Objective:To investigate the self-care contribution and binary coping level of spouse caregivers for middle-aged and young stroke patients and explore the relationship between the two, in order to improve the quality of self-care contribution of spouse caregivers to middle-aged and young stroke patients.Methods:A cross-sectional survey was conducted among 200 middle-aged and young stroke patients ′ spouse caregivers in the People ′s Hospital of Xinjiang Uygur Autonomous Region from January to June 2023 by the general data questionnaire, the Caregiver Contribution to Self-care of Stroke Patient Scale, the Dyadic Coping Inventory. The correlation between self-care contributions and binary coping strategies of spousal caregivers was analyzed, and the factors that affect their self-care contributions were screened. Results:Finally, 192 middle-aged and young stroke patients ′ spouse caregivers were included, including 70 males and 122 females, aged 18-59 years old. The total score of self-care contribution of spousal caregivers of middle-aged and young stroke patients was (75.43 ± 6.80) points, and the total score of binary coping was (117.12 ± 9.59) points, both of which were positively correlated ( r=0.691, P<0.05). Hierarchical regression analysis showed that after controlling for the influence of general data, binary coping could explain 28.4% variation in the self-care contribution of spouse caregivers of middle-aged and young stroke patients ( P<0.05). Conclusions:The duality coping level positively predicts the quality of spouse caregivers ′ self-care contribution to middle-aged and young stroke patients. Medical staff should assess the dual coping level of middle-aged and young stroke patients and their spouses, and carry out targeted dual intervention measures to improve the quality of caregivers' contribution to stroke patients ′ self-care.

Objective To identify symptom clusters in breast cancer patients undergoing chemotherapy and investigate the bridge symptoms that connect the symptom clusters,therefore to provide a guidance for precise intervention in the symptoms.Methods From October 2022 to October 2023,convenience sampling method was employed to selelct 340 breast cancer patients,who underwent postoperative chemotherapy,for investigation in the related symptom clusters and quality of life by using Anderson symptom assessment scale and breast cancer quality of life scale.Cluster analysis was performed to extract the symptom clusters by R software and the impacts of each symptom cluster on quality of life were analysed by stratified regression.A contemporaneous symptom network was constructed to identify the bridge symptoms.Results All 327 patients had completed the study.Three distinct symptom clusters were extracted:-gastrointestinal,psychological and neurological symptom clusters.The gastrointestinal cluster alone accounted for 10.2%of the variation in quality of life.Network analysis highlighted that distress(rbe=3.927,rbs=3.927,rbc=0.436),fatigue(rbe=3.907,rbs=3.907,rbc=0.434)and lack of appetite(rbe=3.842,rbs=3.842,rbc=0.427)were the bridging symptoms which had high expected influence coefficient,strength and closeness centrality index.Conclusion The gastrointestinal symptom cluster makes notably impact on the quality of life in breast cancer patients undergoing chemotherapy.Fatigue,lack of appetite and distress are the bridge symptoms in symptom management strategies in potentially improving the efficiency of intervention and reducing the costs to patient.

Objective:To explore the composition and trajectory of symptom clusters during perioperative period in middle-aged and elderly patients with gynecological malignant tumors, so as to provide reference for formulating symptom management programs.Methods:From December 2022 to September 2023, convenience sampling was used to select 145 middle-aged and elderly patients with gynecological malignant tumors who underwent surgical treatment at the Affiliated Cancer Hospital of Xinjiang Medical University as the study subject. A longitudinal survey was conducted on patients at four time points [1 day before surgery (T1), 1 day after surgery (T2), 3 days after surgery (T3), and 7 days after surgery (T4, before discharge) ] using the General Information Questionnaire and the Chinese version of the Anderson Symptom Inventory-Perioperative Module in Patients with Gynecological Cancer.Results:A total of 145 questionnaires were distributed, and 130 valid questionnaires were collected, with an effective response rate of 89.66% (130/145). Exploratory factor analysis extracted six symptom clusters, namely perimenopausal symptom cluster, psychological symptom cluster, fatigue-pain symptom cluster, gastrointestinal symptom cluster, energy deficiency symptom cluster, and surgery related symptom cluster. Perimenopausal symptom group was a specific symptom cluster of gynecological malignant tumor patients, existing at T1. Psychological symptom cluster persisted during the patient's perioperative period. Fatigue-pain symptom cluster and surgery related symptom cluster existed at T2 to T4. Gastrointestinal symptom cluster and energy deficiency symptom cluster existed at T2 and T3.Conclusions:Middle aged and elderly patients with gynecological malignant tumors have various symptoms during the perioperative period, and the symptoms can cluster at different time points. The number of symptom clusters increases with the progress of surgical treatment, while the core symptoms within the cluster remain relatively stable over time. Clinical nursing staff should pay attention to the dynamic changes in the patient's perioperative symptom cluster, adopt efficient and targeted management measures based on the trajectory of symptom clusters, and reduce the burden of perioperative symptoms on patients.

