Objective This study aimed to explore the potential categories and characteristics of the fear of falling in the initial ambulation day among patients who underwent major abdominal surgery,analyze the factors influencing different potential categories,and propose implications for the care of such patients.Methods A total of 213 patients who u nderwent elective major abdominal surgery in the Department of Gastrointestinal Gland Surgery and Hepatobiliary Surgery in the First Affiliated Hospital of Guangxi Medical University from April to August 2023 were selected as the study subjects.The general data questionnaire and the Revised Version of the Fall Fear Scale and Patient Fall Risk Perception Scale were used to investigate the patients on the day they first got out of bed after surgery.The potential profile of the fall fear characteristics of the study subjects was analyzed,and the relevant influencing factors among different categories were explored by univariate analysis,variance analysis,and logistic regression analysis.Results A total of 202 patients who underwent major abdominal surgery were included in this study.The total score of the fear of falling when getting out of bed for the first time was(35.28±8.85).The fear of falling showed 3 potential categories:low-level fear(22.28％),medium-level fear(47.52％),and high-level fear(30.20％).A significant difference was found in the first time of getting out of bed among different types of fear(H=19.292,P＜0.001).Results of multi-factor logistic regression analysis showed that patients with high levels of personal activity factors in fall perception and those who underwent pancreatic surgery were likely to develop medium-level fear(P=0.037).Patients with high levels of perceived environmental factors,high levels of perceived personal activity factors,and low self-efficacy were likely to develop high-level fear(P＜0.05).Conclusion The fear of falling on the initial ambulation day in patients who underwent major abdominal surgery was distributed in categories,and the proportion of patients with medium and high fear levels was high.Patients'fall risk perception,self-efficacy,and surgical site are important factors influencing fear of falling.Therefore,postoperative nursing staff should focus on developing targeted health education and activity programs to reduce the level of fall fear.

Objective:To investigate the effect of care bundles on prevention of nasal medical device-related pressure injury in patients with nasotracheal intubation undergoing oral and maxillofacial surgery under general anesthesia.Methods:This was a retrospective study. Using the convenient sampling method, patients with a surgical time more than 4 hours and a surgical grade of 3 or 4, with nasotracheal intubation undergoing oral and maxillofacial surgery under general anesthesia from Hospital of Stomatology, Sun Yat-sen University were selected. A total of 96 patients from July to December 2019 were in the control group, and 99 patients from July to December 2020 were selected as the observation group. The control group was treated with routine nursing measures, the observation group was subjected to a nursing care bundle. The incidence of nasal pressure injury was observed after the operation, 24, 48, 72 hours after the nasotracheal intubation was removed, and patients′ satisfaction score was compared.Results:The incidence of nasal pressure injury in the control group was 6.25% (6/96). None of the patients in the observation group had any pressure injury, which was significantly lower than the control group (Fisher exact probability method, P=0.013). The satisfaction scores in the observation group was significantly higher than that in the control group (26.88 ± 1.94 vs 24.71 ± 3.33), the difference was statistically significant ( t=-5.54, P<0.01). Conclusions:The care bundle can effectively prevent the occurrence of nasal pressure injury in patients undergoing oral and maxillofacial surgery with nasotracheal intubation and improve patient satisfaction.

Objective:To summarize the best evidence of pulmonary rehabilitation in adult patients undergoing upper abdominal surgery and provide evidence-based basis for clinical intervention.Methods:Systematically searched clinical decisions, guidelines, expert consensus, evidence summary, systematic review and randomized controlled trial studies on pulmonary rehabilitation for patients undergoing upper abdominal surgery in UpToDate, Cochrane Library, Web of Science, PubMed, Embase, CINAHL, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, National Comprehensive Cancer Network, Guidelines International Network, Medlive, British Thoracic Society, European Respiratory Society, American Association for Cardiovascular and Pulmonary Rehabilitation, Canadian Thoracic Society, American Thoracic Society, WanFang Database, China National Knowledge Infrastructure, VIP Database, and China Biology Medicine. The retrieval time limit was from March 11, 2012 to March 11, 2022. Evidence was extracted, summarized and recommended after strict evaluation of literature quality.Results:A total of 19 pieces of literature were eligible for inclusion. They were 2 clinical decisions, 4 expert consensuses, 4 systematic evaluations, and 9 randomized controlled studies.The best evidence included 22 recommendations in 7 dimensions, namely pulmonary rehabilitation team, patient assessment, sports training, respiratory muscle training, drug rehabilitation, health education and quality control.Conclusions:Summary of the best evidence of pulmonary rehabilitation in patients undergoing upper abdominal surgery can provide evidence-based guidance for clinical intervention, but medical staff should also develop personalized training programs according to the actual situation of patients when applying the evidence.

