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Objective:To evaluate and summarize the best evidence of exercise instructions for patients with atrial fibrillation.Methods:A comprehensive search about evidence on exercise rehabilitation in patients with atrial fibrillation was conducted in following databases: Joanna Briggs Institute (JBI) Library, The Agency for Healthcare Research and Quality (AHRQ), National Institute for Health and Clinic Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses′ Association of Ontario (RNAO), Physiotherapy Evidence Database (PEDro), American College of Physicians (ACP), Cochrane Library, PubMed, Embase, CINAHL, Medlive, China National Knowledge Infrastructure (CNKI), WanFang Database, VIP Database, and China Biology Medicine (CBM). The retrieval period was from the inception of databases to January 2021. Two researchers with evidence-based nursing background assessed the quality of the literature independently and identified the level of evidence.Results:A total of 16 articles were included, including 4 guidelines, 4 systematic reviews, 4 expert consensuses, 4 randomized controlled trials. Combined with professional judgment, 35 pieces of best evidence in 7 aspects were summarized, including exercise benefits, the appropriate crowd, exercise evaluation, exercise mode, exercise intensity, exercise time, exercise supervision and safety.Conclusions:Regular exercise is safe and beneficial for patients with atrial fibrillation. Clinical staff should guide patients to exercise moderately by applying the best evidence with scientific exercise intervention, promoting patients′ physical and mental health.
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Objective To investigate the status quo of hope level as well as the relationship between the hope level and social support in patients with chronic heart failure (CHF). Method A total of 120 CHF patients were surveyed by Herth hope index (HHI) and social support rating scale (SSRS). Results The overall HHI score and SSRS were (30.2±4.2) and (38.4±6.2), respectively. Both were at a medium level. The general score of HHI was positively related to general SSRS (r=0.527, P＜0.01). Conclusions Both of HHI and SSRS of patients with CHF are at moderate level. The patients with higher level of social support have better hope level. Nurses should take pertinent interventions to improve the social support of CHF, helping them to improve their hope and respond to diseases effectively.
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Objective To explore the true experience of patients living with end-stage heart failure Methods The phenomenological methodology was used in the study.Eleven inpatients with end-stage heart failure were treated with semi-structured interviews and recorded live. Colaizzi method was used for data analysis with Nvivo11.0. Results Four themes were extracted:perceivestressful heart failuresymptoms; complex psychological experience, both negative and positive response coexist;perceive insufficient medical system support;ambivalent attitude toward death. Conclusion Health care providers should pay attention to the physical and psychological feelings of patients with end-stage heart failure, take targeted interventions to alleviate their suffering, provide palliative care while providing heart failure management to patients, and attach importance to communication with patients to help them recognize death correctly. At the same time, we should promote the development of grass-roots health institutions and provide patients with more convenient and adequate medical resources.
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Objective To investigate the core competency of grass-roots nurses in Jiangsu Province,and to provide references for training grass-roots nurses.Methods The Competency Inventory for Registered Nurse(CIRN)was used to investigate 593 grass-roots nurses in Jiangsu Province.Results The overall score of importance judgement for core competency was 4.45±0.73.The overall execution frequency was 4.26±0.69.There were significant differences in the importance judgment of clinical care,interpersonal relationship,leadership,and professional development among nurses with different job titles(P＜0.05).There were significant differences in the execution frequency of clinical care,interpersonal relationship,ethical/legal practice,critical thinking and scientific research among nurses with different job titles (P＜0.05).There were certain differences in the importance judgment and the execution frequency for core competency among nurses with different job titles and nurses from different institutions.Conclusion The score for grass-roots nurses' core competency in Jiangsu Province was not high and unbalanced.There were differences between the importance judgment and the execution frequency.Hospital managers should take appropriate measures to address existing problems and improve the grass-roots nursers' core competency according to different characteristics.
