总结1例急性上消化道出血并发急性脑梗塞患者的护理经验。护理要点包括早期液体复苏与容量管理,维持循环稳定;动态性目标化血压血糖管理,预防并发症;预见性护理干预,改善患者健康结局;舒适化护理,改善患者口渴困扰;早期开展全面系统的康复护理,改善患者社会功能。经过8 d的治疗和护理,患者病情稳定,转入普通病房继续治疗。

Objective To explore the mediating effect of self-efficacy and mutuality on preparedness and care stress of caregivers for stroke survivors. Methods The caregivers of 252 stroke survivors hospitalized in the neurology ward of a grade-A tertiary hospital in Henan province between June and September 2022 were selected using the convenient sampling method, and surveyed using the caregiver preparedness scale (CPS), caregiver strain index (CSI), mutuality scale (MS), and the caregiver self-efficacy in contributing to patient self-care scale(CSE-CSC). Results The score of CSI was (9.12±2.13) point, negatively correlated to the CPS, CSE-CSC and MS scores (20.59±2.12, 74.53±5.25, 39.08±2.96; r=-0.655, -0.585, -0.548, P＜0.01 for all). Moreover, the CPS score was positively correlated to the CSE-CSC and MS scores(r=0.750, 0.631, P＜0.01 for both). Caregiver readiness had direct effect on their caregiving stress, or indirect effect through the self-efficacy, mutuality and their chain mediating effect, with the affecting values of -0.092, -0.070 and -0.039. Conclusion Self-efficacy and mutuality play a chain mediating role between caregiving readiness and caregiving stress. Therefore, medical staff should provide targeted education and guidance to help caregivers to adapt actively to their roles, and develop mutuality-centered intervention to reduce their stress efficiently.

Objective To investigate the status quo of postoperative breast cancer patients and analyze its influencing factors. Methods A total of 190 postoperative breast cancer patients admitted to the hospital between January 2021 and February 2023 were selected, and investigated using a general condition questionnaire, comprehensive assessment of acceptance and commitment therapy processes(CompACT), self-rating anxiety scale(SAS), and family intimacy and adaptability and cohesion evaluation scale Ⅱ(FACES-Ⅱ). Results The CompACT score was (82.98±8.76) point. The results of multiple linear regression analysis showed that marital status, family per capita monthly income, anxiety, family intimacy and adaptability were independent influencing factors of the PFCQ score (R²=0.680, _△R²=0.672, F=85.162, P＜0.001). Conclusion The psychological flexibility of postoperative breast cancer patients is not above the average. Therefore, targeted intervention should be given to patients without spouse, or of low income, or with moderate to severe anxiety, or of low family intimacy and adaptability to improve their psychological flexibility.

文章总结了1例反复腹泻的干燥综合征合并重度营养不良患者的护理经验。在明确患者营养不良原因的基础上,结合患者个体情况制定营养支持方案,保障经鼻胃管序贯全肠内营养的顺利实施,减少肠内营养不耐受;加强失禁性皮炎的护理,积极预防压力性损伤的发生;动态监测并预防再喂养综合征;同时给予基于家庭的健康指导,提升患者治疗依从性。经过精心治疗和护理,患者腹泻缓解,营养状况改善,病情明显好转后出院。

Objective To retrieve, evaluate and summarize the best evidences for the management of dysphagia among stroke survivors. Methods The evidence of dysphagia management of stroke survivors was searched in databases including UpToDate, BMJ, JBI, Embase, National Guideline Clearinghouse, Cochrane Library, Web of Science, PubMed and CINAHL, as well as China Biology Medicine(CBM), China National Knowledge Infrastructure(CNKI) and Wanfang data. The retrieval period was January 2018 to March 2023. The literatures were screened, quality evalvated, evidence extracted and summarized. Results A total of 32 articles were found, yielding 44 pieces of best evidence covering eight aspects of multidisciplinary collaboration, dysphagia screening and assessment, dysphagia nutritional management, treatment and rehabilitation, prevention of complications, health education, personnel training, and patient follow-up. Conclusion The best evidence summarized in this study offers evidence-based support for clinical practice.

This paper summarizes the practical experience of providing home nursing service for patients with home nursing needs, led by tertiary hospitals on the “nursing service at home” platform. Between September 2021 and September 2023, the author's hospital carried out a total of 48 kinds of home nursing service projects, completed 2 045 home nursing service orders, and the patient satisfaction evaluation reached 100%. The implementation of “Internet + nursing service” has benefited more people in need, with high satisfaction. However, such limitations of insufficient human resources, insufficient projects and security risks should also be paid attention to, and improved in the future.

