Objective This study aimed to develop and empirically evaluate a sarcopenia management program for lung transplant candidates based on the Transtheoretical Model(TTM).The objective was to improve preopera-tive muscle condition and enhance patients' tolerance to lung transplantation.Methods Using the TTM as the the-oretical framework,the sarcopenia management program was developed through a literature review and 2 rounds of expert consultations.A convenience sampling method was employed to recruit inpatients from the lung transplant department of a tertiary hospital in Zhejiang Province between January 2022 and January 2024.Patients admitted between February 2023 and January 2024 were assigned to an intervention group,while those admitted between January 2022 and January 2023 were allocated to a control group.The intervention group received an 8-week sar-copenia management program based on the TTM in addition to standard prehabilitation care,whereas the control group received only standard prehabilitation care.Outcome measurements included pre-and post-intervention com-parisons of the modified Strength,Assistance with Walking,Rise from a Chair,Climb Stairs,Falls,and Calf Circum-ference(SARC-CalF)score,handgrip strength,6-minute walking distance(6MWD),and upper arm circumference,as well as their respective changes before and after the intervention.Additionally,stage-based behavioral change as-sessment and adverse event incidence were compared between the 2 groups.Results A total of 8 patients from the intervention group and 9 from the control group dropped out,resulting in a final sample of 32 patients in the intervention group and 31 in the control group.Compared to the control group,the intervention group demonstrated significantly greater improvements in SARC-CalF scores,handgrip strength,6MWD,and upper arm circumference(P＜0.05).After the intervention,the intervention group had a statistically significant difference in behavioral stage tran-sition compared to the control group(P＜0.05).During the intervention process,neither group experienced any ad-verse events.Conclusion The sarcopenia management program based on the TTM effectively improved patient ad-herence,enhanced preoperative muscle condition,and demonstrated potential benefits in improving physical function and nutritional status.

Objective To construct and preliminary verify a postoperative pulmonary rehabilitation nursing programme for children with double lung transplantation,aiming to promote early recovery and provide references for clinical nursing practice.Methods A convenience sampling approach was employed to select 25 cases pediatric patients who underwent bilateral lung transplantation at a tertiary teaching hospital in Hangzhou between January 2020 and September 2024,and they were divided into an experimental group and a control group according to the time of admission to the hospital.The experimental group received the newly developed post-transplant rehabilitation nursing program,which encompassed fluid management,mechanical ventilation,sequential oxygen therapy,pulmonary function training,exercise management,and process facilitation.In contrast,the control group received the standard post-lung transplantation rehabilitation protocol.Key outcomes,including mechanical ventilation duration,ICU stay,total hospitalization time,activity level,pulmonary function,incidence of adverse events and rehabilitation adherence,were compared between the 2 groups.Results Finally,24 cases completed the study,including 11 cases in the experimental group and 13 cases in the control group.After the intervention,the experimental group exhibited significantly shorter mechanical ventilation time compared to it in the control group(P=0.009).Additionally,at discharge,the intervention group demonstrated higher activity levels and better rehabilitation compliance(P＜0.05).Conclusion The pulmonary rehabilitation nursing program for children with double lung transplantation is scientifically sound,safe,and feasible.The implementation of this program is beneficial for the early discontinuation of mechanical ventilation,improving postoperative mobility,and enhancing compliance with pulmonary rehabilitation.

To summarize the nursing experience of 14 children after double lung transplantation for secondary bronchiolitis obliterans after hematopoietic stem cell transplantation(HSCT).Nursing points:to improve preoperative evaluation,actively improve the body status;to conduct the whole-process ECMO management to achieve early safe evacuation;to carry out the task feedback breathing training game to promote lung function;to implement the interest-oriented game exercise to promote muscle strength;to conduct the symptom-matched nutritional support,coping with gastrointestinal graft-host disease;to improve discharge preparation and empower primary caregivers.After careful nursing care,all of the 14 children were discharged smoothly.The follow-up result showed that the children had normal lung function and activities of daily living.

