Objective:To understand the factors hindering exercise rehabilitation in aged patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) and provide a reference for clinical interventions.Methods:Aged CHD patients who underwent PCI in the Department of Cardiovascular Medicine at Hunan Provincial People's Hospital from January to June 2022 were selected by purposive sampling and underwent semi-structured interviews. Content analysis was employed for data analysis.Results:The factors hindering exercise rehabilitation in aged CHD patients after PCI can be categorized into two major groups: endogenous factors and exogenous factors. Endogenous factors were categorized into four themes: inadequate understanding, adverse disease experiences, weakness and physical dysfunction, and poor self-perception. Exogenous factors were categorized into four themes: lack of cardiac rehabilitation prescriptions and programs, social environmental barriers, insufficient family support, and restricted medical insurance coverage.Conclusions:The factors hindering exercise rehabilitation in aged CHD patients after PCI are diverse and complex. Prior to implementing exercise rehabilitation, healthcare professionals should thoroughly assess individuals' health conditions, rehabilitation needs, and limiting factors, and provide feasible rehabilitation content and formats.

Objective:To review the scope of related factors that affect the elderly′s participation in digital health intervention, and to provide a certain reference for the application and development of smart elderly technology.Methods:Based on the scope review guidelines issued by the Joanna Briggs Institute in Australia in 2019, the inclusion and exclusion criteria were determined according to the PCCS principles. Chinese and English literatures were searched in PubMed, Cochrane Library, JBI, CINAHL, Web of Science, Scopus, CNKI, Wanfang database and Chinese biomedical literature database. The search time limit was from the establishment of the database to November 30, 2021. Two researchers independently read, and used EndNoteX9 and Excel tables to extract relevant data from the literature for summary and analysis.Results:Totally 20 articles were selected, including 2 mixed studies, 10 cross-sectional studies, 6 qualitative studies, and 2 quasi-experimental studies. Relevant factors affecting the participation of the elderly in digital health interventions involved the developers, users and the user himself of digital health intervention systems, including the degree of system integration of system development, the degree of autonomy of the elderly, the credibility and accessibility of system equipment and ease of use; the degree of compatibility of equipment in the process of use, the degree of digital infrastructure configuration, the degree of Internet penetration, the availability and reliability of health information resources, the degree of training and education, the degree of communication with the elderly in the process of participation, financial payment, etc.; the four inherent factors of the elderly included the cost of technology use, technical anxiety, privacy and safety, and health needs.Conclusions:The elderly, medical staff, developers and other stakeholders should jointly participate in decision-making on the development and management of the digital health intervention system for the elderly, especially by inviting and empowering the elderly , and improve the training and feedback of the system application and use process, accelerate the popularization and promotion of technical resources, and increase social capital and financial payment incentives to reduce the burden on the elderly and the medical system.

Objective:To explore the perception and demand of children's parents on Internet children's hospital, and provide reference for improving the service model of Internet children's hospitals.Methods:This is a qualitative study. Totally 11 parents of children who visited the outpatient services of Guangzhou Women and Children's Medical Center from November to December 2021 were selected by convenience sampling, and a semi-structured interview was conducted with them based on a self-made outline. The Colaizzi phenomenological 7-step analysis method was used to analyze the data and refine the themes.Results:A total of four themes were extracted, namely, the high degree of parental recognition of the Internet children's hospital service model, the need for convenient, timely and safe information acquisition, the need for professional, reliable and friendly diagnosis and treatment services, and the need for reasonable and transparent fees.Conclusions:The online diagnosis and treatment services of Internet children's hospitals meet the needs of parents for medical treatment and have good prospects. At the same time, the service model of Internet children's hospitals should pay more attention to the convenience, professionalism, safety and economy of users, so as to promote its healthy development.

Objective:To analyze the effect of high-flow nasal cannula (HFNC) oxygen therapy in patients with acute respiratory failure, and investigate the indicators that predict the failure of HFNC.Methods:The clinical data of 174 patients with acute respiratory failure were retrospectively analyzed. The patients were treated with HFNC in the Emergency Department of Hunan Provincial People′s Hospital from January 2018 to September 2020. The vital signs, blood gas analysis, Borg score and ROX index of patients before and one hour after HFNC application were compared, and the application effect of HFNC was judged. The HFNC failure group was defined as patients with respiratory support upgraded to non-invasive ventilation, endotracheal intubation or death within 48 h, and the indicators for predicting the HFNC failure were analyzed.Results:The failure rate of HFNC was 24.13%(42/174). There were significant differences in the heart rate, SpO 2, systolic blood pressure, diastolic blood pressure and PaO 2 of successfal group before and after the use of HFNC, t values were -8.12-4.60, all P<0.05. Multivariate Logistic regression analysis showed that the change value of systolic blood pressure was a protective factor of the failure of HFNC ( OR=0.967, 95% CI were 0.949-0.985, P<0.05). Conclusions:The application of HFNC in patients with acute respiratory failure is feasible and effective, and the change value of systolic blood pressure is an indicator to predict the failure of HFNC.

