Objective:To explore the relationship between risk perception and health promoting lifestyle profile in population with cardiovascular disease (CVD), and construct a prediction model for clinical screening and targeted intervention.Methods:A cross-sectional survey method was used to select 272 people at moderate and high risk of CVD from the Second Affiliated Hospital of Zhejiang University School of Medicine from March to August 2022. The general information questionnaire, Chinese version of Attitude and Beliefs about Cardiovascular Disease Knowledge and Risk Questionnaire (ABCD-C), and Health Promoting Lifestyle Profile-II (HPLP Ⅱ) were used. Based on multiple regression analysis, a nomogram model for health promoting lifestyle in high-risk CVD population was constructed.Results:Among 272 participants, male 150 cases, female 122 cases, aged (60.58 ± 10.64) years old. The total ABCD-C score was (56.57 ± 5.69), and the total HPLP Ⅱ score was (111.92 ± 12.47). ABCD-C score was significantly positively correlated with HPLP Ⅱ score ( r=0.556, P<0.01). The median of HPLP Ⅱ total score (111 points) was used as the cut-off point for low level of health-promoting lifestyle (≤111 points) and high level of health-promoting lifestyle (>111 points), and used it as the dependent variable, smoking ( OR=0.215, 95% CI 0.104-0.446) was a barrier factor for participants to adopt healthy lifestyle; being married ( OR=14.237, 95% CI 1.963-103.238), having a family average monthly income higher than 5 000 yuan ( OR=4.101, 95% CI 1.369-12.288), higher score of CVD prevention knowledge ( OR=1.660, 95% CI 1.373-2.007), perceived benefits and intention to change physical activity ( OR=1.445, 95% CI 1.255-1.663), perceived benefits and intention to change healthy diet ( OR=1.322, 95% CI 1.058-1.654) were promoting factors. Conclusions:The health-promoting lifestyle of populations at risk for CVD is above-average, influenced by factors such as smoking, marital and economic status, risk attitudes, and beliefs. Utilizing the nomogram model for early screening and targeted risk communication among key populations may contribute to improving their health behavior.

Cardiovascular disease risk communication is an important tool to help risk individuals understand risk information and guide them to improve their health behaviors.Effective cardiovascular disease risk communication by nurses,who are the subjects of risk communication,is essential to reduce the growing burden of cardiovascular disease and the prevalence of cardiovascular disease.This article provides a 3-aspect overview of the concept and development of health risk communication,factors influencing cardiovascular disease risk communication,and recommendations for its development.It is suggested that when nursing staff carry out CVD risk communication,they should fully consider the actual situation and preference of the communication target and design a personalized risk communication program,to provide references for clinical nursing practice.

Objective This study aims to develop and validate a dynamic web-based nomogram for predicting kinetophobia in patients following percutaneous coronary intervention(PCI).Methods A prospective design was employed to selectively enroll 330 PCI patients admitted to a hospital in Hangzhou from December 2022 to July 2023.Single-factor analysis and Lasso regression were utilized to identify independent risk factors for kinesophobia post-PCI.Logistic regression was performed using R software,and a nomogram was constructed.The model was assessed through the area under the receiver operating characteristic curve(AUC)and Hosmer-Lemeshow tests.Results There were 206 cases of kinesiophobia in 330 patients after PCI,and the incidence was 62.4％.Logistic regression analysis identified combined heart failure,emergency surgery,NYHA cardiac function grade,ADL level,sedentary behavior,Chinese version of PROMIS Physical Function Summary Table score,and Chinese version of Perceptive Social Support Scale score as independent influencing factors for kinesophobia after PCI(P＜0.05).The AUC value of the model was 0.821,with a sensitivity of 70.4％and specificity of 82.0％.The Hosmer-Lemeshow fit test yielded a non-significant result(x2=9.350,P=0.314).Calibration and decision curves demonstrated the model's favorable calibration and clinical practicability.The C-index of the nomogram prediction model was 0.778,0.774,and 0.800,respectively,by 5-fold cross-validation,10-fold cross-validation,and the Bootstrap method.Conclusion The dynamic nomogram model developed in this study effectively predicts kinesophobia in patients after PCI.It provides valuable references and support for clinical staff in early identification of high-risk patients,enabling the formulation of individualized health education strategies and exercise rehabilitation plans.

