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 evaluate factors influencing the e-Health literacy of diabetic patients. Methods Studies on e-Health literacy of diabetic patients were systematically searched in domestic and foreign databases with the time setting from inception till June 30, 2024. Literature screening and data extraction were conducted by two researchers independently, and literature quality was evaluated using the cross-sectional research evaluation tool of JBI evidence-based health care center in Australia. Results A total of 14 studies were included, covering 29 influencing factors. All the factors can be summarized into three aspects of demographic sociological factors, disease-related factors, as well as Internet use and training ones. The main influencing factors were occupation, education level, monthly income, age, place of residence and course of disease, followed by marital status, type of medical insurance, mode of living, complications, self-rated health status, sources of health information, frequency of network use, and usefulness of network health information, with controversial role of the gender factor. Conclusion There are differences in the level of e-Health literacy of diabetic patients. Nursing staff can optimize nursing measures according to the contribution degree of different influencing factors, so as to improve them.

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.

Objective To develop a risk prediction model for psychological distress in patients with pulmonary tuberculosis, and to verify it. Methods By a convenience sampling method, 232 patients with pulmonary tuberculosis admitted to the tuberculosis department of the sixth people's hospital of Nantong City, Jiangsu Province between August 2023 and March 2024 were selected. They were divided into a modeling group (n=162) and a validation group(n=70) at a ratio of 7∶3. Logistic regression analysis was conducted to explore the risk factors of their psychological distress, and a risk prediction model was established. A nomogram was constructed for visual display, and the receiver operating characteristic(ROC) was used to test its predictive effect. Results The incidence of psychological distress was 42.67%. Logistic regression analysis showed that age, gender, course of tuberculosis, coexisting diabetes, coping style, educational level and per capita monthly income of the family were the influencing factors of psychological distress. The area under the ROC curve of the modeling group was 0.887, the sensitivity was 0.843, and the specificity was 0.801. The area under the ROC curve of the validation group was 0.831, the sensitivity was 0.874, and the specificity was 0.791. Both groups of Hosmer-Lemeshow tests showed P>0.05. Conclusion The prediction model constructed in this study has a good predictive effect and can help identify high-risk patients and provide timely intervention.

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 summarize the sexual life of patients after enterostomy, so as to provide references for clinical medical staff to implement intervention strategies. Methods Qualitative studies on the sexual life of patients after enterostomy were searched in such databases as PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine Disc, Wanfang and VIP. The quality of the articles were evaluated using JBI qualitative research quality evaluation criteria, while the results were integrated by the aggregative integration method. Results A total of 8 articles were included. They were grouped into 7 categories and integrated into 3 themes: positive and negative sexual experience, as well as lack of knowledge and information about sex. Conclusion Medical staff should pay attention to the psychological and social support of patients after enterostomy, improve the health education about sex after operation,and formulate targeted intervention strategies to improve their life quality.

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.

In recent years, research on pain management in pediatric orthopedic day surgery has made significant progress, including the application of multimodal analgesia strategies, optimization of local anesthesia techniques, and exploration of non-pharmacological therapies. These advances contribute to relieving postoperative pain, shortening hospital stays, and lowering complication rates of orthopedic pediatric patients, thereby enhancing their postoperative satisfaction and life quality. This article reviewed the current status of pediatric orthopedic day surgery, pain assessment, and strategies for preoperative, intraoperative, and postoperative pain management, aiming to provide a reference for pain management.

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.

E-health literacy was significantly associated with cancer patients' ability to obtain health information and use e-health technologies. This review provided an overview of the concept and connotation, assessment tools, influencing factors and intervention strategies of e-health literacy in cancer patients, and analyzed the challenges. The aim is to provide a reference for the early identification of cancer patients with low levels of e-health literacy and personalized interventions.

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 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 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 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.

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 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 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.