Objective To evaluate the effectiveness of perioperative fasting abbreviation in traumatic patients undergoing selective surgeries.Methods The traumatic patients undergoing selective surgeries from November 2016 to January 2017 at our department were selected for this prospective cohort study.They were divided into an intervention group (69 patients) and a control group (121 patients) according to the wards where they stayed.The intervention group was fasted for solids 6 hours prior to surgery and received oral solution with maltodextrin 2 hours prior to surgery.After surgery,they were allowed to drink liquids as soon as they were awakened.Normal food was allowed 2 hours later.The control group was fasted for either liquids or solids the night before surgery.After surgery,the patients who had received brachial plexus block only were allowed liquids with no limitation while the other patients were allowed liquids 6 hours after surgery and then were free for solids and liquids if no discomfort was observed.The time periods for preoperative liquids and solids fasting and for postoperative intake of liquids and solids were recorded and compared between the 2 groups.The perioperative well-beings (including anxiety,thirst,hunger,nausea,fatigue,dizziness,sweating and stomach discomfort) and serum glucose levels were compared between the 2 groups.Adverse reactions were observed.Results The preoperative fasting time for liquids for the intervention group (4.5 ± 2.9 hours) was significantly shorter than that for the control group (14.3 ±3.9 hours) (P ＜ 0.05).The preoperative fasting time for solids for the intervention group (17.6 ± 3.0 hours) were significantly longer than that for the control group (16.1 ±3.8 hours) (P ＜ 0.05).The postoperative fasting time periods for both liquids [1 (0,3) h] and solids [2 (1,4) h] for the intervention group were significantly shorter than those for the control group [6(6,6) h] hours and [6(6,6) h] (P ＜ 0.05).Compared with the control group,the perioperative anxiety,thirst,hunger,nausea,fatigue,dizziness and stomach discomfort were significantly improved in the intervention group (P ＜ 0.05).The average serum glucose level was similar in both groups upon admission (P ＜ 0.05);it was significantly higher in the intervention group immediately before surgery (P ＜ 0.05) but was gradually decreased after surgery until there was no significant difference between the 2 groups (P ＞ 0.05).No major adverse reaction was observed in either group.Conclusion The protocol of perioperative fasting abbreviation may be safe and feasible in traumatic patients for selective surgeries,showing benefits of decreased anxiety,thirst,hunger,nausea,fatigue,dizziness and stomach discomfort.

Objective To investigate the core competence, self-efficacy and correlation of geriatric clinical front-line nurses in Nantong medical institutions, and to analyze the influencing factors of the two, so as to provide reference for the formulation of training programs for geriatric clinical front-line nurses. Methods Using convenience sampling method, the geriatric clinical front-line nurses in Nantong medical institutions were investigated by Geriatric Nursing Competency Inventory (GNCI) and General Self-Efficacy Scale (GSES) from October to December 2017. Single factor analysis, Pearson correlation and multiple linear regression were used to analyze the correlation between core competence and self-efficacy of geriatric clinical nurses and the influencing factors. Results The score of GNCI was (2.51±0.64), and the score of GSES was (2.60±0.65). Pearson correlation analysis showed that core competence of geriatric nursing was positively correlated with self-efficacy (r=0.472, P＜0.01). There were significant differences in the scores of GNCI of geriatric clinical front-line nurses with different ages, working years, educational background, professional title, marriage, personnel nature, number of night shifts on duty, whether they were teaching, professional interests, whether accept advanced study in superior hospitals and family support (P＜ 0.05). There were significant differences in the scores of GSES among clinical front-line geriatric nurses with different ages, marriages, number of night shifts on duty, whether they were teaching, professional interests and family support (P＜0.05). Multivariate linear regression analysis showed that professional interest was the influencing factor of core competence of geriatric nursing (P＜0.05). Conclusions The core competence of clinical front-line nurses in Geriatrics Department is low, and their self-efficacy is moderate. There is a positive correlation between them. As a nursing administrator in Geriatrics Department, it is significant to strengthen the training of clinical front-line nurses, constantly improve the training curriculum and career planning, and improve the core competence and self-efficacy of geriatric nursing.