Objective To explore the current status of bone metabolism abnormalities after lung transplantation and its influencing factors,and provide scientific references for the formulation of nursing intervention measures.Methods A retrospective analysis of the clinical data of 125 patients undergoing lung transplantation at a lung transplant center from June 2021 to August 2023 was conducted.The paired sample t-test was used to compare the trends in bone mineral density(BMD)before and after transplantation.Postoperative BMD was compared to domestic age-matched norms using the single sample t-test.Univariate analysis and unordered multinomial logistic regression were employed to identify factors associated with bone metabolism abnormalities post-transplantation.Results The incidence of bone metabolism abnormalities after lung transplantation was 62.4％,with osteopenia and osteoporosis rates at 36.8％and 25.6％,respectively.The BMD of the femoral neck and left hip joint generally showed a declining trend post-transplantation(P＜0.001).Additionally,both male and female patients had lower BMD than the age-matched national norms(P＜0.001).Logistic regression analysis indicated that pre-transplant Activities of Daily Living(ADL)score was a significant factor for post-transplant osteopenia(OR 0.957,95％CI 0.928～0.987).Female gender,pre-transplant low body weight,obesity,reduced forced expiratory volume in one second/forced vital capacity percentage(FEV1/FVC),and ADL score were significant factors for post-transplant osteoporosis,with OR values of 7.181,7.521,15.465,0.960,0.964;95％CI were 1.287～40.061,2.039～27.738,1.158～206.586,0.937～0.983,0.930～0.999,respectively.Conclusion Bone metabolism abnormalities are common in patients post-lung transplantation.Healthcare providers should pay particular attention to female patients,those with low pre-transplant body weight,obesity,reduced FEV1/FVC,and lower ADL scores.Timely,individualized,and multidisciplinary interventions are crucial to slowing postoperative bone loss,reducing the incidence of bone metabolism abnormalities,and improving the health-related quality of life for these patients.

To summarize the nursing experience of 14 children after double lung transplantation for secondary bronchiolitis obliterans after hematopoietic stem cell transplantation(HSCT).Nursing points:to improve preoperative evaluation,actively improve the body status;to conduct the whole-process ECMO management to achieve early safe evacuation;to carry out the task feedback breathing training game to promote lung function;to implement the interest-oriented game exercise to promote muscle strength;to conduct the symptom-matched nutritional support,coping with gastrointestinal graft-host disease;to improve discharge preparation and empower primary caregivers.After careful nursing care,all of the 14 children were discharged smoothly.The follow-up result showed that the children had normal lung function and activities of daily living.

Objective To explore the current status of bone metabolism abnormalities after lung transplantation and its influencing factors,and provide scientific references for the formulation of nursing intervention measures.Methods A retrospective analysis of the clinical data of 125 patients undergoing lung transplantation at a lung transplant center from June 2021 to August 2023 was conducted.The paired sample t-test was used to compare the trends in bone mineral density(BMD)before and after transplantation.Postoperative BMD was compared to domestic age-matched norms using the single sample t-test.Univariate analysis and unordered multinomial logistic regression were employed to identify factors associated with bone metabolism abnormalities post-transplantation.Results The incidence of bone metabolism abnormalities after lung transplantation was 62.4％,with osteopenia and osteoporosis rates at 36.8％and 25.6％,respectively.The BMD of the femoral neck and left hip joint generally showed a declining trend post-transplantation(P＜0.001).Additionally,both male and female patients had lower BMD than the age-matched national norms(P＜0.001).Logistic regression analysis indicated that pre-transplant Activities of Daily Living(ADL)score was a significant factor for post-transplant osteopenia(OR 0.957,95％CI 0.928～0.987).Female gender,pre-transplant low body weight,obesity,reduced forced expiratory volume in one second/forced vital capacity percentage(FEV1/FVC),and ADL score were significant factors for post-transplant osteoporosis,with OR values of 7.181,7.521,15.465,0.960,0.964;95％CI were 1.287～40.061,2.039～27.738,1.158～206.586,0.937～0.983,0.930～0.999,respectively.Conclusion Bone metabolism abnormalities are common in patients post-lung transplantation.Healthcare providers should pay particular attention to female patients,those with low pre-transplant body weight,obesity,reduced FEV1/FVC,and lower ADL scores.Timely,individualized,and multidisciplinary interventions are crucial to slowing postoperative bone loss,reducing the incidence of bone metabolism abnormalities,and improving the health-related quality of life for these patients.

