Objective To investigate the frailty status of elderly patients with diabetic retinopathy and analyze its influencing factors, so as to provide a reference for the early identification of high-risk groups as well as the delay or reduction of frailty occurrence. Methods A total of 204 elderly patients with diabetic retinopathy and admitted to Baoding First Central Hospital from January to May 2025 were selected as the research subjects. They were surveyed using the Tilburg frailty scale, the social support rating scale, the mini mental state examination, the geriatric depression scale-15, and the Pittsburgh sleep quality index. Results The incidence of frailty in elderly patients with diabetic retinopathy was 41.18%. Gender, age, marital status, sleep quality, depression, cognitive function and exercise status were the influencing factors. Conclusion Frailty is relatively common among elderly patients with diabetic retinopathy. Medical staff should pay more attention to this population to provide references for early identification, prevention and the formulation of individualized intervention plans.

Objective To explore the application effect of step walking training combined with ankle pump exercise in patients with diabetic peripheral neuropathy (DPN). Methods A total of 82 DPN patients admitted to the First People′s Hospital of Jiujiang between July 2023 and February 2025 were selected and randomly divided into a control group and an observation group, each of 41, according to a random number table. Both groups received conventional treatment for diabetes and ankle pump exercise intervention, while the observation group was additionally provided with step walking training. The degree of peripheral neuropathy, gait regulation ability and balance function were compared between the two groups. Results After the intervention, the peripheral neuropathy score of the observation group was lower than that of the control group (t=14.927, P<0.001), and the numbers of people with abnormal whole-foot pressure change curves, abnormal whole-foot balance curves, and abnormal plantar pressure center trajectory curves were smaller than the latter (χ²=4.473, P=0.034;χ²=3.989, P=0.046; χ²=3.951, P=0.047). Moreover, the timing-standing test time of the former group was shorter than that of the control group (t=14.927, P<0.001), while the single-leg standing test time with eyes closed and the single-leg standing test time with eyes open were both longer than the latter(t=-11.096, P<0.001; t=-7.434, P<0.001). Conclusion The application of step walking training combined with ankle pump exercise in patients with diabetic peripheral neuropathy can reduce the degree of peripheral neuropathy in patients, relieve abnormal gait and improve balance function.

Objective To explore the application effect of discharge planning combined with structured education on young and middle-aged patients with type 2 diabetes. Methods A total of 100 young and middle-aged patients with type 2 diabetes mellitus admitted to Zhucheng People′s Hospital between May and September 2024 were selected as the research subjects. They were randomly divided into a control group and an observation group using the random number table method. Both groups received conventional treatment and care, while the observation group was additionally implemented a discharge plan combined with structured educational intervention. After the intervention, the self-management abilities and blood glucose levels were compared between the two groups. Results After the intervention, the self-management ability score of the observation group was significantly higher than that of the control group (t=-6.765, P<0.001), while the fasting blood glucose, 2-hour postprandial blood glucose and glycated hemoglobin were all significantly lower than the latter(t=2.989, P=0.004; t=2.945, P=0.004; t=3.059, P=0.003). Conclusion The application of discharge planning combined with structured education in young and middle-aged patients with type 2 diabetes can improve the blood glucose control level of patients and enhance their self-management ability.

在新医科建设与“健康中国”战略持续深化的当下,护理学科的发展仍面临科研与临床实践脱节、创新成果转化不畅等现实问题。为此,文章提出“科普-科研-科创”一体化发展的新范式,以系统思维推动护理学科的结构性升级,并为其提供可操作的理论框架与实践指引。通过构建三者相互促进、循环增益的创新生态系统模型,并结合上海交通大学医学院附属上海儿童医学中心多平台协作的具体实践,文章从协同平台搭建、研究方法融合及人才队伍建设三个维度,论证了该范式在解决临床实际困难、培养跨学科复合型人才、推动专利转化与成果获奖等方面的积极作用。同时,研究也对当前存在的评价机制局限与学科组织壁垒等制度性挑战进行了剖析,进而提出应通过深化评价体系改革、营造开放协同的创新生态等一系列举措,助力护理学科完成从“辅助支撑”到“创新引领”的角色转变,为中国式现代化背景下的卫生健康事业贡献学科特有的智慧与创新能力。

