Practice of experience of "Internet + nursing service" mode carried out by tumor specialist nurses: a qualitative research / 中国实用护理杂志

Objective:This study was to explore "Internet + nursing service" mode, the tumor specialist nurses nursing service experience and feelings, in the process of mining "Internet + nursing service" model of current existing problems and future development direction, discussed under the background of constructing a new mode of medical and health services, how to expand the tumor specialized subject "Internet + nursing service" the breadth and depth to improve the quality of life of cancer patients and nursing service benefit.Methods:Through the review of the literature, the focus and direction of the research were determined. A semi-structured interview was conducted with 12 oncology nurses enrolled in "Internet + nursing service" by qualitative research. Colaizzi seven-step method was used to encode, classify and extract the data.Results:The experience of "Internet + nursing service" carried out by oncology nurses can be summarized into the following five themes: Be more willing; professional identity of specialist nurses is higher (self-identity, patient identity, social identity); Multiple psychological experience (stress experience: the limitation of specialized operation and the pressure of communication; Adaptive experience: "Specialist cooperation and two-person home visit mode" is well adapted). The time and economic cost of specialist services are higher. The matching degree of service item supply and market demand is insufficient.Conclusions:In order to further expand the depth and breadth of "Internet + nursing service" in oncology, and to benefit more cancer patients in the long-term treatment and rehabilitation process, it is necessary to improve the recognition degree of nurse specialty, so as to improve the willingness to work; increase nurse training to enhance nurses' comprehensive coping ability; improving policy and economic support based on the characteristics of tumor diseases; improve the oncology "Internet + nursing services" project.

Research practice of using two heating blankets in combination to affect intraoperative temperature and postoperative resuscitation in patients undergoing endoscopic three-incision radical resection of esophageal cancer / 中国实用护理杂志

Objective:To compare the effects of three heating methods on intraoperative temperature and postoperative resuscitation in patients undergoing three-incision radical resection of esophageal cancer under full endoscope.Methods:A total of 145 patients undergoing endoscopic three-incision radical resection of esophageal cancer were randomized to receive forced-air warming respectively on the under-body blanket(UB group, n=48), over-body blanket (OB group, n=48), underbody blanket in combination with over-body blanket(Combined group, n=49). The nasopharyngeal temperature were recorded at the time of entering the operating room, at the beginning of the intubation, at the beginning of the operation and every 30min after the operation, at the end of the operation. The incidence of hypothermia, hypothermia related adverse reactions and postoperative resuscitation indicators of the three groups were compared. Results:During the operation, the patients' temperature fluctuation showed two processes of decrease and two processes of increase. The temperature of Combined group showed a lower fall and a faster rise. The average temperature of the Combined group were higher than the other two group at each time point from the beginning of the intubation, the incidence of hypothermia was 4.08% (2/49), which was lower than the OB group [22.92% (11/48)] and the UB group [18.75% (9/48)], The difference was statistically significant ( χ2 value was 7.397, P=0.025). The temperature of the UB group was (36.52±0.18),(36.31±0.35)℃ at the beginning of intubation and at the end of the operation, respectively, which were higher than that of the OB group (36.44±0.15),(36.13±0.32)℃ ( t value was 2.393, 3.723, P < 0.05). The temperature comfort score of the combined group was 7.81±0.52, higher than that of the other two groups ( F value was 19.962, P<0.01), and the scores of chills, agitation and chills in the recovery period were lower than that of the other two groups ( F value was 8.186, 6.705, 4.051, all P < 0.05). The extubation time and the waking time of the combined group was (15.90±2.97)min, (31.47±4.42)min, respectively, which were both lower than those of the other two groups ( F value was 69.094, 114.549, P < 0.01). Conclusions:In endoscopic three-incision radical resection of esophageal cancer, combined heating makes the patients' temperature rise rapidly to offset the loss of heat, which is conducive to maintain a stable temperature. At the same time, the incidence of intraoperative hypothermia, postoperative chills and agitation is reduced, the temperature comfort of patients is improved, the extubation time and waking time are shortened, which is conducive to promote postoperative recovery of patients, thus reduce postoperative hypothermia related complications.