Objective This study aimed to develop and empirically evaluate a sarcopenia management program for lung transplant candidates based on the Transtheoretical Model(TTM).The objective was to improve preopera-tive muscle condition and enhance patients' tolerance to lung transplantation.Methods Using the TTM as the the-oretical framework,the sarcopenia management program was developed through a literature review and 2 rounds of expert consultations.A convenience sampling method was employed to recruit inpatients from the lung transplant department of a tertiary hospital in Zhejiang Province between January 2022 and January 2024.Patients admitted between February 2023 and January 2024 were assigned to an intervention group,while those admitted between January 2022 and January 2023 were allocated to a control group.The intervention group received an 8-week sar-copenia management program based on the TTM in addition to standard prehabilitation care,whereas the control group received only standard prehabilitation care.Outcome measurements included pre-and post-intervention com-parisons of the modified Strength,Assistance with Walking,Rise from a Chair,Climb Stairs,Falls,and Calf Circum-ference(SARC-CalF)score,handgrip strength,6-minute walking distance(6MWD),and upper arm circumference,as well as their respective changes before and after the intervention.Additionally,stage-based behavioral change as-sessment and adverse event incidence were compared between the 2 groups.Results A total of 8 patients from the intervention group and 9 from the control group dropped out,resulting in a final sample of 32 patients in the intervention group and 31 in the control group.Compared to the control group,the intervention group demonstrated significantly greater improvements in SARC-CalF scores,handgrip strength,6MWD,and upper arm circumference(P＜0.05).After the intervention,the intervention group had a statistically significant difference in behavioral stage tran-sition compared to the control group(P＜0.05).During the intervention process,neither group experienced any ad-verse events.Conclusion The sarcopenia management program based on the TTM effectively improved patient ad-herence,enhanced preoperative muscle condition,and demonstrated potential benefits in improving physical function and nutritional status.

Objective To construct and preliminary verify a postoperative pulmonary rehabilitation nursing programme for children with double lung transplantation,aiming to promote early recovery and provide references for clinical nursing practice.Methods A convenience sampling approach was employed to select 25 cases pediatric patients who underwent bilateral lung transplantation at a tertiary teaching hospital in Hangzhou between January 2020 and September 2024,and they were divided into an experimental group and a control group according to the time of admission to the hospital.The experimental group received the newly developed post-transplant rehabilitation nursing program,which encompassed fluid management,mechanical ventilation,sequential oxygen therapy,pulmonary function training,exercise management,and process facilitation.In contrast,the control group received the standard post-lung transplantation rehabilitation protocol.Key outcomes,including mechanical ventilation duration,ICU stay,total hospitalization time,activity level,pulmonary function,incidence of adverse events and rehabilitation adherence,were compared between the 2 groups.Results Finally,24 cases completed the study,including 11 cases in the experimental group and 13 cases in the control group.After the intervention,the experimental group exhibited significantly shorter mechanical ventilation time compared to it in the control group(P=0.009).Additionally,at discharge,the intervention group demonstrated higher activity levels and better rehabilitation compliance(P＜0.05).Conclusion The pulmonary rehabilitation nursing program for children with double lung transplantation is scientifically sound,safe,and feasible.The implementation of this program is beneficial for the early discontinuation of mechanical ventilation,improving postoperative mobility,and enhancing compliance with pulmonary rehabilitation.