Objective To explore the dilemma of self-management behavior maintenance in ischemic stroke patients,and to provide references for continuous self-management intervention design for ischemic stroke patients.Methods The descriptive qualitative research method was used to select samples by the purpose sampling method.From November to December 2023,18 patients hospitalised with stroke from the neurology ward of a tertiary general hospital in Luoyang City,Henan Province were selected for semi-structured interviews.Based on the Capability,Opportunity,Motivation-Behavior(COM-B)model,the data were analyzed by directed content analysis.Results A total of 3 themes and 12 sub-themes were identified,namely capability factors(poor level of health literacy,lack of self-control),opportunity factors(lack of medical resources impeding the maintenance of behaviors,social customs inducing the return of undesirable behaviors,difficult to satisfy the need for multiple emotional support,behavior being improved briefly after follow-up),and motivation factors(impulsive thinking,role conflict leading to forgetfulness,difficult to change previous bad habits,acceptance of the aging,weak self-management effect,symptoms inducing behavioral changes).Conclusion The maintenance of self-management behavior in ischemic stroke patients is affected by 3 aspects of obstacles,including capability,opportunity and motivation.On the premise of fully evaluating the specific characteristics of ischemic stroke patients,medical staff should meet the multidimensional needs of patients to promote the maintenance of self-management behaviors to improve their health outcomes.

Objective To clarify the concept of self-advocacy in the patients with chronic diseases.Methods A systematic literature search on self-advocacy in the patients with chronic diseases was conducted across various databases,including PubMed,Web of Science,EBSCO,Embase,PsycINFO,CNKI,Wanfang Data,VIP and SinoMed from the inceptions to 30th August,2023.The included literature was analysed using Rodgers'evolutionary conceptual analysis.Results A total of 48 papers were included,with 8 in Chinese and 40 in English.Self-advocacy in the patients with chronic diseases conceptually encompassed four dimensions:self-cognition,self-decision making,effective communication and strength of connection.The antecedents included demographic factors,disease factors,health literacy,psychological status and social support.The consequences affected three aspects:patients,health care systems and models of care.Conclusion The concept of self-advocacy in patients with chronic diseases has been clarified through the conceptual analysis.With this concept,researchers may conduct comprehensive and in-depth researches on the self-advocacy of patients with different chronic diseases in the light of the medical and cultural background of China.

Objective To clarify the concept of self-advocacy in the patients with chronic diseases.Methods A systematic literature search on self-advocacy in the patients with chronic diseases was conducted across various databases,including PubMed,Web of Science,EBSCO,Embase,PsycINFO,CNKI,Wanfang Data,VIP and SinoMed from the inceptions to 30th August,2023.The included literature was analysed using Rodgers'evolutionary conceptual analysis.Results A total of 48 papers were included,with 8 in Chinese and 40 in English.Self-advocacy in the patients with chronic diseases conceptually encompassed four dimensions:self-cognition,self-decision making,effective communication and strength of connection.The antecedents included demographic factors,disease factors,health literacy,psychological status and social support.The consequences affected three aspects:patients,health care systems and models of care.Conclusion The concept of self-advocacy in patients with chronic diseases has been clarified through the conceptual analysis.With this concept,researchers may conduct comprehensive and in-depth researches on the self-advocacy of patients with different chronic diseases in the light of the medical and cultural background of China.

Objective To explore the dilemma of self-management behavior maintenance in ischemic stroke patients,and to provide references for continuous self-management intervention design for ischemic stroke patients.Methods The descriptive qualitative research method was used to select samples by the purpose sampling method.From November to December 2023,18 patients hospitalised with stroke from the neurology ward of a tertiary general hospital in Luoyang City,Henan Province were selected for semi-structured interviews.Based on the Capability,Opportunity,Motivation-Behavior(COM-B)model,the data were analyzed by directed content analysis.Results A total of 3 themes and 12 sub-themes were identified,namely capability factors(poor level of health literacy,lack of self-control),opportunity factors(lack of medical resources impeding the maintenance of behaviors,social customs inducing the return of undesirable behaviors,difficult to satisfy the need for multiple emotional support,behavior being improved briefly after follow-up),and motivation factors(impulsive thinking,role conflict leading to forgetfulness,difficult to change previous bad habits,acceptance of the aging,weak self-management effect,symptoms inducing behavioral changes).Conclusion The maintenance of self-management behavior in ischemic stroke patients is affected by 3 aspects of obstacles,including capability,opportunity and motivation.On the premise of fully evaluating the specific characteristics of ischemic stroke patients,medical staff should meet the multidimensional needs of patients to promote the maintenance of self-management behaviors to improve their health outcomes.

