic diseases. The retrieval time was from construction of the database to May 31, 2020. The quality evaluation was carried out using quality evaluation standard for qualitative research (2016) in Australian Joanna Briggs Institute (JBI) Evidence-Based Health Care Center, and the Meta synthesis was carried out using integrative synthesis method.Results:A total of 23 researches were included and 82 results were extracted. Those researches were included into 9 classifications and were synthesized into 4 integrated results, including multiple stresses in home-based rehabilitation self-management of chronic disease, inadequate supportive resources related to home-based rehabilitation self-management of chronic disease, home-based rehabilitation self-management level of patients with chronic diseases to be further improved and positive experience of home self-management of patients with chronic diseases.Conclusions:Home-based rehabilitation for patients with chronic diseases face multiple obstacles in the process of self-management. Nursing staff should efficiently integrate the available home-based rehabilitation self-management medical resources in the area, accurately connect home-based rehabilitation self-management needs of patients and early identify potential risks in home-based rehabilitation self-management process, so as to improve their home self-management effect.

ObjectiveTo investigate the clinical features of liver function and coagulation function in patients with Alongshan virus (ALSV) infection. MethodsClinical data were collected from 27 patients with ALSV infection who were admitted to Inner Mongolia General Forestry Hospital from May 2018 to September 2019, among whom there were 18 male patients and 9 female patients. Related data were extracted, and a database of relevant case reports was established. The descriptive epidemiological method was used to analyze the clinical features of liver function and coagulation markers, and the features of liver injury caused by ALSV infection were analyzed. ResultsFor the 27 patients, the abnormal rates of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), cholinesterase, and total bile acid were 25.9%, 33.3%, 25.9%, 40.7%, 8%, and 8%, respectively; among the 27 patients, 4 (14.8%) had an ALT level of ＞2×upper limit of normal (ULN), 3 (11.1%) had an AST level of ＞2×ULN, 1 (3.7%) had an ALP level of ＞2×ULN, and 5 (18.5%) had a GGT level of ＞2×ULN. Among the 27 patients, 25 (17 male patients and 8 female patients) had the results of bilirubin test, among whom 1 had a reduction in total bilirubin (TBil) (3.30 μmol/L) and 3 had an increase in TBil (23.7 μmol/L, 26.2 μmol/L, and 32 μmol/L, respectively). The abnormal rates of the coagulation markers international normalized ratio, activated partial thromboplastin time, and fibrinogen were 3.7%, 11.1%, and 22.2%, respectively. ConclusionThere is a certain degree of liver injury in patients with ALSV infection, generally with mild symptoms.

Objective:To explore the effect of positive group psychological counselling on self-efficacy and stigma of patients with ulcerative colitis so as to provide a basis for clinical intervention.Methods:By the convenient sampling method, a total of 100 patients with ulcerative colitis who were hospitalized in the First Affiliated Hospital of Xinxiang Medical University from July 2018 to June 2019 were selected as research subjects. According to the random number table method, they were divided into the control group ( n=50) and the observation group ( n=50) . The control group was given routine nursing while the observation group was given positive group psychological counselling. Inflammatory Bowel Disease Self-Efficacy Scale (IBD-SES) and Social Impact Scale (SIS) were used to evaluate the effect of the intervention. Results:After intervention, scores of stress and emotion management, medical care management, disease management and maintenance management during remission period in the IBD-SES between the two groups had statistically significant differences ( P<0.05) . There was statistically significant difference in the score of social isolation dimension in SIS between the two groups after intervention ( P<0.05) . There were no statistically significant differences in the scores of social exclusion, economic discrimination and intrinsic shame ( P>0.05) . Conclusions:Positive group psychological counselling can improve the self-efficacy of patients with ulcerative colitis, but the effect on the stigma needs further large samples and long-term research.

Objective:To understand the expectations and needs of patients with chronic diseases for the home rehabilitation resource integration and analyze the available resources and integration methods of chronic disease home rehabilitation projects so as to provide a reference for establishing a complete chronic disease home rehabilitation service system.Methods:The research adopted the phenomenological research method in qualitative research. From October to December 2019, the purpose sampling was used to select 16 chronic disease patients with home rehabilitation who were followed up by the Chronic Disease Management Center of a comprehensive Class Ⅲ Grade A hospital in Shanghai for semi-structured in-depth interviews. The Colaizzi 7-step analysis method was used to organize the interview results and refine the theme.Results:A total of 4 themes of the expectations and needs of patients with chronic diseases for the home rehabilitation resource integration were extracted including that the effective resource for home rehabilitation of chronic diseases was limited; the level of home rehabilitation of chronic diseases needed to be improved; resources related to home rehabilitation of chronic diseases were obviously fragmented; the government and primary medical institutions should strengthen the importance of home rehabilitation of chronic diseases.Conclusions:At present, patients with chronic diseases have high expectations and needs for the home rehabilitation resource integration. The medical resources available in the region should be effectively integrated, and a resource sharing platform should be formed to improve the home rehabilitation effect of patients with chronic diseases so as to promote the overall development of chronic disease home rehabilitation projects.