This article summarizes the nursing experience of a patient with extremely preterm caused by uterine and bladder rupture due to invasive placenta accreta. The main points of nursing care include preoperative differential diagnosis and nursing, nursing for special medication, emergency treatment under multidisciplinary collaboration, postoperative support nursing, nursing for infection prevention and personalized psychological nursing. After multi-disciplinary collaborative treatment and meticulous care, the outcomes of both the mother and the baby were favorable.

Objective To construct an evaluation index system for evaluating the quality of venous thromboembolism care for critically ill patients, so as to provide reference for the future evaluation and improvement. Methods Based on the three-dimensional quality structure theory, the original indicator pool was established after literature review. Then an expert questionnaire was prepared after the initial indicators were drafted and discussed by the research team. Delphi method expert consultation was adopted to construct the evaluation index system for the quality of venous thrombosis care in critically ill patients. Results The system constructed contained 3 first-level indexes,6 second-level and 37 third-level indexes. The positive coefficients for the 2 rounds of expert consultation were 100% and 91.4%. Moreover, their coefficients of authority were 0.854 and 0.863, while those of Kendall′s coefficient of concordance were 0.213 and 0.235(P＜0.001 for both). Conclusion The index system established in this study is scientific and reliable, and can provide a reference for the evaluation and improvement of the nursing quality in venous thrombosis care for critically ill patients.

Objective To explore the categories of psychological detachment among the main caregivers of patients with breast cancer after chemotherapy and analyze its influencing factors. Methods A convenience sampling method was used to select 220 main caregivers of patients with breast cancer and who were treated in Suzhou Hospital Affiliated to Nanjing Medical University between December 2023 and June 2024 as the research subjects. They were surveyed using a general information questionnaire, the psychological detachment scale, the self-rating anxiety scale, the self-rating depression scale, Zarit caregiver burden scale, the social support rating scale, and the family adaptability and cohesion scale. Moreover, the latent profile analysis was used to explore the potential category characteristics of psychological detachment among the main caregivers, and multiple Logistic regression analysis was used to analyze the influencing factors of different potential categories. Results The psychological detachment of the main caregivers of patients with breast cancer after chemotherapy can be divided into three potential categories: low detachment group (45.45%), medium detachment group (35.45%), and high detachment group (19.10%). The results of multiple Logistic regression analysis showed that total care duration, daily care time, care burden, and social support were the influencing factors of psychological detachment among the main caregivers. Conclusion There are obvious classification characteristics of psychological detachment among the main caregivers of patients with breast cancer after chemotherapy. Clinical nursing staff can take targeted intervention accordingly to improve their level of psychological detachment.

Objective To explore the effect of introducing hazard analysis and critical control point (HACCP) theory in the nursing care of hemodialysis patients with diabetic renal failure. Methods A total of 100 hemodialysis patients with diabetic renal failure admitted to Kunshan Hospital of Traditional Chinese Medicine from August 2020 to August 2023 were selected and randomly divided into two groups, with 50 patients in each group. The control group received routine nursing care, while the study group received nursing care incorporating HACCP theory at the basis of the control group. The self-perceived burden, renal function and incidence of dialysis-related complications were compared between the two groups. Results After the intervention, the self-perceived burden score in the study group was significantly lower than that in the control group (t=5.178, P<0.001). Additionally, all renal function indicators in the study group were superior to those in the control group (all P<0.05). The incidence of dialysis-related complications in the study group was also significantly lower than that in the control group (χ²=5.741, P=0.017). Conclusion The introduction of HACCP theory in the nursing care for hemodialysis patients with diabetic renal failure can improve renal function, alleviate self-perceived burden and reduce dialysis-related complications.