Study on human body composition of breast cancer patients based on bioelectrical impedance technology / 中国实用护理杂志

Objective:To analyze the body composition of breast cancer patients and the changes with age; to compare the incidence of obesity in breast cancer patients with different diagnostic criteria; To understand the relationship between body mass index (BMI) and body composition; to investigate the incidence of sarcopenia and its relationship with obesity in breast cancer patients.Methods:The bioelectrical impedance technique was used to analyze the body composition of 1 187 female breast cancer patients before surgery.Results:There was a statistically significant difference between different age groups of breast cancer patients with various body composition indicators ( F values were 3.767-32.627, P < 0.01), and the incidence of obesity and sarcopenia was different in different age groups ( χ2 value was 20.819, P < 0.01). The obesity detection rate of different diagnostic methods was different. The obesity rate diagnosed by body fat percentage (PBF) was the highest. 28.14% (334/1 187) of breast cancer patients were diagnosed as "invisible obesity", which refers to normal or low BMI but excessive PBF. BMI was positively correlated with all body composition indicators ( r values were 0.137-0.954, P < 0.01), and moderately correlated with PBF and skeletal muscle mass ( r values were 0.761, 0.534, P < 0.01). The incidence of sarcopenia in breast cancer patients was 8.26% (98/1 187). 8.78% (64/1 187) of the patients with normal BMI were diagnosed as Sarcopenia. Among patients with excess PBF and excess visceral fat area, 6.70% (47/1 187) and 5.98% (15/1 187) were diagnosed with sarcopenia, respectively. Conclusion:The incidence of PBF obesity in breast cancer patients is high, and some patients have sarcopenia, which is not good for prognosis. Bioelectrical impedance technology can accurately assess the body composition of patients, and can find "invisible obesity" and sarcopenia that cannot be diagnosed by BMI, which is worthy of further promotion and application in clinical practice.

Effect of complete decongestive therapy in severe grade Ⅲ lower limb lymphedemabv / 中国实用护理杂志

Objective:To investigate the effect of complete decongestive therapy in the treatment of severe grade Ⅲ lower limb lymphedema.Methods:From January 2018 to December 2018, The patients were admitted to the lymphedema clinic of the cancer prevention and treatment center of Sun Yat-sen University, seven patients with severe gradeⅢ lower limb lymphedema were intervened with complete decongestive therapy, including problem skin care, special techniques of unarmed lymphatic drainage, foam block bandage combined with air wave pressure therapy, filled elastic bandage pressure bandage, functional exercise combined with home bare-handed lymphatic drainage and weight loss management. The intervention had two courses, and 20 times was a course of treatment. Perimeter measurement and weight measurement were used to evaluate the therapeutic effect at the 0, 5, 10, 15, 20, 30, 40 times of treatment.Results:After two courses of treatment, the circumference value of each measurement point on the affected side was lower than that before treatment, and the difference was statistically significant ( F values were 7.449-23.073, P < 0.05). The circumference value of the affected side decreased by 7.10 - 24.53 cm, and the weight after treatment was 9.0 - 20.5 kg less than that before treatment. During the follow-up period, it was found that the lower extremity diameter value at 3 months of follow-up at 5 sites increased and tended to be stable compared with that at 1 year of follow-up. Conclusion:Step 6 comprehensive swelling treatment can obviously improve the symptoms of patients with lower limb lymphedema of this research, and in the subsequent follow-up found that self-therapy at home, no recurrence or aggravate the limb swelling degree, and can reduce or stability treatment effect, enhance confidence in the treatment of patients, so as to improve the quality of life of patients and treatment compliance.