Objective: To explore the prevalence of health risk behaviors and the association between locus of control and health risk behaviors among college students, and to provide reference for the formulation of health risk behavior intervention for college students. Methods: A multi stage cluster random sampling method was used to select 2 provinces from the east, central and west regions of China, respectively. Two universities were then randomly selected from each selected province. A total of 3 951 college students from 12 universities completed the electronic and anonymous questionnaires, which included demographic characteristics, Multidimensional Health Locus of Control Questionnaire (MHLC) and Health Risk Behaviors Questionnaire. Chi square test and binary Logistic regression were applied to analyze data. Results: Totally 2 287(57.88%) students reported having three or more kinds of health risk behaviors. The prevalence of excessive screen time, insufficient physical exercise, poor eating behaviors, drinking and smoking were 97.34%(3 846), 74.72%(2 952), 72.21%(2 853), 13.62%(538) and 5.57%(220). Internal locus of control was associated with lower risk of three or more kinds of health risk behavior ( OR =0.98) and inadequate physical activity ( OR =0.93) and associated with higher risk of smoking ( OR =1.07). The powerful others was associated with lower risk of three or more kinds of health risk behavior ( OR =0.98), drinking ( OR =0.95) and unhealthy eating behavior ( OR =0.97). And the chance was associated with higher risk of three or more kinds of health risk behavior ( OR = 1.04 ), drinking ( OR =1.04) and inadequate physical activity ( OR =1.03)( P <0.01). Conclusion College students have serious health risk behavior problems, the locus of control is associated with health risk behaviors among college students. Which might be helpful to prevent the occurrence of health risk behaviors, and improve overall health of college students.

Objective:To establish a postoperative thirst management strategy for liver cancer patients to improve patient comfort.Methods:A total of 100 patients with liver cancer resection in the First Affiliated Hospital of Guangxi Medical University from July to December 2020 were chosen as the research objects by convenient sampling method. They were divided into observantion group and control group by random number table method, 50 cases in each group. The control group received routing nursing, and the observation group adopted the thirst management strategy. The thirst score, salivary flow rate, salivary pH value, lip mucosa moistening degree and oral comfort score of the two groups were compared.Results:The scores of thirst at 2 h, 4 h and 6 h after operation in the observation group were (7.09 ± 1.01), (5.24 ± 0.94), (3.24 ± 1.03) points, which were significantly lower than (7.97 ± 1.26), (7.00 ± 1.25), (5.67 ± 1.34) points in the control group, the differences were statistically significant ( t=-3.12, -6.46, -8.24, all P<0.05); the salivary flow rate at 2 h, 4 h and 6 h after operation in the observation group were 0.18 (0.15, 0.20), 0.23 (0.20, 0.26), 0.30 (0.25, 0.33) ml/min, which were significantly higher than 0.13 (0.13, 0.18), 0.18 (0.15, 0.20), 0.23 (0.18, 0.25) ml/min in the control group. The differences were statistically significant ( Z=-3.94, -5.81, -6.85, all P<0.05); there was no significant difference in salivary pH between the observation group and the control group after intervention ( P>0.05). The scores of oral mucosa moistening degree at 2 h, 4 h and 6 h after operation in the observation group were 3 (2, 3), 3 (3, 3), 4 (4, 4), which were significantly higher than 2 (2, 2), 3 (2, 3), 3 (3, 3) in the control group, the difference was statistically significant ( Z=-4.04, -5.02, -8.70, all P<0.05); the oral comfort of the observation group after the intervention was (5.73 ± 1.04) points, significantly higher than (4.42 ± 0.61) points, the difference was statistically significant ( t=6.20, P<0.05). Conclusion:The symptom management strategy can effectively improve the thirst of patients after liver cancer resection and improve the comfort of patients.

OBJECTIVE: To evaluate the effect of clinical nursing pathway(CNP) on clinical nursing of patients with pneumoconiosis. METHODS: A total of 120 patients with pneumoconiosis were selected as the subjects by the judgment sampling method. The patients were divided into control group and observation group by random number table method, with 60 cases in each group. The patients in the control group were given routine treatment and nursing after admission, while the patients in the observation group were treated similarly to that of the control group plus CNP. The treatment of patients in both groups were carried out until they were discharged from hospital. General Self-Efficacy Scale, Medical Coping Style Questionnaire and Quality of Life Scale were used to measure the self-efficacy, coping style and of quality of life of these two groups before and after the implementation of CNP. RESULTS: Before the implementation of CNP, there was no significant difference in the scores of self-efficacy, three dimensions of coping style and four dimensions quality of life between the two groups(P>0.05). After the implementation of CNP, the scores of self-efficacy, face dimension and quality of life in the observation group were higher than those in the control group(P<0.01). The scores of surrender and avoidance dimensions decreased(P<0.01). CONCLUSION: The implementation of CNP can improve the self-efficacy, coping style and quality of life of pneumoconiosis patients.