Objective To systematically evaluate and integrate qualitative research on the experience of moral distress experienced by ICU nurses, so as to provide references for clinical intervention strategies. Methods Qualitative research on moral distress of ICU nurses were searched in PubMed, Web of Science, Embase, EBSCOhost, CNKI, Wanfang, VIP, and China Biology Medicine Disc, with the time setting from the inception until July 2023. The articles selected were evaluated using the quality evaluation criteria of Australian evidence-based health care center, and Meta integration was performed using the pool integration method. Results From 9 studies selected, 39 research results were extracted and summarized into 8 new categories, and further integrated into 3 results of the factors contributing to the moral distress of ICU nurses, feelings of moral distress, and ways of coping with moral distress. Conclusion The moral distress of ICU nurses is often related to many factors, and hurt them physically and mentally, affecting nursing safety. It is recommended to pay attention to such problem, and establish targeted support systems to help nurses to deal with it.

Objective To identify the risk factors for hypoglycemia in elderly patients with diabetes mellitus. Methods Studies on risk factors for hypoglycemia in elderly patients with diabetes mellitus were searched in databases such as PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Database, with the search time up to July 15, 2023. Two independent researchers conducted literature screening, data extraction and quality evaluation, followed by the data processing using the Stata 15.1 software. Results A total of 20 studies were included, covering 656 293 subjects. According to the Meta-analysis, age ≥80 years, BMI＜25 kg/m², insulin, sulfonylureas, combined use of hypoglycemic drugs, disease duration＞10 years, no self-monitor blood glucose, impaired renal function, dementia or cognitive dysfunction were risk factors for hypoglycemia in elderly patients with diabetes mellitus. Conclusion Many factors can result in hypoglycemia in elderly patients with diabetes mellitus. Therefore, nursing staff should carry out early screening and intervention to lower its occurrence.

Objective To explore the impact of maternal voice stimulation on the extremely premature infants based on augmented reality sound simulation technology. Methods Seventy-six extremely premature infants born in a grade-A tertiary hospital in Guangzhou between January 2021 and June 2022, were divided into an observation group and a control group, each of 38, according to a random number table. Both groups were given routine nursing, while the observation group was additionally provided with maternal voice stimulation based on augmented reality sound simulation technology for 14 days. Then, the growth and development indicators, heart rate, rehabilitation effect and incidence of complications were compared between the two groups. Results There were statistically significant differences in heart rate between the two groups in terms of time, groups and interaction effects(F_time=10.318,P<0.001; F_group=7.399,P<0.001;F_intergroup=9.281,P<0.001), and the number of days receiving total enteral nutrition was shorter than the latter (t=2.621, P=0.011). However, after the intervention, no significant differences were found between the two groups in the body length, head circumference,body weight, ventilator use time, oxygen use time, hospital stay and complication rate(P>0.05). Conclusion Maternal voice stimulation based on augmented reality sound simulation technology has a good effect on the extremely preterm infants, which can stabilize their heart rate and help them to reach full intestinal feeding as soon as possible.

Objective To systematically evaluate the intervention effect of ice stimulation therapy on thirst of critically ill patients. Methods Databases including the PubMed,CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine, Wanfang and VIP database were searched to collect the literatures on the intervention effect of ice stimulation therapy on thirst of critically ill patients with the time setting from the establishment to March 31, 2023. Two researchers screened the literature according to the literature inclusion and exclusion criteria, and extracted the data. Then RevMan 5.4 software was used for Meta-analysis. Results Ten studies involving 1 117 patients were included. Meta-analysis showed that ice stimulation therapy could alleviate thirst [MD=-2.867,95%CI(-4.102,-1.632),P＜0.001] and dry mouth [SMD=-1.449,95%CI(-1.658,-1.240),P＜0.001], improve the saliva pH value[MD=0.922,95%CI(0.824,1.021),P＜0.001]. However, such intervention could not relieve the pain of thirst [SMD=-1.481,95%CI(-2.391,-0.571),P=0.050]. Conclusion Ice stimulation therapy can relieve the thirst and dry mouth of critically ill patients, and improve their saliva PH value. Such therapy is worthy further studying and applying.

This paper reviews the definition of mobile health, the application of mobile health in the health management of coronary heart disease, the existing problems and future prospects, aiming to provide reference and basis for the future development of mobile health services for patients with coronary heart disease in China.

目的 探讨团体心理辅导对规培护士心理弹性、自我效能及心理压力的影响。方法 选取笔者所在医院的50名规培护士,在常规护理理论和操作培训基础上,对其实施团体心理辅导,比较干预前后规培护士的心理弹性、自我效能及心理压力。结果 干预后,规培护士心理弹性及自我效能得分均高于干预前(t=2.371,P=0.020;t=3.172,P=0.002);心理压力得分低于干预前(t=2.370,P=0.019)。结论 团体心理辅导能够提高规培护士心理弹性和自我效能,减轻其心理压力,有利于其更好地适应临床护理工作。

Objective To explore the nursing experience of family caregivers in different stages of female enterostomy disease, so as to provide references for designing corresponding nursing support programs. Methods Forty-one family caregivers of female enterostomy patients treated between February and December 2022 were selected from Benxi central hospital, and given a non-structured interview. The Colaizzi 7-step analysis method was applied to analyze, summarize and extract the themes. Results Four themes were extracted for patients in different stages: lack of disease cognition, decreased diet and sleep quality in the perioperative period, increased fatigue when preparing for discharge, longing for professional guidance in the adjustment period, as well as post-traumatic growth in the adaptive period. Conclusion The care experience of family caregivers of female enterostomy patients at different stages is dynamic,and medical staff should provide individualized technical guidance as well as emotional and social support,so as to help them overcome the difficulties and improve the quality of continuous care services.