Longitudinal study of limb functional exercise compliance after breast cancer surgery based on dependent curve / 中国实用护理杂志

Objective:To investigate the level and change of compliance of functional exercise in patients with breast cancer in one year after operation.Methods:The compliance of limb functional exercise in 90 patients with breast cancer at 3, 6 and 12 months after operation was measured by the compliance scale of functional exercise after operation of breast cancer. Taking time as independent variable( x), functional exercise compliance and index of each dimension as dependent variable( y), regression curve estimation equation was used to draw compliance curve. Results:The functional compliance index of patients at 3, 6, 12 months after surgery was 67.31±14.21, 62.93±12.53, 56.62±14.75, there was significant difference( F value was 31.13, P<0.01). The physical exercise compliance index of patients at 3, 6, 12 months after surgery was 63.06±17.69, 58.03±14.86, 50.83±16.75, there was significant difference ( F value was 30.82, P<0.01). The active recommendation index of patients at 3, 6, 12 months after surgery was 58.56±19.75, 48.56±17.94, 42.94±18.69, there was significant difference( F value was 4.99, P<0.05). The post-consideration index of patients at 3, 6, 12 months after surgery was 81.95±12.70, 83.30±13.25, 78.10±16.55, there was significant difference ( F value was 38.26, P<0.01). The compliance curve of the functional exercise compliance score was y=50.22-1.08 x-0.69 x2 ( R2 value was 0.091, F value was 13.426, P<0.01); the body exercise compliance curve formula was y=23.73-0.64 x-0.39 x2 ( R2 value was 0.086, F value was 12.522, P<0.01); the actively seeking the recommendation compliance curve formula was y=11.67-2.652 x+0.35 x2 ( R2 value was 0.106, F value was 15.911, P<0.01); the postoperative cautionary compliance curve formula was y=14.82+2.22 x-0.65 x2 ( R2 value was 0.023, F value was 3.188, P<0.05). The functional compliance of breast cancer patients during the first year after operation was moderate, and then showed a downward trend. Among them, physical exercise compliance and active seeking compliance showed a low level, and a downward trend. But the postoperative attention complied with a high level. And a trend of a small increase after 6 months after surgery. Conclusions:According to the compliance curve, the overall compliance of postoperative functional exercise in breast cancer patients is poor, and the compliance has a general downward trend with time. This may be related to the low attention of patients, family members and health care workers after discharge or the patient′s own "forgotten curve".Therefore, after discharge, the nurse needs to repeatedly strengthen the patient′s memory, and follow up and supervise the patient according to the key points of the patient′s functional exercise and the reasons for the decline of compliance.

The study about role function of infusion nurse specialists / 中国实用护理杂志

Objective@#To explore the role function of infusion nurse specialists suitable for China′s national conditions by using Delphi method.@*Methods@#Totally 24 experts were consulted for two rounds, According to the consultation results, the role function of infusion nurse specialists were formulated.@*Results@#After two rounds expert consultation, six primary indexes and fifty-two secondary indexes for the role function of infusion nurse specialists have been developed. The average coefficient of authority, coefficient of determination, coefficient of familiarity of experts were 0.83, 0.93, 0.73 respectively.@*Conclusion@#the consensus has achieved between experts about the indexes of role function, the result of study has high credibility, it could provide reference information for relevant department to set the role function of infusion nurse specialists.

A study of the effect of case management on postoperative lymphedema in breast cancer patients / 中国实用护理杂志

Objective@#To explore the effect of case management on postoperative affected limb lymphedema in breast cancer patients.@*Methods@#This study is a non-concurrent control trial. A total of 157 cases of breast cancer patients who met the inclusion/exclusion criteria were selected from the Sun yet-sen University Cancer Center from June 2016 to July 2017 and from June 2016 to July 2017 by the convenient sampling method. Among them, 80 patients from June to July 2016 were listed as the control group, and 77 patients from June to July 2017 were listed as the intervention group. The control group implemented the routine nursing mode of breast cancer. The intervention group implemented case management on the basis of routine nursing. Lymphedema of the affected limb were compared between the two groups before intervention, 3 months after surgery, 6 months after surgery and 1 year after surgery.@*Results@#The incidence of postoperative lymphedema (OR=2.467, 95%CI1.177-5.169, P<0.05) of the affected limb was lower in the intervention group than in the control group. The incidence of lymphedema in the limbs of the two groups was not statistically different 3 months after operation (χ2=0.617, P>0.05). There was a statistically significant difference between the two groups 6 months after operation (χ2=5.835, P<0.05) and 1 year after operation (P=0.003). The incidence of lymphedema in the affected limbs in the experimental group was lower than that in the control group. There was an increased incidence of lymphedema in the control group, the incidence of side pain, but an incidence of lymphedema in the intervention group was in a downward trend.@*Conclusion@#Case management mode can effectively prevent and improve the occurrence of postoperative lymphedema in patients with breast cancer.

