Objective:To explore the clinical training needs for postgraduates with master's degree in oral nursing based on job competency, so as to provide a basis for improving the postgraduate training system and enhancing the job competency of postgraduates with master's degree in oral nursing.Methods:This study was descriptive and qualitative. From March to April 2023, purposive sampling was used to select 8 postgraduates with master's degree in oral nursing for semi-structured in-depth interviews. The targeted content analysis method was used for data sorting and analysis.Results:The clinical training needs for postgraduates with master's degree in oral nursing based on job competency were summarized into four themes and 13 sub-themes, namely self-awareness (understanding of oral nursing, understanding of postgraduates with master's degree in oral nursing, understanding of the current training model for postgraduates with master's degree in oral nursing), ability traits (self-learning ability, reform and innovation ability, interpersonal communication ability), learning motivation (self-improvement, career development, serving society), and clinical training needs (theoretical knowledge, skill operation, scientific research and innovation ability, evidence-based practice ability) .Conclusions:Universities should collaborate with hospitals to develop clinical training plans and carry out theoretical and practical education for postgraduates with master's degree in oral nursing, and pay attention to the cultivation of the research innovation and evidence-based practice abilities of postgraduates with master's degree in oral nursing, in order to help them further improve their job competency.

Objective:To analyze the current status, development trends, and gaps in studies on symptom clusters in patients with head and neck tumors using bibliometric methods.Methods:Relevant literature on symptom clusters in patients with head and neck tumors was retrieved from databases including China National Knowledge Infrastructure, WanFang data, China Biology Medicine disc, Web of Science Core Collection, PubMed, and Scopus. A visual analysis of the literature content was conducted.Results:A total of 37 studies were included. The studies primarily focused on patients with nasopharyngeal carcinoma. Symptom clusters in patients with head and neck tumors demonstrated dynamic variability. Emerging trends in this field include nutrition-related symptom clusters, symptom interventions, and the identification of core symptoms. However, current studies still exhibit limitations, such as using singular research tools and clustering methods and a lack of exploration of internal mechanisms.Conclusions:Future research should focus on improving study design through multidisciplinary collaboration, utilizing data mining techniques to systematically explore the internal mechanisms of symptom clusters in patients with head and neck tumors, identifying symptom intervention targets, and conducting high-quality intervention studies to verify the reliability and effectiveness of these targets and interventions.

Objective To investigate the related influencing factors of unplanned reoperation (UR) in patients with oral cancer.Methods A total of 160 oral cancer patients with UR who were hospitalized in the Department of Head and Neck Oncology,West China Hospital of Stomatology,Sichuan University from Janu-ary 1,2018 to December 31,2022 were selected as the study group,and another 160 patients without UR in the same period were selected as the matching group by 1:1 matching.The clinical data of the two groups were compared.The variables that met the requirements were screened.The multivariate logistic stepwise regres-sion model was further used to analyze the influencing factors of UR in oral cancer.Results UR mostly oc-curred within one day after surgery in patients with oral cancer (66.88％),mainly due to flap vascular crisis (48.13％).Compared with the matched group,the hospitalization time of the study group was prolonged,the hospitalization cost was increased,and the differences were statistically significant (P<0.05).Multivariate lo-gistic stepwise regression analysis showed that albumin and neutrophil-lymphocyte-ratio score (ANS,OR=1.693,95％CI:1.207-2.347,P=0.002),difference in hemoglobin levels before and after surgery (OR=1.056,95％CI:1.035-1.077,P<0.001) and free tissue flap repair (OR=4.609,95％CI:2.350-9.036,P<0.001) were the influencing factors for UR in patients with oral cancer.Conclusion UR prolongs the hospi-talization time and increases the hospitalization cost of patients.High ANS,large difference in hemoglobin lev-els before and after surgery,and free tissue flap repair are independent risk factors for UR in patients with oral cancer.