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Objective To investigate the nutrition status, sleep quality, anxiety and depression in patients with chronic heart failure (CHF), and to analyze the relationships between them. Method Hospital anxiety and depression scale (HADS), mini nutritional assessment (MNA) and Pittsburgh sleep quality index (PSQI) were used to assess anxiety and depression, nutrition status and sleep quality in 118 CHF patients who were selected by convenience sanpling respectively. Results The score of anxiety of the patients was with a median of 5 (3, 8) and the score of depression was with a median of 5 (2, 8). Anxiety was present in 47 cases (39.8％). Depression was present in 48 cases (40.7％).MNA score was with an average of 21.5 ±3.5, 19 patients (16.1％) were malnourished, 59 patients (50.0％) were at risk of malnutrition and 40 (33.9％)well nourished. The MNA scores of patients with anxiety or depression were significantly lower than those with no anxiety or depression (P<0.001). The PSQI score in 118 patients was 6(4, 10), where 42(35.6％) were with sleep disorder and patients with depression and anxiety were higher than those without (P<0.01). The MNA score was negatively correlated with anxiety and depression (all P<0.001). The PSQI score was positively related with anxiety and depression (all P<0.01). Conclusions The prevalence of anxiety and depression was high in CHF patients. Both nutrition status and sleep quality were related to them. In the clinic work, medical workers should pay attention to the treatment of heart failure and the assessment of psychological status in heart failure patients with malnutrition or sleep disorders.
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Objective To investigate the diagnosis value of immunophenotype and karyotypes in newly diagnosed chronic lymphocytic leukemia (CLL).Methods To retrospect the flow cytometry (FCM) immunophenotype and karyotypes characteristics in newly diagnosed 70 CLL cases.Results In all cases,the positive rates of CD19,CD20,CD5,CD23,CD22 were 100 ％,88.5 ％ (54/61),77.1％ (54/70),67.6 ％ (23/34)and 51.9 ％ (27/52),respectively.And 6 were misdiagnosed,2 was CD+5CD+19(+),but CD20,CD22 were strongly positive,final diagnosed as mantle cell lymphoma (MCL) by FISH t(11;14) examination and CyclinDl; CD+5CD+19(-) CLL were 16 cases (22.9 ％),but 4 were misdiagnosed,the misdiagnosis rate was 25 ％,significantly higher than that of CD+5CD+19(-) CLL (P =0.030).59 cases were examined by conventional cytogcnetic (CC),and 13 cases were with abnormal karyotypes,positive rate was 22.0 ％,with complex karyotypes in 5 cases (8.5 ％); 10 cases combined with FISH abnormalities karyotype examination rate was 60 ％.Conclusion Typical CLL immunophenotypic characteristics were CD5,CD19,CD23 co-expression,and CD－5 CLL with higher misdiagnosis rate,combined with CD20 (,) CD22 expression and karyotype analysis helps to CLL and other B lymphoid proliferative diseases (B-LPD) identification.Conventional cytogenetic detection combined with FISH scan can improve the recognition ability of abnormal chromosome.
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Objective To explore appropriate organization and financing models of urban employees supplementary medical insurance under the conditions of the market economy. Methods Employee surveys on willingness to participate in, willingness to pay for, and actual enrolment in supplementary medical insurance were conducted in Shanghai, Wenzhou and Chengdu and nationally different operational models were compared so as to analyze prospectively coverage and operational models of feasible supplementary medical insurance options. Results Characteristics of the employees needs for various supplementary medical insurance options were garnered and appropriate coverage and operational models were put forward. Conclusion It is suggested that the role of the government in the development of supplementary medical insurance be clearly defined, the development of supplementary medical insurance be promoted through policy support and guidance, and the supervision of supplementary medical insurance be strengthened.
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Objective:To study the clinical effect of herba Houttuyniae Injection by aerosol inhalation for respiratory tract infection. Methods: 107 patients with respiratory tract infection (the main symptoms were cough and expectoration) were treated with Herba Houttuyniae Injection by aerosol inhalation. The conditions of symptom improvement and bacteria in sputum before and after treatment were observed. The case control studies on parts of patients in acute attack and delayed peroids of chronic bronchitis were carried out. The treatment processes patients were given 25mL Herba Houttuyniae Injection and 25mL normal saline by aerosol inhalation for 30 minutes, twice a day. Results: The effective rates were 91.59% for cough symptom, 85.06% for expectoration symptom. 98.13% patients experienced comfort of pharyngeal and thoracic protions after treatment. Among 55 patients whose cough symptom wasn't improved after they were treated with anti inflammatory agent and antitussive the effective rate was 72.72% after treatment with Herba Houttuyniae Injection by aerosol inhalation. The 45 case control studies of acute attack and delayed periods of chronic brochitis showed no statistically difference between them. The clearance rate of bacteria in sputum after treatment was 80.39%. Conclusions: Herba Houttuyniae Injection by aerosol inhalation is effective for respiratory tract infection with the main symptoms of cough and expectoration.