Objective:To systematically evaluate the factors that promote and hinder exercise in patients with chronic kidney disease, and to provide reference for exercise intervention.Methods:The Cochrane Library,Web of Science, PubMed, Embase, CNKI, Wanfang, VIP and China Biomedical Literature Database were searched for qualitative researches on the promoting and hindering factors of exercise in patients with chronic kidney disease.The retrieval period was from the establishment of the database to January 2022. Qualitative Research Authenticity Evaluation Tool (version 2016) from JBI Evidence-Based Health Care Center was used to evaluate the quality of the literatures, and Meta-integration was used to analyze the results.Results:A total of 10 articles were included and 60 results were extracted, which were grouped into 8 new categories and integrated into 2 results:the promoting factors included personal exercise motivation,exercise self-efficacy stimulation,physical and psychological benefits and good social support;the hindering factors included disease and treatment factors,low exercise self-efficacy,fear of exercise risk and weak social support.Conclusions:Exercise of patients with chronic kidney disease is affected by many factors, so we should deeply understand the actual situation of patients,pay attention to the core factors affecting exercise, and improve the health of patients.

Objective:To investigate the application value of oral stimulation combined with maternal milk sucking in the pain caused by PICC in children with congenital digestive tract malformations.Methods:Using convenience sampling method, 80 children with congenital digestive tract malformations who were admitted to Hunan Children's Hospital from July 2018 to December 2019 were selected and divided into the experimental group and the control group of 40 cases in each group according to the random number table method. The control group was given routine nursing mode, while the experimental group was given oral stimulation combined with maternal milk sucking intervention on the basis of routine nursing. The intervention effects were evaluated by the Neonatal Infant Pain Scale (NIPS), the onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face, and indicators such as heart rate, respiratory rate and SpO 2. Results:The NIPS scores of children in the experimental group were (5.60 ± 1.24) and (4.10 ± 0.31) in the puncture period and the recovery period, which were significantly lower than those in the control group (6.10 ± 0.84), (4.93 ± 0.35), the differences were statistically significant (t = 2.12, 3.00, both P<0.05). The heart rate and respiratory rate of the children in the experimental group were (151.10 ± 12.37), (147.00 ± 12.16) times/min and (47.48 ± 7.59), (45.58 ± 6.51) times/min in the puncture period and the recovery period, which were significantly lower than those in the control group (159.75 ± 13.81), (156.05 ± 12.99) times/min and (52.38 ± 8.12), (49.75 ± 7.59) times/min, the differences were statistically significant (t values were 2.64-3.22, all P<0.05). The SpO 2 in the experimental group were 0.980 5 ± 0.009 0, 0.982 5 ± 0.010 8 in the puncture period and the recovery period, which were significantly higher than those in the control group 0.970 8 ± 0.014 2, 0.971 8 ± 0.018 1, the differences were statistically significant (t = 3.66, 3.23, both P<0.05). The onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face in the experimental group were (41.55 ± 6.38), (22.05 ± 4.47), (35.08 ± 5.94), (24.65 ± 5.46) s, significantly shorter than those in the control group (46.58 ± 5.26), (29.50 ± 6.48), (44.68 ± 13.31), (30.65 ± 9.42) s, the differences were statistically significant (t values were 2.63-5.98, all P<0.05). Conclusions:Oral stimulation combined with maternal milk sucking can effectively relieve the pain caused by PICC in children with congenital digestive tract malformation, and reduce the physiological stress response of children.

ObjectiveTo investigate the effects of Asari Radix et Rhizoma-Zingiberis Rhizoma herb pair （XGHP） on lung and liver lipid metabolism in rats with chronic obstructive pulmonary disease （COPD）. MethodForty SD male rats were divided into a normal group （10 rats） and a model group （30 rats）. The method of cigarette smoke + tracheal injection of lipopolysaccharide（LPS） + cold stimulation was used to replicate COPD model with the syndrome of cold phlegm obstruction in lung. A COPD group， a XGHP group （5.4 g·kg^-1·d^-1）， and an aminophylline group （0.5 g·kg^-1·d^-1） were established after successfully inducing the model， with 10 rats in each group. After treatment， the serum triglyceride （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） levels of rats in each group were measured. Gas chromatography-mass spectrometer （GC-MS） was used to detect the differential metabolites in the lung and liver tissues of rats in each group， and the relevant targets of the differential metabolites were predicted by network pharmacology. Molecular docking was used to verify the binding ability of key components in XGHP to the relevant targets in network pharmacology. The mRNA and protein expression levels of peroxisome proliferator-activated receptor α （PPARα） and fatty acid binding protein 4 （FABP4） in lung and liver tissues of rats in each group were detected by real-time polymerase chain reaction （PCR） and Western blot. ResultXGHP significantly increased the levels of TG， TC， and LDL-C in serum （P<0.05）， and decreased the level of HDL-C （P<0.05） in rats with COPD. GC-MS results showed that there were 8 lung differential metabolites and 17 liver differential metabolites in the COPD group and XGHP group. Network pharmacology predicted 59 common targets for the two differential metabolites， mainly enriched in the PPAR signaling pathway. Molecular docking results showed that the main components in XGHP were well combined with both PPARα and FABP4. Real-time PCR showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 mRNA （P<0.05）， and Western blot showed that XGHP effectively up-regulated the expression levels of PPARα and FABP4 proteins （P<0.05） in lung and liver tissues of rats with COPD. ConclusionXGHP effectively improves the blood lipid levels of rats with COPD， which may be related to the increase of the expression levels of PPARα and FABP4 mRNA and proteins in the PPAR signaling pathway， thus regulating lung and liver lipid metabolism.