Effects of cancer case management in the whole processing management of nasopharyngeal carcinoma patients / 中国实用护理杂志

Objective@#To explore the application and effect of the cancer case management led by cancer case managers in the whole processing management of nasopharyngeal carcinoma (NPC) patients.@*Methods@#A randomized controlled study was designed. 510 patients with nasopharyngeal carcinoma were randomly divided into two groups: the observation group (255 cases) and the control group (255 cases). The observation group adopted the case management led by cancer case managers, and the control group adopted the cancer case management. To evaluate the rate of seeing a doctor, the implementation rate of the treatment plan and the rate of the first follow-up visit between the two groups. M.D. Anderson symptom Inventory-head-neck (MDASI-H&N) was used to evaluate the symptom disturbance (the day of hospitalization, the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge).@*Results@#The treatment rate was 90.2% (230/255) in the observation group, 78.04% (199/255) in the control group, The rate of implementation of established treatment plans 99.57% (229/230) in the observation group and 90.95% (181/199) in the control group. The first follow-up rate was 98.70% (227/230) in the observation group and 84.42% (168/199) in the control group. The difference was statistically significant (Z=19.768, 15.207, 7.042, P < 0.01). In the observation group, the average value of symptom disturbance, the average severity of symptom distress and the average degree of symptom disturbance in 3 times (the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge) were (3.00±0.95) , (2.43±0.16) , (2.03±0.34) , (2.95±0.97) , (2.46±0.12) , (2.11±0.16) , (2.89±0.46) , (2.41±0.33) , (1.99±0.16) ; Significantly lower than the control group (3.69±1.51) , (2.82±0.23) , (2.42±0.13) , (3.88±1.39) , (2.87±0.34) , (2.54±0.22) , (3.61±0.75) , (2.72±0.42) , (2.38±0.17) , the difference has the statistical significance (t=-21.152—10.372, P < 0.01).@*Conclusion@#The case management led by cancer case manager can effectively improve the rate of seeing a doctor, the rate of completion of the plan and the rate of the first visit, and ensure the patients to receive effective, standard and full treatment in time. In addition, the case management can effectively improve the symptoms of patients and promote their early return to the community.

Study on the relationship between the port competency and standardized training of the new nurses of the third-grade hospitals in Guangzhou / 中国实用护理杂志

Objective@#To describe the post competency level and standardized training of new nurses in Guangzhou tertiary hospitals, and to explore the correlation between them.@*Methods@#By using the questionnaire method, 525 new nurses from 8 tertiary hospitals in Guangzhou were surveyed in June 2016 by convenience sampling, using the general information questionnaire, nursing competency questionnaire and standardized training status questionnaire of new nurses in Guangzhou tertiary hospitals.@*Results@#The competency level of new nurses in Guangzhou tertiary hospitals was 333.53±46.96. The scores of standardized training level were 131.43±23.20. The scores of training management level, training content level and nurses′ belief level were 28.30±5.49, 59.07±14.80, 44.06±2.91. Competency level was positively correlated with standardized training level and each dimension with statistical significance (r=0.099-0.132, P<0.05).@*Conclusions@#The post competence of new nurses in Guangzhou tertiary hospitals is at the middle level, and the post competence of new nurses is positively correlated with the level of standardized training. Improving the level of standardized training of new nurses is helpful to enhance the post competence of new nurses. The level of standardized training management, management content and nurse belief can improve the post competence of new nurses.