Objective To explore the impact of exercise intervention based on the Fogg behavior model on cardiac function, self-efficacy and life quality of patients with chronic heart failure (CHF). Methods A convenience sampling method was used to select 192 CHF patients admitted to the department of cardiology of Tongji Medical College, Huazhong University of Science and Technology between November 2023 and October 2024. They were randomly divided into a control group and an observation group, according to a random number table. The control group received conventional intervention, while the observation group received exercise intervention based on the Fogg behavior model on top of the control group's intervention. Cardiac function, self-efficacy, exercise compliance and life quality were compared between the two groups. Results After intervention, the left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide, and 6-minute walk distance, as well as self-efficacy and exercise compliance in the observation group were all better than those of the control group(t=-5.478, P<0.001; t=39.378, P<0.001; t=-6.781, P<0.001; t=-7.829, P<0.001; t=-19.521, P<0.001), while the Minnesota living with heart failure questionnaire score was lower in the observation group(t=24.398, P<0.001). Conclusion Exercise intervention based on the Fogg behavior model can enhance exercise self-efficacy, exercise compliance, cardiac function and life quality of patients with chronic heart failure, and is worthy of clinical promotion and application.

Objective To explore the effect of plantar reflex area and hand point massage in the nursing care of neonates with hyperbilirubinemia. Methods A total of 112 neonates with hyperbilirubinemia and admitted to the neonatal intensive care unit of the Third People′s Hospital of Yunnan Province between March and July 2024 were selected as study subjects. They were randomly divided into a control group and an experimental group, each of 56, according to a random number table. Both groups received conventional blue light therapy, while the experimental group was additionally provided with plantar reflex area and hand point massage. Then, the transcutaneous bilirubin levels, total serum bilirubin levels, jaundice resolution time, length of hospital stay, frequency of defecation and incidence of adverse symptoms were compared between the two groups. Results The experimental group showed significantly lower transcutaneous bilirubin levels and total serum bilirubin levels than those of the control group (F_group=27.690, P<0.001; F_group=83.178, P<0.001). Moreover, the jaundice resolution time and length of hospital stay of the experimental group were significantly shorter than those of the control group(t=6.131, P<0.001; t=5.559, P<0.001), while the incidence of adverse symptoms was significantly lower than the latter(χ²=5.617,P=0.018). Meanwhile, the frequency of defecation in the experimental group was significantly more than that in the control group (t=-2.819, P=0.006). Conclusion The plantar reflex area and hand point massage demonstrates significant efficacy in the treatment of neonatal hyperbilirubinemia. It effectively reduces bilirubin levels, promotes defecation to accelerate jaundice resolution, shortens hospital stays and alleviates clinical discomfort symptoms.

Objective To analyze and clarify the conceptual connotation of spiritual care for cancer patients, so as to provide a theoretical reference for nursing research and practice. Methods Studies on spiritual care were systematically searched in China National Knowledge Infrastructure, Wanfang Data, VIP, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information Database (PsycINFO), covering the period from database inception to February 2025. A total of 65 articles were included and analyzed using Rodgers′ evolutionary concept analysis framework. Results Spiritual care for cancer patients encompasses four core attributes: patient-centered care, identification and response to spiritual needs, meaning reconstruction and transcendental connection, as well as integrative and multidisciplinary collaboration. Its antecedents included heightened awareness and understanding of patients′ spiritual needs, reflection on the traditional biomedical model and the rise of the holistic care concept, as well as academic promotion of the spiritual care across multiple disciplines. Moreover, the consequences were reflected in the improvement of the overall life quality of patients and their family members. Conclusion Spiritual care is a patient-centered, integrative care model that aims to identify and address the profound spiritual needs arising from illness through multidisciplinary collaboration. It assists patients in reconstructing life meaning and establishing transcendent connections, ultimately achieving holistic well-being of body, mind, and spirit. Spiritual care is of significant importance in the nursing of cancer patients, as it not only helps healthcare professionals better understand and implement such care but also guides the development and optimization of interventions, thereby enhancing their life quality.