Objective:To explore the effect of the demand-oriented system training in the training of advanced nurses in the Chest Pain Center Cardiac Catheterization Laboratory.Methods:From January 2018 to December 2020, convenience sampling was used to select nurses who were trained in the Chest Pain Center Cardiac Catheterization Laboratory of Hunan Provincial People's Hospital as the research subject. The nurses who engaged in advanced studies from January 2018 to June 2019 were set as the control group ( n=57) , and the nurses who engaged in advanced studies from July 2019 to December 2020 were set as the observation group ( n=60) . The control group conducted traditional training, and the observation group carried out demand-oriented system training on the basis of the control group. The theoretical and operational assessment scores, comprehensive ability and satisfaction were compared between the two groups of nurses before and after advanced studies. Results:After the intervention, the nurses in the observation group had higher scores in theoretical and operational assessment, clinical skill and management in comprehensive ability and the satisfaction score than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The effect of the demand-oriented system training in the advanced nurses in the Chest Pain Center Cardiac Catheterization Laboratory is better than the traditional training, and it is worthy of clinical promotion.

Objective:To evaluate the application effect of a personalized nutritional program based on nutrition risk screening in kidney transplant patients.Methods:Using the convenient sampling method, a total of 90 patients who completed kidney transplantation in the Second Xiangya Hospital of Central South University from November 2020 to May 2021 were selected as the research objects. Envelopes were used to draw lots, and patients were randomly divided into the control group (45 cases) and the test group (45 cases) . The control group was given routine basic treatment and nursing care, while the test group was given a personalized nutrition plan based on nutritional risk screening at basis of the control group. The changes of nutritional indexes such as total protein, albumin, prealbumin, retinol-binding protein, serum iron, total iron-binding capacity, and hemoglobin were observed before operation and on the 3rd, 7th, and 14th days after operation in the two groups. The changes of renal function indicators (such as serum creatinine level, endogenous creatinine clearance rate, glomerular filtration rate) were compared between the two groups, and the incidence of readmission within 3 months of discharge was compared between the two groups.Results:The levels of retinol-binding protein in the experimental group on the 3rd, 7th, and 14th days of intervention were better than those in the control group, while the serum creatinine level and glomerular filtration rate were lower than those in the control group, and the differences were statistically significant ( P<0.05) . On the 14th day of intervention, the levels of total protein, hemoglobin, total iron binding capacity and serum iron in the test group were higher than those in the control group, and the clearance rate of endogenous creatinine was lower than that in the control group, and the differences were statistically significant ( P<0.05) . Repeated measures analysis of variance showed that time had an effect on the recovery of nutritional and renal function indexes of patients in both groups ( P<0.05) . There were statistically significant differences in the levels of total protein, hemoglobin, retinol-binding protein, serum creatinine and the main effect of glomerular filtration rate intervention between the two groups ( P<0.05) . And there was an interaction between intervening factors and time of hemoglobin, retinol-binding protein and serum iron levels ( P<0.05) . After 3 months of follow-up, the readmission rate of patients in the experimental group was 0, and that in the control group was 13.6% (6/44) , and the difference was statistically significant ( P<0.05) . Conclusions:Nutritional risk screening combined with personalized nutrition program can effectively improve the nutritional status of kidney transplant patients, promote the recovery of transplanted kidney function, reduce the readmission rate and improve the clinical outcome of patients.

Objective:To understand the current situation of the demand for Internet plus nursing service among nurses at different levels, and analyze the influencing factors, so as to provide reference for the improvement of relevant national policies.Methods:A total of 19 762 in-service nurses from 32 provinces in China were investigated by cross sectional survey in April to May 2019. The demand for Internet plus nursing services was investigated, including 5 dimensions, including institutional demand, safety demand, demand for fees, quality demand and training needs.Results:Among the 19 762 nurses surveyed, there were 135, 4 736, 8 847, 4 827 and 1 217 nurses at N0-N4 levels respectively. The safety needs of nurses ranked first(4.68±0.52). The institutional needs of N3 and N4 nurses were the most significant, and the safety needs of N0-N2 nurses were the most significant; Training demand was the third demand of nursing staff at all levels. Multiple linear regression analysis showed that education and professional title were the factors that affected nurses′ demand for Internet plus nursing service( P<0.01). Conclusions:Nurses at different levels have a high and diversified demand for Internet+ nursing services.