Objective:To construct a bundled therapy management and practice program for sepsis and explore its clinical application effect.Methods:① Construction of sepsis bundled therapy management and practice program: a project team was established to conduct literature review, select experts, compile and distribute questionnaires, organize, analyze expert opinions, and ensure quality control throughout the research process. From October to November 2022, expert letter consultation was carried out, and questionnaires were distributed and collected by on-site filling and WeChat. The Likert 5-point scale was used to rate each item. ② Clinical application of the protocol: ninety patients with sepsis admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Xinjiang Medical University from January to July 2022 were retrospectively selected as the control group, and routine bundle treatment and nursing strategy for sepsis were adopted. Ninety patients with sepsis admitted from January to July 2023 were prospectively selected as the intervention group. Based on the treatment and nursing strategy of the control group, sepsis bundled therapy management and practice program constructed using the Delphi inquiry method was implemented. The completion rate of 1-hour, 3-hour and 6-hour bundle, the levels of inflammatory indicators at 1, 3, 7 days of treatment, and prognostic indicators were compared between the two groups.Results:① Construction of sepsis bundled therapy management and practice program: the final plan consists of 4 primary indicators, 15 secondary indicators and 34 tertiary indicators. The response rates for both rounds of inquiry questionnaires were 100%. The coefficients of expert authority value were 0.948 and 0.940, respectively. The coefficient of variation for each item was 0-0.287 and 0-0.187, respectively. Kendall's W coefficients were 0.242 and 0.249, respectively, with statistical significances (all P < 0.05). ② Clinical application of the protocol: there were no statistically significant differences in baseline data such as age, gender, infection site, pathogen species, duration of mechanical ventilation, sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) between the two groups. The completion rate of 1-hour, 3-hour and 6-hour bundle in the intervention group were higher than those in the control group (1-hour bundle completion rate: 53.30% vs. 21.10%, 3-hour bundle completion rate: 92.20% vs. 80.00%, 6-hour bundle completion rate: 88.89% vs. 65.56%, all P < 0.05). The levels of C-reactive protein (CRP), white blood cell count (WBC), procalcitonin (PCT), and interleukin-6 (IL-6) in two groups of patients showed statistically significant differences at different time points, between groups, and in interaction effects. Compared with the control group, the length of ICU stay in the intervention group was significantly shortened [days: 7.00 (4.00, 14.00) vs. 8.00 (7.00, 20.00), P < 0.01], and the hospitalization cost of ICU was significantly reduced [ten thousand yuan: 4.63 (3.36, 6.19) vs. 6.46 (3.32, 11.34), P < 0.05]. The 28-day mortality in the intervention group was lower than that in the control group (33.33% vs. 46.67%), but the difference was not statistically significant ( P > 0.05). Conclusions:The constructed bundled therapy management and practice program for sepsis can improve the completion rate of bundle treatment, shorten the length of ICU stay of sepsis patients, reduce the hospitalization cost in ICU, and have a tendency to reduce the 28-day mortality.