Objective This study aimed to investigate the incidence and severity of surgical fear in patients with oral and maxillofacial tumors.Methods The survey participants were composed of patients with oral and maxillofacial tu-mors,who were scheduled to undergo surgery.A general information questionnaire,the Surgical Fear Questionnaire(SFQ),the Patient Health Questionnaire(PHQ)-9,and the Generalized Anxiety Disorder(GAD)-7 score were used for the investigation.Results A total of 203 patients were investigated.Among them,85.22%had fear of surgery.The me-dian score of SFQ was 20,and the quartile was(6,36).The patients were categorized into none,mild,moderate,and severe groups according fear level.Gender,diabetes,obvious discomfort before surgery,PHQ-9,and GAD-7 scores were the variables with statistical difference in each fear level.Multifactor analysis showed that women were more likely to have moderate and severe fear than men(OR=2.19,P=0.03;OR=2.72,P=0.01),patients with obvious preoperative discomfort symptoms were more inclined to have no fear(OR=4.73,P=0.02),and patients with diabetes were more likely to have severe fear(OR=3.33,P=0.02).The incidence rates of depression and anxiety were 31.03%and 24.63%,respectively.The incidence of anxiety and de-pression in patients with severe fear was 40.00%.Surgical fear was moderately positively correlated with anxiety(r=0.491,P<0.001)and depression(r=0.514,P<0.001).Conclusion The fear of surgery in patients with oral and maxillo-facial tumors is common and distributed in all levels.Medical staff can screen and assess patients with moderate and se-vere fear of surgery in accordance with the influencing factors and implement targeted interventions to reduce fear of sur-gery,anxiety,and depression on the basis of the source of fear.

Objective This study aimed to explore the risk factors of postoperative hypokalemia in patients with oral cancer and to provide a basis for preventing and controlling postoperative hypokalemia.Methods We included 366 pa-tients undergoing oral cancer surgery in the Department of Head and Neck Oncology,West China Hospital of Stomatolo-gy,Sichuan University from January 2022 to August 2022.Univariate and multivariate analyses were used to determine the risk factors of postoperative hypokalemia.The receiver operation characteristic(ROC)curve was used to quantify the effectiveness of the factors.A nomogram of the risk factors for postoperative hypokalemia in oral cancer patients was de-veloped and validated.Results A total of 224 patients(61.20％)had postoperative hypokalemia,the lowest serum po-tassium level(3.50±0.35)mmol/L on the 4th day after surgery,and the highest incidence of hypokalemia(54.68％).Vari-ables with P＜0.05 in the univariate analysis were quantified by ROC curve followed by multivariate logistic regression analysis.Results showed an independent correlation with postoperative hypokalemia as follows:preoperative se-rum potassium＜3.87 mmol/L(P=0.008),preoperative se-rum calcium＜2.31 mmol/L(P=0.033),preoperative PNI＜49.16(P=0.032),postoperative drainage volume＞264.25 mL(P=0.002).The above variables were constructed into a postoperative hypokalemia risk nomogram and verified,and a good degree of fit was found.Conclusion The indepen-dent risk factors for postoperative hypokalemia in patients with oral cancer were as follows:preoperative serum potassi-um＜3.87 mmol/L,preoperative serum calcium＜2.31 mmol/L,preoperative PNI＜49.16,and postoperative drainage vol-ume＞264.25 mL.Clinical attention should be paid to managing the above high-risk patients.Preventive potassium sup-plementation should be performed as soon as possible to reduce hypokalemia occurrence.

Objective:To explore the research status, hotspots and trends in the field of discharge readiness in the past 20 years.Methods:We searched the article on discharge readiness in the core collection of Web of Science published from January 1, 2000 to March 23, 2022. Visual analysis was implemented through CiteSpace software.Results:A total of 3 781 articles were included. The country with the largest number of publications was the United States. The author with the largest number of publications was Professor Mor of Brown University. The journal with the largest number of publications and the largest influence of literature was the Journal of Clinical Nursing. The research hotspot keywords on discharge readiness were care, outcome, mortality, frailty, skilled nursing facility, and hospital readmission. The research hotspots were nursing and geriatrics. The people concerned were the elderly and newborn. The diseases concerned were chronic diseases and surgeries. The research frontier was to reduce the incidence of postoperative complications and readmission rate of elderly patients through out-of-hospital continuous nursing services based on multidisciplinary team cooperation. Conclusions:Researchers should carry out the research of hospital-community-family out-of-hospital continuous nursing service led by nurses for elderly patients with chronic diseases based on the multidisciplinary team cooperation.

Objective:To form the expert consensus on screening and evaluation of dysphagia with oral cancer patients (abbreviated as Consensus) , so as to standardize the relevant contents of screening and evaluation of dysphagia in the whole cycle of oral cancer. Methods:By referring to domestic and foreign literature related to dysphagia, combining with the specialty characteristics of oral cancer and the clinical experience of experts, a preliminary consensus was formed through in-depth interviews with experts. A total of 21 experts were selected for three rounds of expert letter consultation and expert meeting, the corresponding items were sorted out, analyzed and modified based on expert opinions, and the Consensus was finally formed. Results:The effective recovery rates of the three rounds of correspondence were 100.00% (21/21) , the expert authority coefficient was 0.91, the variation coefficient of each item was 0.04-0.20, and Kendall's harmony coefficient was 0.05 ( P<0.05) . The final consensus included four aspects, such as the effect of oral cancer on swallowing, the clinical manifestations of dysphagia, the basic procedures of screening and evaluation and the prevention and treatment of complications during evaluation. Conclusions:This Consensus is scientific and practical, which can provide clinical guidance for the screening and evaluation of dysphagia in the whole cycle of oral cancer.