Objective:To evaluate the rehabilitation efficacy of early mobilization based on collaboration care model for patients with laparoscopic colorectal surgery.Methods:Cluster sampling method was used in the department to recruit colorectal cancer patients with laparoscopic surgery. The control group (49 cases) received routine perioperative care and exercise, and the intervention group (47 cases) received the coordinated early mobilization combined with routine perioperative care and exercise, from January to March 2019. Primary outcome were health status and the proportion of patients returning to preoperative functional walking capacity (6-min walk test) at 4 weeks after surgery. The in-hospital mobilization (time out-of-bed), time to achieve discharge criteria, time to recover gastrointestinal function and complication rate were explored.Results:In intervention group,89.4%(42/47) of patients achieved mobilization target on 4 days after surgery compared with 42.6%(20/47) on the day of surgery. Time out of bed were greater in the intervention group compared with the control group, and there were differences between the two groups( Z values were -8.437--7.381, P<0.01). Time to recover gastrointestinal function and the recovery of energy on 3 days after surgery were (58.74±17.41) h, (59.02±9.46) points in the observation group, and (71.82±21.53) h, (62.61±7.68) points in the control group, and there were significant differences between the two groups ( t values were -3.263, -2.046, P<0.05). But other outcome measures were not different between the two groups ( P>0.05). Conclusions:For colorectal laparoscopic surgery patients, the coordinated early mobilization improved the adherence to ambulation, in-hospital mobilization, time to recover gastrointestinal function and recovery of energy to promote rehabilitation.

Objective:To search and obtain the best evidence of aerobic exercise for patients with chronic heart failure (CHF) to provide a basis for clinically formulating scientific and standardized aerobic exercise programs for CHF patients.Methods:BMJ Best Practice, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, Guideline International Network (GIN) , UpToDate, National Guideline Clearinghouse (NGC) , National Institute for Health and Clinical Excellence (NICE) , Scottish Intercollegiate Guidelines Network (SIGN) , CINAHL, Embase, Cochrane Library, Chinese Guidelines Network, PubMed, China Biomedical Literature Database (CBM) , WHO and cardiology professional websites were searched to collect all evidence for aerobic exercise for CHF patients. The search time limit was from the establishment of the database to May 31, 2020.Results:A total of 14 articles were included, including 6 guidelines, 1 expert consensus and 7 systematic reviews. Finally, a total of 17 best evidence for 4 aspects including the necessity of aerobic exercise, preparation before aerobic exercise, 4 elements of aerobic exercise and the mode of aerobic exercise were summarized.Conclusions:Aerobic exercise is safe and effective for patients with heart failure with decreased ejection fraction. The setting of exercise intensity should be based on the results of a symptom-restricted cardiopulmonary exercise test. Exercise for more than 6 months is effective for CHF patients. Intermittent aerobic training assisted resistance exercise can improve peak oxygen uptake, cardiorespiratory fitness and muscle strength of patients, so as to improve cardiac function and quality of life, which should be regarded as an important way of exercise for patients with stable CHF.

Objective:To develop a family-involved institutional care behavior scale for the elderly and provide a tool for assessing the status quo and level of long-term institutional care for the elderly involving the family.Methods:From December 2018 to July 2019, based on the theory of balance and responsibility sharing and the conceptual model of family participation, the dimensions and item pools of the family-involved institutional care behavior scale for the elderly were constructed through literature review, semi-structured interviews and expert group meetings. Totally 18 experts from 11 provinces and cities in China related to this field were selected, and the Delphi method was used to conduct two rounds of consultations by correspondence. The active coefficient, authoritative coefficient, Kendall's W of experts, and the coefficient of variation, the importance score of items, the full score rate were calculated. Results:In the first and second rounds of consultations by correspondence, the positive coefficients of the experts were 90% and 100%; the authority coefficient was 0.925; and the Kendall's W were 0.160 and 0.287, respectively (both P<0.01) ; the coefficients of variation were 0.10-0.31 and 0.05-0.24; the importance score of items were 3.67-4.78 and 3.78-4.97. Finally, the family-involved institutional care behavior scale for the elderly including 6 dimensions and 35 items were constructed. Conclusions:The construction of the family-involved institutional care behavior scale for the elderly is reliable and robust, which can provide a reference for further developing the content of family participation in care institutions for the elderly and improving the quality of life in the elderly.