Objective:To explore the impact of Cox interaction model of client health behavior (IMCHB) on stress response and rehabilitation outcome in patients undergoing coronary artery bypass graft, and to provide reference for caregivers to reduce stress response in such patients and improve rehabilitation outcomes.Methods:This was a quasi-experimental study, and 62 surgical patients undergoing coronary artery bypass graft in the cardiac surgery department of the First Affiliated Hospital of Xinjiang Medical University were selected from January to June 2023.Among them, 31 patients admitted from January to March 2023 were in the control group, and routine nursing measures were taken; 31 patients admitted from April to June 2023 were in the intervention group with IMCHB nursing based on this routine nursing. The anxiety, depression, quality of life, hemodynamic indicators, postoperative activity time, evacuation time, pericardial/mediastinal drainage time, ICU stay length and total hospitalization length between the two groups were compared.Results:There were 31 cases were admitted in each group. There were 28 males and 3 females,aged (57.42 ± 7.38) years old in the control group. There were 27 males and 4 females, aged (56.29 ± 7.29) years old in the intervention group. After intervention, the total score of anxiety and depression and SF-36 in the intervention group were respectively (16.87 ± 4.83) points and (78.32 ± 13.41) points, and the control group were (20.81 ± 6.35) points and (69.97 ± 11.37) points, respectively, and the differences between the two groups were statistically significant ( t=2.75, -2.65, both P<0.05). Immediately after completion of cardiopulmonary bypass (T3), the mean arterial pressure in the intervention group was (85.55 ± 8.46) mmHg (1 mmHg=0.133 kPa), higher than (74.33 ± 17.40) mmHg in the control group, heart rate was (77.72 ± 10.97) times/min, lower than (88.35 ± 15.96) times/min in the control group. At the beginning of cardiopulmonary bypass (T2), and when leaving the operation room (T4), the heart rate of patients in the intervention group was (69.50 ± 10.94), (81.11 ± 10.22) times/min, significantly lower than (77.98 ± 14.51), (90.47 ± 15.44) times/min in the control group, the differences were statistically significant ( t values were -3.23 to 3.06, all P<0.05). In the intervention group, first ambulation, exhaust, pericardial/mediastinal drain retention, ICU stay, total hospitalization were (7.48 ± 2.83), (3.06 ± 0.99), (6.52 ± 2.39), (5.35 ± 3.20), (28.90 ± 5.63) d, all were significantly lower than (12.81 ± 4.84),(4.55 ± 1.65), (8.87 ± 3.30), (12.74 ± 7.31), (35.94 ± 8.82) d in the control group with statistical differences ( t values were 3.21-5.29, all P<0.05). Conclusions:The application of Cox health behavior interaction mode can reduce the anxiety and depression in coronary artery bypass graft patients, improve the quality of life, reduce the stress response of patients, and improve the rehabilitation outcomes.

Objective:Based on the health ecological model, this paper systematically explores the influencing factors of mild cognitive impairment among the elderly herders in Nanshan pastoral area of Xinjiang, and provides the basis for local medical institutions to formulate prevention and control strategies for mild cognitive impairment among the elderly herders.Methods:A total of 1 145 valid questionnaires were collected, all of them were permanent herdsmen aged over 60 years in Nanshan pastoral area of Xinjiang were selected from June 2022 to February 2023 by stratified cluster random sampling method in a cross-sectional survey. Under the guidance of health ecological model, the research variables were included from five dimensions: physiology, psychology, behavioral lifestyle, social network and medical and health environment, and questionnaires were conducted. SPSS 23.0 was used for chi-square test and binary Logistic regression to analyze the influencing factors of mild cognitive impairment in elderly herders.Results:There were 564 males and 581 females with age of (70.84 ± 5.69) years old in the study. The prevalence rate of mild cognitive impairment among elderly herdsmen in Nanshan pastoral area of Xinjiang was 36.1%(413/1 145). Binary Logistic regression analysis showed that: personal monthly income (1 000-2 999 yuan)( OR = 0.583, 95% CI 0.366 - 0.926, P<0.05), education level (junior high school and above)( OR = 0.479, 95% CI 0.315 - 0.728, P<0.01) were the protective factors for mild cognitive impairment among the elderly herdsmen in Nanshan pastoral area. Hypertension ( OR = 1.842, 95% CI 1.256 - 2.702, P<0.01), dyslipidemia ( OR = 1.449, 95% CI 1.069 - 1.964, P<0.05) and chronic pain ( OR = 1.549, 95% CI 1.082 - 2.216, P<0.05) were the risk factors of mild cognitive impairment in elderly herders in Nanshan pastoral area. Conclusions:The prevalence rate of mild cognitive impairment among elderly herders in Nanshan pastoral area of Xinjiang is high, so it is necessary to carry out mild cognitive impairment screening as soon as possible, especially focusing on people suffering from hypertension, dyslipidemia and chronic pain, and making intervention plans to delay the occurrence and development of mild cognitive impairment and improve the quality of life of elderly herders.