Objective To explore the application effect of Fire Dragon Cupping therapy in patients with constipation after thoracolumbar fracture surgery based on the theory of teapot lifting and lid-lifting. Methods By using the convenience sampling method, 68 patients with constipation after thoracolumbar fracture surgery and admitted to the department of orthopedics of Shenzhen Hospital(Futian) of Guangzhou University of Chinese Medicine between June 2024 and February 2025 were selected as the research objects. They were randomly divided into a control group and an observation group, each of 34, according to a random number table. Both groups were given conventional treatment and postoperative care for thoracolumbar fractures, while the observation group was additionally treated with Fire Dragon Cupping therapy. The constipation symptom scores and life quality of the two groups were compared. Results After intervention, the constipation symptom score and the score of patient assessment of constipation quality of life questionnaire in the observation group were both significantly lower than those of the control group (t=8.194, P<0.001; t=9.143, P<0.001). Conclusion The therapy in this study can alleviate the related symptoms of constipation in patients and improve their life quality, it′s worthy of clinical promotion and application.

Objective To construct evaluation index system of nursing service quality in interventional catheterization rooms based on the service quality gap model. Methods Based on the service quality gap model, the initial draft of the evaluation index system for the nursing service quality of the interventional catheterization room was drafted after literature research and semi-structured interviews. The Delphi method was adopted to revise and determine the index system, and analytic hierarchy process was employed to determine the weight of evaluation indicators at all levels. Results The positive coefficients of the experts in the two rounds of letter consultations were 92.59% and 96.00% respectively, while the expert authority coefficients were 0.908 and 0.940 respectively. Moreover, the Kendall's harmony coefficients of the first-level indicators were 0.285 and 0.282 respectively, and those of the second-level were 0.243 and 0.255 respectively. The final established evaluation system included 6 first-level indicators, namely tangibility, reliability, responsiveness, assurance, empathy and economy, as well as 39 second-level indicators. Conclusion The constructed evaluation indicator system is Objective and comprehensive in content, with good scientificity, reliability, and practicability. It can be used for the evaluation and continuous improvement of the nursing quality in related fields.

Objective To explore the application effect of different bowel preparation programs in infant colonoscopy. Methods A total of 120 infants who underwent colonoscopy in the digestive endoscopy center of the People′s Hospital of Guangxi Zhuang Autonomous Region in years from 2021 to 2024 were selected as the research objects. They were randomly divided into group A, group B and group C, with 40 cases in each group. Group A was treated with physiological saline bowel preparation program, group B was done with Kaisailu combined with physiological saline bowel preparation program, and group C was given dimethicone in addition to the bowel preparation program of group B. The intestinal cleaning effect, intestinal defoaming effect, tolerance and incidence of adverse reactions were compared among the three groups. Results The intestinal cleaning effect was significant differences among the three groups(Z=11.537, P=0.003), with that of group B and group C significantly better than group A (P=0.007; P=0.002), but no significant differences between group B and group C (P=0.660). Moreover, there were significant difference in the intestinal defoaming effect among the three groups (Z=39.847, P＜0.001), with that of group C significantly superior to group A (P＜0.001) and group B (P＜0.001). Meanwhile, significant differences were found among the three groups in tolerance (Z=9.565,P=0.008), with that of group C significantly better than group A(P=0.004) and group B (P=0.014). Furthermore, the incidence of abdominal distension was significant differences among the three groups(χ²=8.750,P=0.013), with that of group C was significantly lower than group A (P=0.003) and group B (P=0.012). Conclusion Kaisailu and dimethicone bowel preparation program can improve the quality of bowel preparation in infants and toddler, reduce the incidence of abdominal distension, and increase the tolerance of bowel preparation. It can provide references for clinical practice of bowel preparation in infant and toddler colonoscopy.