Objective:To explore the effect of aromatherapy in the management of symptom clusters of oral cancer patients at different time points during perioperative period.Methods:In the first phase of the study, 132 patients with oral cancer who were admitted to the West China Hospital of Stomatology of Sichuan University from September to December 2021 were selected as the subjects by the convenient sampling, and the symptom cluster was extracted by exploratory factor analysis. In the second phase of the study, 45 patients with oral cancer admitted to the West China Hospital of Stomatology of Sichuan University from January to March 2022 were selected as the observation group by convenient sampling. According to the matching principle of nested case-control study, 132 patients with oral cancer in the first phase of the study were matched as the control group with age, sex and other information as the matching conditions. The control group was treated with routine nursing, while the observation group was treated with aromatherapy on the basis of the control group. The severity of symptom cluster at admission, one day before operation, one day after operation, three days after operation, 7 days after operation and 30 days after operation were compared between the two groups.Results:There were 7 symptom clusters in patients with oral cancer during the perioperative period, which were rest activity, gastrointestinal activity, mental psychology, oral motor function, oral secretory function, respiratory function and neurosensory function. The mixed effect model analysis showed that there were inter-group, time and interaction effects between the two groups of patients with oral cancer in terms of the severity of gastrointestinal activity, mental psychology, and oral motor function, and the differences were statistical differences ( P<0.05). There were inter-group effects and time effects in the severity of rest activity and respiratory function, and the differences were statistically significant ( P<0.05). There were time effects in the severity of oral secretory function and neurosensory function with statistically significant differences ( P<0.05), but there were no statistically significant differences in the inter-group effect ( P>0.05) . Conclusions:Aromatherapy can improve the rest activity, mental psychology and oral motor function of patients with oral cancer. Nurses can use aromatherapy to actively intervene the symptom clusters of oral cancer patients during the perioperative period.

Objective:To explore the influencing factors of vascular crisis in the free tissue flap repair for oral and maxillofacial defects after tumor surgery through Meta-analysis.Methods:The articles on factors related to vascular crisis in the free tissue flap repair for oral and maxillofacial defects after tumor surgery were searched in Medline, Embase, the Cochrane Central Register of Controlled Trials, ProQuest, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medline disc. The search period was from the establishment of the database to August 31, 2022. Meta-analysis was conducted on the included articles using RevMan 5.3 software.Results:A total of 22 articles were included, including 6 Chinese articles and 16 English articles. There were 19 cohort studies and 3 case control studies. A total of 18 569 flaps were included, of which 976 had vascular crises. Meta-analysis showed that the influencing factors of vascular crisis in the free tissue flap repair for oral and maxillofacial defects after tumor surgery included preoperative radiotherapy [ RR=1.45, 95% CI (1.20, 1.76) ], diabetes [ RR=2.15, 95% CI (1.40, 3.31) ], anastomosing vessels with stapler [ RR=0.25, 95% CI (0.16, 0.41) ], anastomosing two vessels [ RR=0.44, 95% CI (0.21, 0.90) ] . Conclusions:The risk factors of vascular crisis in patients with oral and maxillofacial tumor defects repaired by free tissue flaps were preoperative radiotherapy and diabetes, while the use of stapler and anastomosis of two vessels were protective factors. Medical and nursing staff can identify and intervene in the vascular crisis in the free tissue flap repair for oral and maxillofacial defects after tumor surgery as early as possible based on the influencing factors.

Objective : To investigate the influencing factors of vascular crisis after oral and maxillofacial tumor free tissue flap transplantation. Methods : A retrospective analysis was performed on all patients who underwent free tissue flap transplantation and developed vascular crisis in the surgical ward of head and neck cancer in a grade A specialized hospital. Forty-six possible influencing factors were collected using 1:1 matching according to surgeons, operation time, sex and age of patients from patients without vascular crisis from 2015-2020 in this ward during the same period. SPSS 26.0 statistical software was used for univariate and multivariate logistic regression analyses of the data. Results : A total of 158 patients were enrolled, including 79 in the crisis group and 79 in the pairing group. Univariate analysis was performed for each variable. Paired logistic regression analysis showed that only postoperative blood potassium (P = 0.048, OR = 3.118, 95% CI: 1.008-9.641) and preoperative and postoperative red blood cell count differences (P = 0.004, OR = 4.53, 95% CI: 1.609-12.750) were statistically significant. Conclusion High blood potassium levels and red blood cell count differences before and after surgery were risk factors for vascular crisis.