Objective To explore and analyze the quality of life and family care in elderly patients with type 2 diabetes and their correlation, and to offer a basis for making family care plans after being discharged from hospital.Methods Totally 441 elderly patients with type 2 diabetes between July 2014 and June 2016 were investigated with the Simplified Health Questionnaire (SF-36) and Family APGAR Index, and the Pearson correlation analysis was conducted on their correlation.Results The patients scored (6.27±1.74), (535.46±22.33) and (3.35±0.83) in family care, quality of life and health transition, respectively. Family care was positively correlated with the eight dimensions indicating quality of life (r=0.138-0.660,P<0.01), and negatively correlated with health transition (r=-0.100,P<0.05).Conclusions Elderly patients with type 2 diabetes show a low quality of life, and their family function is between moderately dysfunctioning and well-functioning. Therefore, the hospital, community, family and individual need to work together to improve patients' family function and quality of life.

Objective To explore the effect of transitional care model on health recovery in discharged elderly patients with angiocardiopathy.Methods A group of transitional care of geriatric department was formed by physicians and nurses of geriatric department, physicians and therapists of rehabilitation department and so on. A total of 81 discharged patients with angiocardiopathy of geriatric department in the Second People's Hospital of Nantong were selected as research group from July 2015 to February 2016 using purposive sampling. They accepted transitional care. A total of 85 elderly patients with angiocardiopathy were recruited as control between December 2015 to June 2016 with routine health education. The effect and the patients' satisfaction were compared between two groups.Results The compliance rate of medication of patients was 93.6% in research group and 65.8% in control group in the second week after leaving hospital with a significant difference (χ2=20.447,P<0.05). There was a statistically significant difference in satisfaction between research group [(95.21±1.98)%] and control group [(88.34±1.84)%] (t=32.7470,P<0.05).Conclusions The transitional care can improve the medication compliance in discharged elderly patients with angiocardiopathy, help them build up health lifestyle and improve the quality of life of patients.

Objective To investigate the risk factors of falls and balance force in community elderly patients with orthostatic hypotension,so as to prevent from fall risk.Methods The elderly fall risks assessment tool and the elderly balance force test table were investigated in community elderly patients with orthostatic hypotension in community.Results The average score in fall risk assessment of 189 elderly patients with orthostatic hypotension in community was (6.78±5.49)and the average score in balance ability was(5.42±5.23), and there were statistically significant differences in occupation, gender and marital status(P<0.05).The fall risk assessment was positively correlated with the balance ability(r=0.637,P< 0.01).Conclusions The elderly patients with orthostatic hypotension in community have a higher risk of falls and balance problems, so the community should carry out comprehensive measures to improve the environment of community and home, strengthen the balance ability training,and reduce the risk of falls.

Objective To explore the influence of acupuncture point massage combined with limb function exercise on ankle brachial index (ABI) and pulse wave velocity (PWV) in patients with coronary heart disease (CHD). Methods According to scores by grace score scale, 180 CHD patients were divided into three groups: low risk group (n=58), moderate risk group (n=68) and high risk group (n=54). Within the three groups, the patients were divided into the experiment group and the control group by using the random digital table. The control group was treated with routine nursing intervention , while the experiment groups accepted acupuncture point massage and limb function exercise training on the basis of control groups. We collected the values of ABI and PWV at four points-in-time: before intervention, 7 days after intervention, 30 days after intervention and 90 days after intervention. Results Repeated measurement data analysis of the experiment group and control group suggested that:in the moderate and high risk groups, there was statistically significant difference (P<0.05) in the data at the four time points. There was no statistically significant difference (P > 0.05) in time and group interaction effect. The difference between the experiment group and control group was statistically significant (P<0.05). Repeated measurement data analysis showed that there was no statistically significant difference (P>0.05) in ABI&PWV interaction effect at the four time points between the experiment group and control group. In the low-risk group,the differences in time points compared with the main effect were insignificant (all P>0.05). In comparison of main effect at all the four time points, there was significant different in the moderate and high risk group (P<0.05), And it suggested that time and group interaction, namely effect of time factor (1 d, 7 d, 30 d, 90 d), was not decided by the division of groups. In comparison of main effect, the difference was statistically significant (all P < 0.01) in the moderate and high-risk group, which indicated the main effect (intervention) playing main role. However, there was no statistically significant difference (P>0.05) of ABI&PWV before and 90-days after intervention. Conclusion Acupuncture point massage combined with limb function exercise can effectively improve the peripheral artery blood supply in CHD patients, lower ABI and promote PWV.