Objective To develop the nutritional literacy evaluation scale for patients with chronic heart failure (CHF) and test its reliability and validity. Methods Based on the hierarchical model of health literacy and the theory of knowledge, action and belief, item pool was initially formed after literature review and semi-structured interviews. Then the items are revised using the Delphi method. A total of 318 CHF patients admitted to the cardiovascular department in the second half of 2023 were surveyed using the new scale to test its reliability and validity. Results The scale constructed included 4 dimensions and 21 items. The content validity at the scale level was 0.852, and the content validity of items ranged from 0.805 to 0.861. Moreover, 4 common factors were extracted using the exploratory factor analysis, with a cumulative variance contribution of 72.314%. The Cronbach′s alpha coefficient of the overall scale was 0.858, while that of the four dimensions of nutritional cognition and attitude, nutrition knowledge, skill operation, as well as nutritional information and critical decision-making were 0.898, 0.916, 0.920 and 0.925, respectively. Conclusion The nutritional literacy assessment scale for CHF patients constructed in this study has good reliability and validity, and can be used as an evaluation tool in the clinical practice.

Niemann-Pick disease (NPC) often leads to feeding difficulties in affected children due to hepatosplenomegaly and abnormal digestive tract anatomy. Traditional nasogastric tubes are prone to causing aspiration, while gastroscopy-guided catheterization is highly invasive. This article reports the case of a 1-year-11-month-old child with NPC and digestive system anatomical abnormalities who underwent bedside nasojejunal tube placement assisted by magnetic navigation technology. Using electromagnetic positioning to track the catheter trajectory in real time, the insertion angle was precisely adjusted, successfully overcoming difficult catheterization caused by gastric looping and liver compression. Postoperatively, progressive enteral nutrition support was delivered through the nasojejunal tube, significantly improving the child's nutritional status and reducing the risks of gastric retention and aspiration.

Objective To construct a training program for clinical communication skills of junior nurses, so as to provide a reference for improving their communication skills. Methods Based on literature research and semi-structured interviews, the training program was initially drafted. Two rounds of expert letter consultation were conducted using the Delphi method, and the final training program was determined. Results The response of the experts in the two rounds of expert inquiries was 100% and 95.45% respectively, with the authority coefficients of 0.896 and 0.883 respectively, and the Kendall harmony coefficients of 0.180 and 0.213 respectively. The final training program included 5 first-level items, 14 second-level items and 46 third-level items, namely training objectives, training instructors, training methods, training contents and training evaluation. Conclusion The training program for clinical communication skills of junior nurses constructed in this study is scientific and practical, and can provide an effective reference basis for the training of clinical communication skills of junior nurses.

Objective To summarize evidence related to prevention and management of local complications of patients after subcutaneous injection of anticoagulants, so as to provide references for clinical practice. Methods The articles about prevention and management of local complications after subcutaneous injection of anticoagulants were searched from domestic and international databases, guideline websites and professional association websites, with the search time setting from January 1, 2016 to November 30, 2023. Two researchers screened and extracted data independently. Results Totally 18 articles were selected, including 2 practice recommendations, 1 evidence summary, 2 clinical decisions, 1 best clinical practice, 11 systematic reviews, and 1 expert consensus. Then 17 pieces of best evidence were summarized from 5 aspects, consisting of preparation before injection, selection of appropriate body position,selection of appropriate injection position, injection skill and treatment of complications. Conclusion The prevention and management of local complications after subcutaneous anticoagulant injection in patients is of great significance to reduce adverse outcomes in patients, and clinicians should construct an evidence-based standardized subcutaneous anticoagulant injection process.

The emergency treatment and nursing care of a child with Bartter syndrome combined with upper gastrointestinal bleeding was summarized. The main nursing measures included early recognition of acute upper gastrointestinal bleeding symptoms, early enteral nutritional support, dynamic monitoring of potassium changes and nasogastric potassium supplementation, early psychological nursing. After 16 days of meticulous treatment and nursing, the symptoms of gastrointestinal bleeding and electrolyte imbalance improved, and there was no arrhythmia or cardiac arrest, and the child was discharged after his condition was stable.