OBJECTIVE: To explore the application effect of clinical nursing pathway( CNP) in nursing care on patients with occupational noise-induced deafness( ONID) under medical observation.METHODS: The patients with ONID under medical observation in hospital were randomly selected and divided into CNP group( 50 cases) and control group( 50 cases) by random number table method.The control group was given routine nursing care,and the CNP group was given CNP care according to the nursing path table.Self-Rating Anxiety Scale,Self-rating Depression Scale and SF-36 Scale were used to observe the anxiety, depression and quality of life of these two groups.The time and expenses of hospitalization,and degree of nursing satisfaction were also observed.RESULTS: Before nursing care implementation,the scores of anxiety,depression and 8 dimension of quality of life did not show statistical significance between these two groups( P > 0.05).After nursing care implementation,the improvement of anxiety,depression and quality of life in the CNP group were significantly better than that of the control group( P < 0.01).The patients in the CNP group had shorter duration of hospitalization( P < 0.01),decreased hospitalization expenses( P < 0.05),and increased nursing satisfaction( P < 0.01) compared with the control group.CONCLUSION: CNP implementation can effectively reduce the anxiety and depression symptoms of patient with ONID under medical observation during the diagnostic process of occupational diseases.It can reduce the time and costs of hospitalization,improve their quality of life and satisfaction of nursing care.CNP can be widely used in clinical practice.

Objective To compare three dimensional arterial spin labeling(3D-ASL) and dynamic susceptibility contrast-perfusion weighted imaging(DSC-PWI) in evaluating the cerebral hemodynamic of Moyamoya disease. Methods Approved by the institutional review board, 26 cases of Moyamoya patients who were diagnosed by DSA were enrolled. Diffusion weighted image, 3D-TOF-MRA, 3D-ASL, DSC-WPI, and T1WI were performed in 3.0 T MR scanner. ROI were positioned in the abnormal perfusion areas and the control area according to the arterial dominant territory to obtain quantitative parameters of perfusion. Perfusion parameters including cerebral blood flow(CBF) of ASL, cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT), and time to peak(TTP)of DSC-PWI , and relative parameters (ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, DSC-rTTP) that the ratio of abnormal perfusion area and the control area were calculated. Meanwhile, the areas of the lower perfusion region of ASL and TTP images in the same slice were measured. Difference of the above-mentioned parameters and areas was processed by paired Student′ t test. Furthermore, correlation of relative values of perfusion parameters(ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, and DSC-rTTP) was processed by Pearson correlation test. Results There were significant statistics differences between values of ASL-CBF, DSC-MTT, and DSC-TTP in abnormal perfusion [(28.18 ± 10.19)ml · 100 g-1 · min-1,(7.98 ± 2.22)s,(29.93 ± 3.95)s] and the control areas [(49.50 ± 11.37)ml · 100 g-1 · min-1,(6.07 ± 1.11)s,(27.34 ± 2.58)s] (t=-12.818, 4.193, 6.163, all P<0.01). There was no significant statistics difference in the lower perfusion area between ASL-CBF [(5 729.63 ± 4 563.79) mm2]and DSC-TTP[(5 875.33 ± 4 723.08)mm2](t=-1.774,P>0.05). Furthermore, the Pearson correlation test showed significant linear dependence between ASL-rCBF(0.56±0.14)and DSC-rMTT(1.34± 0.42), and DSC-rTTP(1.09 ± 0.69)(r=-0.630,-0.748, P<0.01). Conclusions There is a correlation between 3D-ASL and DSC-PWI in assessing the magnitude and areas of the reduction of blood perfusion of Moyamoya patients. Moreover, the ASL technique possesses advantages of non-invasion use of the gadolinium contrast.

OBJECTIVE: To investigate the effect of health education in the treatment of pneumoconiosis patients with bronchoalveoar lavage( BAL) during perioperative period. METHODS: Ninety-six pneumoconiosis patients treated with BAL in hospital were divided into observation group and control group( 48 cases in each group). The patients in the control group were given routine perioperative health education, and the patients in the observation group implemented perioperative health education in accordance with the health education pathway. Adverse reactions in hospital were collected,and the awareness of perioperative health knowledge of BAL was surveyed. RESULTS: Before implement of the health education pathway,there was no difference( P > 0. 05) in the health knowledge between the 2 groups. After implementation of the health education pathway,the awareness of health knowledge of observation group and control group were higher than that of the same group before implementation of the health education pathway( P < 0. 01). The awareness of 15 items of health knowledge was higher( P < 0. 05) and the incidences of intraoperative cough and postoperative low fever were lower in the observation group than in the control group( 4. 2% vs 25. 0%,2. 1% vs 16. 7%,P < 0. 05).CONCLUSION: Executing effective healthy education pathway in perioperative BAL is helpful to improve the knowledge of disease prevention and control in pneumoconiosis patients,and reduce the occurrence of adverse reactions during BAL.