Objective:To investigate the current status of exercise fear in patients with chronic heart failure (CHF) and explore the different potential classifications and influencing factors of exercise fear, in order to provide theoretical basis for formulating targeted interventions.Methods:The subjects of this study were 278 patients with CHF treated in the Department of Cardiology, the First Affiliated Hospital of Xinjiang Medical University from July 2023 to November 2023 using convenience sampling method. A questionnaire survey was conducted using a general information questionnaire, Fear of Activity in Patients with Chronic Heart Failure, Cardiac Exercise Self-Efficacy Instrument, Personal Support Scale From Family, and Multidimensional Fatigue Index-20. Latent profile analysis to identify potential subtypes of motor fear in patients, and unordered multiple logistic regression to evaluate the influencing factors of different subtypes were used.Results:Totally 278 valid questionnaires were collected, including 96 females and 182 males, with a majority aged between 60 and 74 years old, with 114 cases accounting for 41.0%. The 278 CHF patients had a fear of movement score of (34.78 ± 13.17) points were divided into three potential categories based on their fear of movement: low-level fear of movement group (107 cases, 38.5%), moderate fear of movement group (108 cases, 38.8%), and high-level fear of movement group (63 cases, 22.7%). Disordered multiple logistic regression analysis showed that family support level ( OR = 2.520), exercise self-efficacy ( OR = 0.913), and fatigue ( OR = 1.065) were significant influencing factors for high-level exercise fear in CHF patients (all P<0.05), while age, education level, disease course, number of coexisting diseases, family support level, exercise self-efficacy, and fatigue were significant influencing factors for high-level exercise fear in CHF patients ( OR values ranged from 0.007 to 6.292, all P<0.05). Conclusions:There are three potential categories of exercise fear in patients with CHF. Medical staff should develop targeted intervention plans based on the characteristics of different categories of patients to reduce their level of exercise fear.

Objective:To investigate the prevalence and potential classification of symptoms after total knee arthroplasty (TKA) in patients with knee osteoarthritis (KOA), and to analyze the differences in demographic characteristics and surgical data, compare the different potential subgroups, in order to provide a basis for clinical symptom management plans.Methods:This study was a multicenter cross-sectional survey. Through convenience sampling, patients with KOA undergoing TKA in the orthopaedic wards of four tertiary hospitals in Urumqi were selected as the study from November 2023 to February 2024. The study subjects were surveyed using a general information questionnaire, the Visual Analogue Scale (VAS) for pain, the Hospital Anxiety and Depression Scale (HADS), and the Pitts Burgh Sleep Quality Index (PSQI), and the degree of postoperative joint swelling and size of ecchymosis were measured. Latent class analysis was performed using Mplus 8.3 software, and Logistic regression analysis was conducted using SPSS 26.0 software to explore the influencing factors of the latent classes.Results:Totally 337 effective questionnaires were collected, and the recovery rate was 94.7% (337/356), and the age distribution ranged from 47 to 85 (65.19 ± 6.99) years old, with 90 (26.7%) males and 247 (73.3%) females. There were 92.3% (311/337) of TKA patients with postoperative symptom cluster. The symptom cluster of patients with TKA were identified as 3 classes. They were named as "high level pain-psychological disorder group"(12.5%, 39/311), "high bruises-moderate psychological disorders group"(25.4%, 79/311) and "low symptom burden group" (62.1%, 193/311). The results of the unordered multi-class logistic regression analysis showed that age 45-59 years ( OR = 2.367), body mass index 24.0-27.9 kg/m 2 ( OR = 0.207), living with children/parents ( OR = 6.473), and this being the second joint surgery ( OR = 0.040) were the factors influencing the "high level pain-psychological disorders group" (all P<0.05). The factors influencing the "high bruises-moderate psychological disorders group" were living with children/parents ( OR = 4.023), comorbid chronic diseases ( OR = 1.979, 3.842), and intraoperative blood loss ≤100 ml ( OR = 2.342) (all P<0.05). Conclusions:The postoperative symptom cluster of TKA patients have a relatively high incidence, and there is heterogeneity within the symptom cluster, so nurses need to identify at-risk patients early according to the characteristics of different categories and give interventions.