Objective:To explore the different types and characteristics of rehabilitation exercise compliance of patients with first stroke at 2 weeks of onset, and analyze its influencing factors, so as to provide reference for the formulation of targeted health education.Methods:A cross-sectional investigation was conducted in Neurology Department of the Second Affiliated Hospital of Zhejiang University School of Medicine from January to June, 2021. 276 patients with first-episode stroke were investigated by the Questionnaire of Exercise Adherence at 2 weeks of the onset. The potential profile analysis was conducted to explore characteristics classification of the rehabilitation exercise compliance. And the chi-square test was used to compare demographic differences among different categories and ordered multi classification Logistic regression was used to explore the influencing factors of rehabilitation exercise compliance.Results:The patients were divided into 109 cases with high rehabilitation exercise compliance (39.5%), 114 cases with moderate rehabilitation exercise compliance (41.3%), and 53 cases with low rehabilitation exercise compliance (19.2%). There were statistically significant differences in education level, consciousness level at admission, complications and limb muscle strength among the three types of patients ( χ2 values were 6.17-31.50, all P<0.05). Ordered multi classification Logistic regression showed that the patient′s education level, the patient′s consciousness level at admission, whether there were complications and limb muscle strength would affect the rehabilitation exercise compliance of stroke patients ( P<0.05). Conclusions:There are three potential categories of rehabilitation exercise compliance in patients with first stroke. Patients with illiteracy, drowsiness, complications and poor limb muscle strength have poor rehabilitation exercise compliance.

Under the background of efficiency medical reform, the authors introduced the nursing efficiency management system of a large public hospital, which was divided into two dimensions: nursing resource allocation efficiency and nursing service efficiency. The specific four measures included the establishment of multi-campus unified management organization structure based on nursing management committee, nursing performance reform based on structured big data information platform, the construction of nurse-led patient whole process management model and the accelerated rehabilitation nursing practice from surgery to the whole hospital, so as to provide reference for the nursing efficiency management of large general public hospitals under the medical reform.

Objective:To observe the effect of evidence-based early activity training on postoperative delirium in patients with brain tumor resection.Methods:This study used non-contemporary comparison method, a total of 238 patients admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine in 2019, were included. 121 patients who met the inclusion criteria and signed informed consent after craniotomy during January 1st,2019 to June 31th,2019 were included in the control group, and 117 patients who met the criteria and obtained informed consent after craniotomy during July 1 to December 31,2019, were included in the experimental group. Neurosurgical postoperative routine nursing care were given to the control group. The experimental group received evidence-based early activity training. The incidence of delirium, duration of delirium, Barthel Index (BI), delirium-related adverse events and other indicators of postoperative hospitalization were compared between two groups.Results:The incidence of delirium, duration of delirium and postoperative hospital stay in the experimental group were 9.5%, 2.0 (1,3) days and 7 (5,10) days, lower than 23.3%, 3.0 (1,5) days and 8 (6,11) days in control group, and the differences were statistically significant ( χ2 value was 8.17, Z value were 2.96 and -2.01, P<0.05). BI index 1 week and 1 month after discharge in the experimental group was 90 (85, 90), 100 (100, 100), higher than the control group of 90 (86, 90) and 100 (100,100), with statistically significant difference ( Z values were -2.41 and -2.46, P<0.05), the comparison of adverse events, 0 case in experimental group, 1 case in control group, there was no statistically significant difference ( χ2 value was 0.97, P>0.05). Conclusions:Early evidence-based activities in patients with brain tumor resection can reduce the incidence of postoperative delirium, shorten the duration of postoperative delirium and postoperative hospital stay, and improve the ability of patients to take care of themselves after surgery, which is safe and effective.

With the aging of the population and the change of disease spectrum in China, the number of emergency department patients at the elderly, chronic end-stage, advanced tumor and cerebrovascular accident is increasing gradually, and the quality of life in emergency end of life patients is getting more and more attention. This paper reviews the relevant literature of "do not resuscitate" (DNR) in emergency department at home and abroad, introduces the current status of DNR application and the influencing factors of decision-making in emergency department at home and abroad, in order to provide reference for the application and practice of DNR in emergency department in China.

Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke . Methods In this multi‐center study ,2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to M ay 2016 were enrolled . Carotid ultrasonography and transcranial color‐coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion . According to the distribution of lesions ,the subjects were divided into 2 groups :the simple intracranial artery stenosis group and the simple extracranial artery stenosis group . T he difference of risk factors between the two groups was compared . Results Of the 2 310 patients with ischemic stroke ,1 516 ( 65 .6% ) had simple intracranial artery stenosis and 794 ( 34 .4% ) had simple extracranial artery stenosis . T he incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group ( 68 .1% vs 48 .7% , P ＜0 .001) . Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group ( 36 .4% vs 22 .1% ,14 .9% vs 9 .8% ;all P ＜0 .001) . Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension , diabetes ,obesity ,and family history of stroke ,and their systolic blood pressure ,diastolic blood pressure , body mass index ( BM I) ,fasting blood‐glucose ,glycosylated hemoglobin ,triacylglycerol ,total cholesterol , and low‐density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group ( all P ＜ 0 .05 ) . T he proportion of elderly ( ≥ 65 years old ) ,male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group ( all P ＜0 .05) . Multivariate logistic regression analysis showed that elderly ( ≥65 years old) ,male , and smoking history were independent risk factors for extracranial arterial stenosis ( OR＝ 2 .012 ,1 .637 , 1 .325 ,respectively ;all P ＜0 .05) . While hypertension ,diabetes ,less physical activity ,and high BM I levels were independent risk factors for simple intracranial arterial disease ( OR ＝ 1 .301 ,1 .252 ,1 .248 ,1 .030 , respectively ;all P ＜0 .05) . Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China .

Objective: To study and analyze the risk factors of deep Venous Thrombosis of Lower limbs in patients with Orthopaedic bed rest. Methods: 273 cases of patients with bed rest who were treated by Orthopaedic operation from November 2015 to March 2016 and from November 2016 to March 2017 in our hospital were.collected and divided into 2 groups according to whether there were deep venous thrombosis after operation, and A group had 232 patients who did not have deep venous thrombosis of lower limbs after Operation. B Group had 41 patients who had deep venous thrombosis of lower limbs after Operation. The two groups of patients were treated with orthopedic treatment, the researchers recorded the basic data of two groups of patients, and analyzed the risk factors of lower extremity deep venous thrombosis in patients with orthopedic Bed rest. Results: In group B, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m², with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500 μgP/L, operating time over 4 h were 54.10% (23/41), 58.54% (24/41), 75.61% (31/41), 60.98% (25/41), 58.50% (24/41), 63.41% (26 /41), 48.78% (20/41), respectively.In group A, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m², with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500ugP/L, operating time over 4 h were 24.14%(56/232), 23.28% (54/232), 13.36% (31/232), 23.28% (54/232), 21.12% (49/232), 10.78% (25/232), 9.91% (23/232), respectively, The difference between the two groups was statistically significant (χ²=3.602~11.623, all P < 0.05); Related risk factors for deep venous thrombosis in lower limbs logistic regression analysis showed that age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m², with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500 μg/L, operating time over 4 h were the related risk factors for deep venous thrombosis in patients with bed rest after operation. Conclusion the risk factors for deep venous thrombosis of lower limbs in the elderly patients with bed rest after orthopedic operation are mainly age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m², with chronic diseases (such as hypertension, diabetes, etc.), bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500 μg/L, operating time over 4 h, nursing staff should carry out nursing intervention according to the risk factors related to deep venous thrombosis of lower limbs to avoid the formation of deep vein thrombosis of lower limbs as far as possible.

Objective To systematically evaluate the optimal dose of early enteral nutrition support in critically ill patients.Methods Systematic search database including PubMed,Web of science,Scopus,CINAHL,CBM,CNKI.RCTs about early enteral nutrition dose selections in critically ill patients were chosen according to include and exclude criteria by two researchers independently.Cochrane system evaluation manual bias risk assessment was used to evaluate quality of literature.RevMan5.3 Meta analysis software was used to analyze the data.Results A total of 1 571 literatures were retrieved and 8 RCT studies were included,2 713 subjects in total.Meta analysis results showed that there were statistically significant differences in mechanical ventilation time,incidence of diarrhea,and utilization rate of gastro dynamic drugs between trophic feeding and full feeding (P＜0.05).There were no statistically significant differences in mortality,length of stay,incidence of nosocomial infections,reflux,vomiting,constipation,etc.(P＞0.05).Conclusions Trophic feeding has familiar effects on mortality,length of hospital stay compared to full feeding,but it can help to shorten ICU mechanical ventilation time,improve the gastrointestinal tolerability.