文章总结了1例急性Stanford A型主动脉夹层合并巨大升主动脉瘤形成患儿的护理体会。通过术前紧急、快速的救治处理,急诊手术,术后控制出血、维持血压稳定、加强呼吸道管理及神经系统监测、做好环境及心理护理、加强营养支持,患儿康复出院。

Objective To conduct a Meta-analysis of the influencing factors of medication adherence among the middle-aged and elderly diabetic patients. Methods Observational studies related to factors influencing medication adherence among the middle-aged and elderly diabetic patients were searched in databases including the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Internet, CINAHL, Wanfang Data, VIP and CBM. The time period was set from inception until December 2023. Then the literature screening, quality assessment and data extraction were conducted and cross-checked by 2 independent researchers. Moreover, the Meta-analysis was performed using the Stata 17.0 software. Results A total of 14 articles were selected, covering a total sample size of 4 920, with 3 023 patients of good medication adherence. Gender, marital status, education, income, belief in taking medication, times of glucose monitoring, perceptions of complications and number of medications were the influencing factors of medication adherence among middle-aged and elderly diabetic patients. Conclusion The medication adherence of the middle-aged and elderly diabetic patients is affected by a variety of factors, and medical staff should take targeted actions to promote their medication adherence.

Objective To explore the mediating effect of e-health literacy on social support and benefit discovery in patients with chronic heart failure(CHF). Methods Totally 292 CHF patients in a grade-A tertiary hospital in Henan province were investigated by using a general condition questionnaire, a social support rating scale(SSRS), an eHealth literacy scale(eHEALS) and the Chinese version of benefit finding scale(C-BFC). Results The total C-BFC, EHLS and SSS scores were(49.32±11.46) points, (24.50±3.89) points and (40.29±8.18) points, respectively. E-health literacy played a partial mediating role in the relationship between social support and benefit discovery in patients with chronic heart failure. The mediating effect was 0.057, accounting for 20.36% of the total effect. Conclusion It is suggested that clinical staff should strengthen the social support and e-health literacy of CHF patients, so as to improve their level of benefit discovery.

Objective This article summarized the nursing experience of a case of extremity artery thrombosis caused by transradial catheter in a very low birth weight infant. It mainly includes early identification, local wet hot compress with nitroglycerin to dilate blood vessels, anticoagulation of low molecular weight heparin sodium, urokinase thrombolysis, combined with oxygen blowing, wet compress with magnesium sulfate and other comprehensive nursing measures. Through targeted treatment and intensive care. The blood circulation of the affected limb was restored, the finger color and finger activity were restored to normal, and the patient was discharged after 33 d recovery.

Maintenance hemodialysis is an important means to treat end-stage renal disease, and effective home management is the key to their life quality. Mobile health is a service by using the mobile devices to support medical and public health practices. It is easy to track characteristics, can break the time and space constraints. This paper reviews the definition of mobile health care, the mobile medical management model and needs of MHD patients at home, in order to provide references for future development.

Objective To explore the level of illness uncertainty among fathers of the neonatal intensive care unit (NICU) premature infants and analyze its influencing factors. Methods Totally 236 fathers of premature infant in NICU were selected, and surveyed using a general condition questionnaire, the Chinese version of the illness uncertainty parental scale, and the simplified coping style questionnaire. Results The total score of illness uncertainty was (77.54±10.25) points, and the scores of the positive and negative coping dimension were (25.28±5.66) points and (9.40±3.08) points, respectively. Multiple linear regression analysis showed that the gestational age of premature infants, educational level of premature fathers, positive and negative coping were the main influencing factors(R²=0.322,_△R²=0.307,F=21.806,P=0.021). Conclusion Fathers of premature infants are of high illness uncertainty. Therefore, medical staff should take effective measures to lower their level of illness uncertainty and promote their physical and mental health.

Objective To investigate the life space of elderly patients with ischemic stroke (IS) after discharge, and to analyze its influencing factors. Methods Totally 340 elderly IS patients were selected at 1 year after discharge, and surveyed using a general situation questionnaire, Hamilton anxiety scale and Hamilton depression scale, Connor-Davidson resilience scale, exercise self-efficacy scale, and life space assessment scale. Results The life space score of elderly patients with IS after discharge was(42.49±10.93) points. Multiple linear regression analysis showed that age, degree of education, complications with other chronic diseases, living condition, monthly income per capita, depression, quality of home care, mental resilience and exercise self-efficacy were independent influencing factors (F=260.208,P＜0.001). Conclusion The life space of elderly patients with ischemic stroke is low, which can be bettered by providing good family rehabilitation nursing, psychological support and improving the living condition, then improving life space of elderly patients with IS.