Objective:To investigate the level of beliefs about medication in young patients with newly treated pulmonary tuberculosis and analyze its influencing factors.Methods:This was a cross-sectional study. Using the convenient sampling method, a total of 320 young newly treated pulmonary tuberculosis patients who visited the designated tuberculosis hospitals in Kashgar Prefecture and Hotan Prefecture of Xinjiang Uygur Autonomous Region from January 2022 to April 2023 were selected as the research objects. The investigation was carried out with the General Information Questionnaire, Beliefs about Medicines Questionaire Specific (BMQ-S), 8-Item Morisky Medication Adherence Scale (MMAS-8), Brief Illness Perception Questionnaire (BIPQ) and Tuberculosis-related Stigma Scale (TSS). Multiple linear regression was used to analyze the influencing factors of medication beliefs in young patients with newly treated tuberculosis.Results:A total of 320 questionnaires were distributed in this study, and 302 valid questionnaires were collected, with an effective response rate of 94.38% (302/320). The total score of BMQ-S of 302 young patients with newly treated tuberculosis was -1.00 (-2.00, 1.00), MMAS-8 score was 5.38 (4.75, 5.75), BIPQ score was 37.00 (24.00, 44.00) and TSS score was 48.00 (44.00, 52.00). The results of multiple linear regression analysis showed that comorbidities, medication adherence, disease perception and stigma were the influencing factors of medication beliefs in young newly treated pulmonary tuberculosis patients ( P<0.01) . Conclusions:The medication belief level of young patients with newly treated pulmonary tuberculosis needs to be improved. Medical staff should correct the negative cognition of the patient's disease, emphasize the benefits of drug treatment and enhance the patients' beliefs in the necessity of medication.

Objective:To explore the risk factors of oral-mucosal pressure injury (OMPI) in patients with tracheal intubation in ICU and to establish a nomogram model.Methods:Using the convenient sampling method, a total of 640 patients with oral tracheal intubation admitted to ICU of the First Affiliated Hospital of Xinjiang Medical University from January to May 2023 were selected as the research objects. They were divided into the occurrence group ( n=286) and the non-occurrence group ( n=354) according to whether OMPI occurred or not. Binomial Logistic regression analysis was used to explore the risk factors for OMPI in patients with tracheal intubation in ICU. A risk nomogram model was created based on independent risk factors, and internal verification was conducted by Bootstrap repeated sampling method. Results:OMPI occurred in 286 of 640 ICU patients with tracheal intubation. Binomial Logistic regression analysis showed that high APACHEⅡ score, modified Beck oral score greater than or equal to 11 points, use of sedative drugs, prone ventilation, long retention time of tracheal catheter, low oxygenation index less than 200 mmHg (1 mmHg=0.133 kPa) and tracheal catheter fixation frequency of 1 time /24 h were the risk factors for OMPI in patients with tracheal intubation in ICU ( P<0.05). A risk nomogram model for OMPI in patients with tracheal intubation in ICU was established based on independent risk factors. The results showed that the predictive performance (area under the receiver operating characteristic curve of subjects was 0.918, 95% confidence interval was 0.897 to 0.938) and calibration (χ 2 value of 4.647, P=0.795) of the risk nomogram model for OMPI in patients with tracheal intubation in ICU were good. When the threshold probability was 0 to 1, the decision curve showed that the model had good clinical effectiveness. Conclusions:The OMPI risk nomogram model of tracheal intubation patients in ICU established in this study has good calibration and differentiation, which can be used as an effective tool for screening high-risk patients.