Study on the relationship between the port competency and standardized training of the new nurses of the third-grade hospitals in Guangzhou / 中国实用护理杂志

Objective To describe the post competency level and standardized training of new nurses in Guangzhou tertiary hospitals, and to explore the correlation between them. Methods By using the questionnaire method, 525 new nurses from 8 tertiary hospitals in Guangzhou were surveyed in June 2016 by convenience sampling, using the general information questionnaire, nursing competency questionnaire and standardized training status questionnaire of new nurses in Guangzhou tertiary hospitals. Results The competency level of new nurses in Guangzhou tertiary hospitals was 333.53 ± 46.96. The scores of standardized training level were 131.43±23.20. The scores of training management level, training content level and nurses′belief level were 28.30 ± 5.49, 59.07 ± 14.80, 44.06 ± 2.91. Competency level was positively correlated with standardized training level and each dimension with statistical significance (r=0.099-0.132, P<0.05). Conclusions The post competence of new nurses in Guangzhou tertiary hospitals is at the middle level, and the post competence of new nurses is positively correlated with the level of standardized training. Improving the level of standardized training of new nurses is helpful to enhance the post competence of new nurses. The level of standardized training management, management content and nurse belief can improve the post competence of new nurses.

The study about role function of infusion nurse specialists / 中国实用护理杂志

Objective To explore the role function of infusion nurse specialists suitable for China′s national conditions by using Delphi method. Methods Totally 24 experts were consulted for two rounds, According to the consultation results, the role function of infusion nurse specialists were formulated. Results After two rounds expert consultation, six primary indexes and fifty-two secondary indexes for the role function of infusion nurse specialists have been developed. The average coefficient of authority, coefficient of determination, coefficient of familiarity of experts were 0.83, 0.93, 0.73 respectively. Conclusion the consensus has achieved between experts about the indexes of role function, the result of study has high credibility, it could provide reference information for relevant department to set the role function of infusion nurse specialists.

Correlation between oral chemotherapy adherence and illness perception in colorectal cancer patients:a longitudinal study / 中华护理杂志

Objective To explore the correlation of oral chemotherapy adherence and illness perception among colorectal cancer patients at different stages of chemotherapy in order to provide evidence for improving oral chemotherapy adherence among colorectal cancer patients in clinical practice.Methods A prospective longitudinal study was employed.Convenience sampling was used to recruit 132 cases of colorectal cancer patients.Data of general information,oral chemotherapy adherence and illness perception were collected by questionnaire.Results At different stages of chemotherapy,patient's score of oral chemotherapy adherence were 7.24±1.15,6.97±1.43,6.95± 1.17;patients' illness perception scores were 40.12±9.47,39.91±8.65,37.01±6.83.Oral chemotherapy adherence was negatively correlated with illness perception (r=-0.225,P＜0.05;r=-0.279,P＜0.01;r=-0.277,P＜0.01).Conclusion Higher level of patient's illness perception was related to worse oral chemotherapy adherence.Nurses should instruct patients to understand the disease and the treatment correctly,to reduce the adverse impact on patients' life and emotion,and to improve patients' compliance with oral chemotherapy.

Adequate feeding of early enteral nutrition in critical patients with cancer / 中国实用护理杂志

Objective To describe the adequate feeding of early enteral nutrition in critical patients with cancer, and explore its influencing factors. Methods A retrospective analysis study was performed and 161 patients were involved. Results Nearly 57.14%patients got adequate feeding. The independent risk factors included complications (P < 0.05,OR=2.312,OR 95%CI 1.078-4.958), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) scores (P < 0.05,OR=1.111,OR 95%CI 1.017-1.214) and hypoalbuminemia (P<0.05,OR=2.252,OR 95%CI 1.036-4.892) , and the protective factor was previous enteral nutrition experience (P<0.01,OR=0.123,OR 95%CI 0.021-0.494). Patients who got adequate feeding showed more increase in albumin levels, more decrease in APACHEⅡscores and shorter ICU stays. Conclusions Part of patients got inadequate feeding, due to comprehensive effects of many factors. And adequate feeding may be beneficial to the increase of albumin levels, also helps patients rehabilitate early and shorten the ICU stays.