Objective:To analyze and evaluate caring experience of caregivers of patients undergoing tracheotomy.Methods:PubMed, Web of Science, Cochrane Library, EBSCO, Embase, Chinese National Knowledge Infrastructure (CNKI) , Wanfang Database, VIP Database and SinoMed were searched by computer, and literature on quality studies on caring experience of caregivers of patients undergoing tracheostomy were searched. The time limit for retrieval was from the establishment of the database to November 30, 2020. The quality of literature was evaluated by using the quality evaluation standards of Australia Joanna Briggs Institute (JBI) Evidence-based Health Care Center. The results were analyzed by the collective integration method.Results:A total of 7 articles were included, including 5 English articles and 2 Chinese articles. Among them, 6 articles were phenomenological studies and 1 article was grounded theory research. In the end, it was summarized into 10 categories and integrated into 3 integrated results. The first integration result was psychological overload of caregivers, difficulties in role adaptation and social interaction and negative state. The second integrated result was that the caregivers' ability to care for was insufficient and they were exhausted. For them, the transition period after discharge was difficult to adapt and they were eager for support. The third integrated result was that caregivers gradually adapted, actively faced reality, changed their concepts and learned to be grateful while achieving self-growth.Conclusions:The status of caregivers of patients undergoing tracheotomy has both negative and positive aspects, and there are many psychological, social and family problems as well as nursing guidance needs. Medical staff should pay attention to the psychological pressure of caregivers of patients undergoing tracheotomy, provide them with disease care guidance, help caregivers strengthen the social and family support system, reduce the caregiver burden and improve the quality of care.

Objective:To explore the quality evaluation index system of Internet plus nursing service suitable for China's national conditions, aiming to provide a basis for the quality evaluation and monitoring of Internet plus nursing service.Methods:Based on the "structure-process-result" proposed by Donabedian as the theoretical framework, combined with literature retrieval, qualitative interview, group discussion, and referring to the relevant systems and policies of advanced regions in China, the quality evaluation index item pool and initial questionnaire were preliminarily constructed. In the first and second rounds of questionnaires, Delphi method was used to select indicators. In the third round of questionnaires, the expert importance assignment method was used to clarify the weights of the indicators.Results:The 3 rounds of expert positive coefficients were respectively 92%, 100% and 100%, the expert authority coefficients were respectively 0.870, 0.870 and 0.877 and Kendall's W coefficients were 0.101, 0.105 and 0.119. Finally, an Internet plus nursing service quality evaluation index system with 3 first-level indicators, 19 second-level indicators and 176 third-level indicators was formed. Conclusions:For quality evaluation index system of Internet plus nursing service based on quality three-dimensional theory, the expert opinions are relatively concentrated and results are relatively, which can provide a basis for the establishment of quality evaluation standards of Internet plus nursing service for medical institutions and guide and promote the healthy development of Internet plus nursing service in China.

Objective:To explore the current status and influencing factors of psychological resilience in in-service nurses in Hunan Province, and provide a certain reference for the development of nursing human resource management and occupational mental health.Methods:A mixed study method was adopted. Quantitative study: in August 2018, a total of 749 in-serve nurses from hospitals in Hunan Province were selected by convenient sampling and investigated with the general information questionnaire and Conner-Davidson Resilience Scale (CD-RISC) . SPSS 23.0 was used for statistical analysis. Qualitative study: totally 21 in-service nurses who participated in the quantitative study were randomly selected for semi-structured interviews. Based on the principle of data saturation, the subject analysis method was used to organize the data.Results:The total CD-RISC score of the 749 in-service nurses was (87.28±13.28) , higher than (65.40±13.90) of the domestic norm, and the difference was statistically significant ( P<0.01) ; the average score of each dimension in descending order was (3.69±0.55) for strength, (3.41±0.58) for toughness, and (3.34±0.60) for optimism. There were statistically significant differences between the total CD-RISC score of in-service nurses with different ages, educational levels, working years, type of affiliation, form of employment, and professional title ( F=7.295, 5.446, 6.915, 3.238, 4.342, 7.914; P<0.05) ; Multi-factor analysis showed that age and education level were the main influencing factors ( P<0.05) . Two themes were extracted from the qualitative study, namely internal factors and external factors. The internal factors included the lack of personal adaptability and mental health guidance awareness, while the external factors included differences in hospital management culture, and lack of psychological service institutions, professionals and trust. Conclusions:The psychological resilience of in-service nurses in Hunan Province is higher than that of domestic norms, and is affected by both internal and external factors. It is recommended to enhance the nurses' rights protection bill in future organization and management, attach importance to their on-the-job education and provide personalized psychological service channels for employees, and further strengthen the hospital's internal psychosocial service construction.