Objective? To investigate the application status of transitional care quality indicators for chronic disease in hospitals in China so as to provide a reference for improving transitional care quality evaluation for chronic disease. Methods? We selected nursing managers from 55 hospitals participating a national nursing conference in Shanghai in 2018 as subjects by convenience sampling. The self-designed hospital transitional care quality indicators questionnaire for chronic disease was used to investigate the usage condition of transitional care quality indicators for chronic disease in 55 hospitals. χ2 test was used to compare the utilization ratio of third-level indexes of transitional care of Class Ⅱand Class Ⅲ hospitals. Results? Among 55 hospitals, the highest usage of first-level indexes was structure index (0.813±0.164). The top 3 usage of second-level indexes included hospital readiness (0.932±0.047), patient satisfaction (0.927±0.262) and adverse event rate (0.888±0.143); the bottom 3 usage included health status of patients (0.470±0.112), external hospital extension (0.418±0.280) and connect inside and outside of hospital (0.309±0.149). In importance of second-level indexes, the top 3 usage included the adverse event rate, hospital readiness and material resources; the bottom 3 usage involved the utilization ratio of medical resources, connect inside and outside of hospital and external hospital extension. There were statistical differences in the usage rates of medical resource indexes in ClassⅡand ClassⅢ hospitals, such as readmission rate, visiting rate in emergency department, hospital stay and mortality (χ2=9.406, 5.430, 6.339, 6.339;P＜ 0.05). Conclusions? Among 55 hospitals of China, the transitional care quality evaluation for chronic disease is generally insufficient which is needed to be paid attention to. Hospitals needs to optimize the proportion of indexes, improve and pay more attention to the evaluation for process indicators and outcome indicators, and perfect management and monitor for transitional care.

Objective? To understand the situation of cardiac rehabilitation from Class Ⅱ and Class Ⅲ hospitals in China, so as to provide a reference for optimizing cardiac rehabilitation. Methods? In June 2018, we selected 68 nursing managers of ClassⅡ and ClassⅢ hospitals from totals of 12 provinces, autonomous regions and municipalities directly under the central government such as Shanghai, Zhejiang Province, Jilin Province, Guizhou Province and the Xinjiang Uygur Autonomous Region as subjects by convenience sampling. We investigated the basis development condition, rehabilitation content, implementation of transitional nursing of cardiac rehabilitation in those hospitals. Results? Among 68 ClassⅡ and ClassⅢ hospitals, the score of cardiac rehabilitation was (4.75±1.73) with the lower middle level as a whole. The good development of cardiac rehabilitation included the smoking cessation guidance, diet guidance and blood pressure control. The poor development of cardiac rehabilitation involved the vocational rehabilitation guidance, assessment for quality of life and mental management. The main influencing factors of development of cardiac rehabilitation were staff shortage (70.59%), lack of perfect operational mechanism (66.18%) and lack of policy support (52.94%). Conclusions? In China, the Class Ⅱ and Class Ⅲ hospitals have developed cardiac rehabilitation in succession however with many deficiencies. Hospitals should strengthen the basic construction of cardiac rehabilitation, perfect the rehabilitation content and promote the development of transitional nursing.

Objective? To investigate the status of follow-up service of discharged patients from ClassⅡ or ClassⅢ comprehensive hospitals in China. Methods? In June 2018, we selected 150 clinical departments and 228 nurses of 89 ClassⅡ or ClassⅢ comprehensive hospitals in 17 provinces, Municipality and autonomous regions by convenience sampling. The self-designed questionnaire was used to investigate the ways, contents, existing problems and suggestions of follow-up of discharged patients. Results? Follow-up service was mainly carried out by nurses including ward primary nurses and full-time nurses. Besides, the follow-up was mainly with the telephone follow-up, and its content tended to disease health education and consultation. The main existing problems of discharged patients in follow-up service were "follow-up form was too simple and lacking specialty characteristics", "follow-up way was single and follow-up effects were unsatisfactory", "human resources limits and lack of special follow-up staff", "follow-up effects lacking aggregate and analysis" and"nursing problems existing in follow-up lacking following and evaluation". Nurses suggested that "aggregate as well as feedback of follow-up data should be done regularly", "increase follow-up center unified management for discharged patients", "follow-up form should reflect specialty characteristics" and "develop multidisciplinary teamwork". Conclusions? Follow-up service has great significance for improving rehabilitation and quality of life among discharged patients. There are a lot of problems in follow-up service system for discharged patients. We should perfect the common discharged follow-up forms applied to specialties, construct multidisciplinary support platforms and make follow-up management system scientific and informative.

ObjectiveTo understand the self-acceptance among nurses at a Class Ⅲ Grade A hospital and to analyze its influencing factors so as to provide a basis for psychological health education by hospitals. MethodsIn July 2018, we selected 202 nurses at a Class Ⅲ Grade A hospital in Shanghai by convenience sampling. The general information questionnaire and Self-Acceptance Questionnaire (SAQ) were used to investigate the self-acceptance of nurses. ResultsAmong 202 nurses, the total score of self-acceptance, self-acceptance factor score and self-assessment factor score were (42.29±4.40), (22.12±3.16) and (20.19±2.82) respectively. Single factor analysis showed that there were statistical differences in self-acceptance among nurses with different departments, genders, ages, working lives, marital status, titles, posts, education levels, whether recruited with authorized strength, monthly income and times of night shift (P＜0.05). Multiple linear regression showed that the influencing factors of self-acceptance of nurses included departments, genders, ages, titles, posts, education levels and monthly income. ConclusionsAs a whole, nurses of this hospital can adopt appropriate self-acceptance. Hospital managers need to take targeted measures based on self-acceptance of nurses to carry out psychological health education to help nurses know and accept themselves so as to provide high quality nursing for patients.