Objective We sought to evaluate the effect of structured health education on quality of life and the end point of patients with coronary disease with evidence-based method.Methods The Cochrane Library,Cochrane Database of Systematic Reviews (CDSR),Medline (OVID),Pubmed and Web of Science were searched to collect the randomized controlled trials (RCT) which mentioned the structured health education to CHD patients,the quality of the RCTs was evaluated by Jadad Score,then effective data were extracted and analyzed by Meta-analysis with RevMan 5.2 software.Results A total of 12 eligible studies of RCT were included in the study with Jadad Score evaluations at B level or above.There were 20 476 cases in the intervention group,14 522 cases in the control group.Meta-analysis showed that the quality of life scores of the intervention group were significantly higher than those of the control group,weighted mean difference was 3.29,95％ CI (0.49-6.09).No significant difference was found in cardiac morbidity outcomes,re-hospitalization and the mortality rate,relative risk,95％ confidence interval were respectively 0.72(0.50-1.04),0.98(0.86-1.11),0.77(0.58-1.03).Conclusions The structured health education can improve the quality of life of patients with coronary disease,but has no obvious effect on the cardiac morbidity outcomes,re-hospitalization and mortality rate.We suggest transitional care to be carried out in future research to decrease the incidence rates of them.

Objective To establish a scientific and feasible evaluation index system of the quality of health education among the elderly in the community.Methods Based on the results of literature review,theory analysis,cross-sectional study and interviews,a draft evaluation index system was formulated.Then Delphi method was conducted on 28 specialists around the country,the weight of each index was determined by hierarchy analysis.Results After three rounds of Delphi procedure,the response rates of the three round consultation were all above 85％,and the authority coefficient and coordination coefficients was 0.858,0.210,respectively.An evaluation index system which covered three first-level items,7 second-level items and 35 third-level items was formulated.Conclusions Based on survey of the elderly and interviews of health education staffs in the community,and using the method of Delphi to collect experts' suggestion,a strong maneuverability and high reliability quality evaluation index system was formulated,which provided guidance for community health education of the elderly,and promoted its development towards scientization and standardization.

Objective To parse the concept of self-management in the context of coronary heart disease based on the content analysis,to clarify the connotation of the concept of self-management.Methods Thirty-four references were recruited through the databases of CNKI,VIP journals knowledge service platform,Wanfang Data Services Platform and Pubmed.We broke the concept of self-management in the context of coronary heart disease into such three aspects as implementing body,major behavior,and facilitators.Results The most common indicators were symptom management(which was mentioned by 78.57％ of domestic literature and 66.67％ of foreign literature),and protect and promote healthcame second,the person with the chronic diseasewas 42.85％,other indicators' frequency existed differences.The major body of coronary artery disease self-management was the patient itself,with the help of assist staff and using lifestyle management,symptom management,rehabilitation and exercise,environmental control,emotional awareness behavior management and medication to maintain patients' satisfactory functional status.Conclusions To parse the concept of self-management in the context of coronary heart disease can be applied as the basis for clinical nursing research and build an effective reference and guidance for future coronary heart disease self-management model building.

Objective To apply the nursing intervention based on the protection motivation theory in community elderly patients with hypertension , in order to establish a health behavior and to control bloodpressure and enhance better quality of life .Methods Using the random number table method , 144 elderly patients with hypertension were randomly divided into control group and intervention group .The intervention group received comprehensive nursing intervention based on protection motivation theory .The physiological index, health behavior and the scores of protection motivation questionnaire for elderly patients with hypertension were compared between the control group and the intervention group .Results Before the intervention , the physiological index , health behavior and the scores of protection motivation questionnaire for elderly patients with hypertension between groups had no significant difference (P>0.05).For the intervention group after 6-month-intervention, the systolic blood pressure was( 136.85 ±15.32 ) mmHg, the diastolic blood pressure was (80.78 ±10.54) mmHg, the cholesterol level was (4.49 ±0.83) mmol/L, the score of self-efficacy was (18.03 ±1.75) and the score of susceptibility was (18.32 ±3.04).Those values and scores in the control group were (139.28 ±13.44)mmHg, (89.25 ±8.78) mmHg, (5.33 ±0.91) mmol/L, (7.24 ±1.04), (16.82 ±1.97) and (16.56 ±4.22).The differences between groups were statistically significant (t=1.35, 5.17, 4.98, 3.36, 3.69, 2.11, respectively;P <0.05 ).After 6 months of comprehensive nursing intervention , the physiological index , health behavior and the scores of protection motivation questionnaire for elderly patients with hypertension were statistically significant ( P <0.05).Conclusions Comprehensive nursing intervention based on protection motivation theory can promote the health behavior of community elderly hypertensive patients and can effectively control high blood pressure and improve patients ’ quality of life.