A correlative analysis of nursing competence and self efficacy of new nurses in a tumor hospital / 中国实用护理杂志

Objective To describe the characteristics of nursing competence and self efficacy of new nurses in a tumor hospital and to explore the correlative relationship between them. Methods By convenience sampling method, a total of 303 new nurses who were employed in 2013 to 2015 from a tumor hospital were recruited in the study. A self-designed demographic questionnaire, the nursing competence scale (NCS) and the general self-efficacy scale (GSES) were used. Results The average score of nursing competence of new nurses was (83.80 ± 10.35) points. Among the six dimensions of nursing competence, the interpersonal relation competence had the highest score of (86.74 ± 10.55) points, while the nursing process applying competence had the lowest score of (81.41 ± 11.02) points. The level of nursing competence and each dimensions were positively related with self-efficacy (r=0.443-0.557, P<0.01). Conclusions The level of nursing competence of new nurses in a tumor hospital is good, but the nursing process applying competence, critical patient care competence and the health education competence were still insufficient, so it is necessary to take corresponding measures to improve the overall quality of new nurses. Self efficacy can effectively predict the nursing competence of new nurses. The hospital can improve the nursing competence by intervene the self efficacy of new nurses, in order to improve the clinical nursing quality and promote the development of nursing.

A correlative analysis of nursing competence and self efficacy of new nurses in a tumor hospital / 中国实用护理杂志

Objective To describe the characteristics of nursing competence and self efficacy of new nurses in a tumor hospital and to explore the correlative relationship between them. Methods By convenience sampling method, a total of 303 new nurses who were employed in 2013 to 2015 from a tumor hospital were recruited in the study. A self-designed demographic questionnaire, the nursing competence scale (NCS) and the general self-efficacy scale (GSES) were used. Results The average score of nursing competence of new nurses was (83.80 ± 10.35) points. Among the six dimensions of nursing competence, the interpersonal relation competence had the highest score of (86.74 ± 10.55) points, while the nursing process applying competence had the lowest score of (81.41 ± 11.02) points. The level of nursing competence and each dimensions were positively related with self-efficacy (r=0.443-0.557, P<0.01). Conclusions The level of nursing competence of new nurses in a tumor hospital is good, but the nursing process applying competence, critical patient care competence and the health education competence were still insufficient, so it is necessary to take corresponding measures to improve the overall quality of new nurses. Self efficacy can effectively predict the nursing competence of new nurses. The hospital can improve the nursing competence by intervene the self efficacy of new nurses, in order to improve the clinical nursing quality and promote the development of nursing.

Effectiveness of case management model in patients with breast cancer in China:a systematic review / 现代临床护理

Objective To systematically evaluate the effect of case management model in patients with breast cancer in China. Methods The internet-based retrieval was done through SinoMed, CNKI, WANFANG data, VIP, Pubmed and Web of Science (WOS) with case management model of breast cancer patients in the randomized controlled trails. Data extraction and quality evaluation were conducted from the acquired literature. Results Eight studies were included. The case management was showed to improve the treatment compliance of patients with breast cancer and the satisfaction of patients effectively. It also reduced hospitalization time and hospitalization costs of the patients, improve the quality of life and social psychological adaptability. Conclusion The application of case management model is effective, but the case management model is still in the initial stage in China, needing to be strengthened.

Relationship between pre-hospital delay and health belief in patients with colorectal cancer / 中国实用护理杂志

Objective To describe the current situation of pre-hospital delay and health belief in patients with colorectal cancer and explore the relationship between them. Methods With convenient sampling methods,totally 385 patients with colorectal cancer were recruited from January to June 2016. Patients with colorectal cancer were investigated using a general data survey questionnaire, visit situation questionnaire and the Champion Health Belief Model Scale. Results The median pre-hospital delay time was 3.00 months.The rate of pre-hospital delay was 43.1%(166/385). The score of the overall health belief was (119.52 ± 12.62) points. The two dimensions of"perceived susceptibility and perceived severity" scored lower, and the two dimensions of "health motivation and perceived therapeutic benefits" scored higher. The health belief was negatively correlated with the pre- hospital delay among colorectal cancer patients (r=- 0.737, P<0.01). Conclusions Pre-hospital delay occurred among patients with colorectal cancer is severe. Patients with a higher level of health belief have shorter pre-hospital delay.It′s important to improve the level of health belief of"perceived susceptibility and perceived severity"and reduce the time of pre-hospital delay to improve outcomes in patients with colorectal cancer.

