Objective To explore the communication preferences for advance care planning(ACP)among elderly hospitalized patients and to provide references for improving the ACP implementation rate.Methods Convenience sampling was used to select elderly hospitalized patients from a tertiary hospital in Wenzhou City between April and November 2023.Face-to-face surveys were conducted using a general data collection form and a self-designed questionnaire on ACP communication preferences.Mixed Logit Model,willingness-to-pay analysis,relative importance analysis,and subgroup analysis were employed to explore preferences.Results 204 questionnaires were distributed and 200 valid questionnaires were recovered,with a valid questionnaire response rate of 98.04％.The Mixed Logit Model analysis indicated that key attributes-communication timing,communication form,family participation in ACP communication,legal validity of ACP documents,and out-of-pocket costs-significantly influenced preferences(P＜0.05).Willingness-to-pay analysis showed that changes in communication timing,communication form,and family participation altered patients' willingness to pay.Relative importance analysis ranked the top 3 attributes as commu-nication timing,communication form,and family participation.Subgroup analysis revealed that gender,education level,and residence location affected preferences(P＜0.05).Conclusion Key attributes of ACP communication affect elderly hospitalized patients' preferences and willingness to pay,with variations across subgroups.Healthcare professionals should develop optimal communication programs based on patient preferences and individual characteristics.

Objective To explore the communication preferences for advance care planning(ACP)among elderly hospitalized patients and to provide references for improving the ACP implementation rate.Methods Convenience sampling was used to select elderly hospitalized patients from a tertiary hospital in Wenzhou City between April and November 2023.Face-to-face surveys were conducted using a general data collection form and a self-designed questionnaire on ACP communication preferences.Mixed Logit Model,willingness-to-pay analysis,relative importance analysis,and subgroup analysis were employed to explore preferences.Results 204 questionnaires were distributed and 200 valid questionnaires were recovered,with a valid questionnaire response rate of 98.04％.The Mixed Logit Model analysis indicated that key attributes-communication timing,communication form,family participation in ACP communication,legal validity of ACP documents,and out-of-pocket costs-significantly influenced preferences(P＜0.05).Willingness-to-pay analysis showed that changes in communication timing,communication form,and family participation altered patients' willingness to pay.Relative importance analysis ranked the top 3 attributes as commu-nication timing,communication form,and family participation.Subgroup analysis revealed that gender,education level,and residence location affected preferences(P＜0.05).Conclusion Key attributes of ACP communication affect elderly hospitalized patients' preferences and willingness to pay,with variations across subgroups.Healthcare professionals should develop optimal communication programs based on patient preferences and individual characteristics.

Objective To investigate the risk factors of postoperative fecal contamination in children pa-tients with Hirschsprung's disease(HSCR),and to construct and evaluate the risk predictive model.Methods The clinical data in 377 children patients with HSCR in 3 class 3A hospitals in Guangxi from Janu-ary 2016 to June 2021were retrospectively analyzed by adopting the convenience sampling method.The pa-tients were divided into the modeling group(n=264)and testing model group(n=113)with a ratio of 7∶3.The risk factors of postoperative fecal soiling were analyzed by the single factor and multiple factors,and the risk predictive model was constructed.The receiver operating characteristic(ROC)curve was used to detect the discriminative ability of the model and the H-L test was used to determine the goodness of fit of the mod-el.The model was prospectively validated in 21 children patients with HSCR from August to December 2021.Results Among 377 children patients with HSCR,the fecal soiling occurred in 131 cases with a incidence rate of 34.75％.The constructed predictive model of fecal contamination risk after HSCR operation:logit(P)=-2.385+1.697 × special type of megacolon+0.929 × Soave+0.105 × length of bowel resection+2.065 × il-literate caregivers+0.808 × caregivers'implementation of postoperative diet+0.867 × postoperative defecation training by caregivers.The area under the curve(AUC)in the modeling group was 0.849,the Yoden index was 0.53,the optimal critical value of the model was 0.32,the sensitivity was 76.00％,and the specificity was 77.00％.The H-L test,X2=6.649,P=0.575.AUC of the testing model group was 0.736,the sensitivity was 81.25％,and the specificity was 78.46％.The prospective validation results showed that the sensitivity and specificity of the model were 66.67％and 100％respectively.Conclusion The constructed model has good i-dentification and predictive ability.

Objective: To explore the effect of case management mode on self-management ability of enterostomy patients. Methods: A total of 104 cases of enterostomy patients were divided into 54 cases in control group and 50 cases in experimental group according to admission time.Used Enterostomal Therapist(ET) as the leading organization of the experimental group to establishing personal files by coordinating team psychological counselors, dietitians, specialists and nurses for individualized nursing services. Patients would receive a three-month nursing practice of case management. The control group would be given nursing intervention and health guidance according to the standardized nursing procedure for enterostomy. After discharge, the nurse-in-charge followed up patients′ treatment completion status. The incidence of enterostomy complications and self-management ability of the stoma in two groups were evaluated at 3 months after surgery. Results: In experimental group,the nursing management score of enterostomy was 33.48±4.90, the score of information management was 12.84±2.21, thesymptom observation score was 12.36±1.55, the daily life management score was 30.00±3.40, the psychological management score was 11.64±1.55. Meanwhile,in control group, the nursing management score of enterostomy was 29.74±8.34, the score of information management was 12.10±1.74, the symptom observation score was 11.25±2.56, the daily life management score was 26.59±5.22, the psychological management score was 10.74±2.59. Nursing management score of enterostomy, symptom observation, daily life management, psychological management score between two groups showed significant difference(t=1.529-2.808, P<0.01 or 0.05). The incidence of peristomal dermatitis was 8.0% (4/50) in the experimental group, much lower than that in the control group which was 27.8%(15/54).The difference was statistically significant (χ²=6.801, P<0.05). Conclusions Nursing practice of case management can improve the life quality and accelerate the social adaptability of enterostomy patients.

OBJECTIVE:To establish derivative spectrophotometry for the determination of the main component of Captopril tablets.METHODS:Under the alkaline condition of sodium hydroxide,2,4-dinitrofluorobenzene was used as derivatization reagent to react with captopril at 40 ℃ in the water bath.Then UV spectrophotometry was adopted to detect the content of captopril with detection wavelength set at 342 nm.RESULTS:The linear range of captopril was 1.0～14.0 ?g?mL-1(r=0.999 9) with an average recovery of 99.61%(RSD=1.27%,n=9).The RSD of intra-day and inter-day both were less than 2%.CONCLUSION:This method is stable,reliable,rapid and simple for the determination of the main components of Captopril tablets.