Study of uncertainty in illness among patients with hepatocellular carcinoma intending to undergo transcatheter artery chemoembolization / 中国实用护理杂志

Objective To describe uncertainty in illness of patients with hepatocellular carcinoma intending to undergo transcatheter artery chemoembolization (TACE) and to identify the related factors. Methods A descriptive and correlative design was used. By convenience sampling, 95 patients with hepatocellular carcinoma were recruited from Sun Yat-Sen University Cancer Center in this study. Mishel Uncertainty in Illness Scale was used to assess uncertainty in illness and information needs of patients with hepatocellular carcinoma intending to undergo TACE and the demographic questionnaire and Information Needs Assessment Scale were used to measure demographic data, disease and treatment characteristics and information needs of patients. Results The level of uncertainty in illness in most patients with hepatocellular carcinoma intending to undergo TACE was middle (77.61±9.15) points. The mean score of indeterminacy subscale was (50.16 ± 6.16) points. Uncertainty in illness of patients with hepatocellular carcinoma intending to undergo TACE was affected by the degree of education background, domicile, family economic status, way to pay for the medical expenses, course of diseases, how many times he (she) used to undergo assisted treatments and the level of information needs. Conclusions The level of uncertainty in illness in most patients with hepatocellular carcinoma intending to undergo TACE was middle and it is important to assess patients′uncertainty in illness at clinical work and to take effective interventions to content patients′information needs to decrease the level of uncertainty.

Building research on the access standard and role function of cancer case manager / 中国实用护理杂志

Objective To build the access standard and role function of cancer case manager which is suitable for China.Methods The draft indicators of access standard and role function of cancer case manager were formulated based on literature review,group discussion and Delphi method.All the indicators were appraised by using two-round Delphi method.Results Round 1 consulting experts 43,and round 2 consulting experts 41.The experts showed high degree on the access standard and role function of cancer case manager during the two rounds of expert advice (two advisory Kendall coordination coefficients were 0.300,0.358 and 0.375,0.358,P ＜ 0.01).The access standard of cancer case manager included 4 first-level indicators and 34 secondary indicators,and the system of role functions included 7 first-level indicators,35 secondary indicators.Conclusions It indicates that the outcome is high reliability.The finding provide scientific basis for the selection of cancer case manager as well as clear identify of role functions which are significant for improving their work efficiency.

The impact of different body posture and bed time on the headache of lumbar puncture: a Meta-analysis / 中国实用护理杂志

Objective To compare the effect of different body position and length of bed time after lumbar puncture on the postoperative headache.Methods Literatures were searched at home and abroad through the database,and provided comprehensive quantitative analysis to compare the effect of different body position and length of bed time after lumbar puncture on the postoperative headache by the Cochrane collaboration Meta-analysis.Results A total of 20 studies (3 514 patients) were included for Meta-analysis.Mter lumbar puncture for the low supine pillow and the pillow recumbent position,headache incidence rate had no significant difference between the two positions,combined odds ratio (OR) and 95％ confidence intervals were 0.87 (0.41-1.87)(P＞ 0.05);After lumbar puncture to stay in bed for a long time to rest (≥ 4 h) and short time in bed rest (＜1 h),headache incidence rate had no significant difference between the two different time,the combined odds ratio (OR) and 95％ confidence intervals were 0.77 (0.58-1.02)(P ＞ 0.05).Conclusions After lumbar puncture,the occurrence rate of headache is not increased after taking a low pillow lying position or a short time in bed rest (＜1 h).