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To solve the problems of insufficient airway opening, insufficient or excessive ventilation, ventilation interruption, and the rescuer's physical strength during the process of cardiopulmonary resuscitation (CPR) outside the hospital and in the hospital, and to ensure the accuracy of ventilation frequency rate and tidal volume. Zhongnan Hospital and School of Nursing, Wuhan University, jointly designed and developed a smart emergency respirator with open airway function, that has been granted National Utility Model Patent of China (ZL 2021 2 1557989.8). The device is structured of pillow, pneumatic booster pump and mask. It can be used simply by plugging the pillow under the patient's head and shoulder, turning on the power supply and wearing the mask. The smart emergency respirator can quickly and effectively open the patient's airway and give accurate ventilation with adjustable ventilation parameters. The default settings are 10 times/min in respiratory rate and 500 mL in tidal volume. The whole operation does not require the operator have professional operation ability, which can be independently applied used in any cases without oxygen source or power supply, therefore, the application scenario has no limit. The device has the advantages of small size, simple operation and low production cost, which can reduce human source, save physical strength and significantly improve the quality of CPR. The device is suitable for respiratory support in multiple scenes outside and inside the hospital, and can significantly improve the success rate of treatment.
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Objective:To summarize the relevant evidence of motor rehabilitation of stroke at home and abroad, so as to provide reference for medical staff to carry out motor rehabilitation.Methods:The related evidence on exercise management for patients with stroke in BMJ Best practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, National Guideline, American Heart Association/American Stroke Association, European Stroke Organization, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Canadian Medical Association, American Association of Critical Care Nurses, National Stroke Foundation, Chinese Stroke Association, Medlive, Cochrane library, PubMed, Web of Science, Embase, OVID, Medline, China National Knowledge Infrastructure, Wanfang, VIP, SinoMed were searched by computer. The retrieval time limit was from 2012 to June 30, 2022. Two to four investigators independently assessed the quality of the included article, and extracted and summarized the evidence that met the quality standards.Results:A total of 22 articles were included, including 5 guidelines, 2 summary of evidence, 2 expert consensus, and 13 systematic evaluations. A total of 42 pieces of evidence related to exercise rehabilitation were extracted and integrated, including 11 aspects such as multidisciplinary teams, exercise goals, exercise timing, exercise evaluation, exercise venue, exercise style, exercise intensity, exercise time and frequency, safety monitoring, exercise behavior maintenance, and health education.Conclusions:The best evidence summarized in this study can provide a reference for clinical medical staff to implement exercise rehabilitation, but in clinical practice, it is necessary to select and apply evidence in a targeted manner in combination with specific circumstances, so as to improve the safety and effect of exercise rehabilitation.
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Objective:To understand the current status of nursing for chronic constipation patients accepted fecal microbiota transplantation and provide reference basis for constructing clinical nursing plan.Methods:From April to August 2021, a field research was conducted in the Tenth People′s Hospital of Tongji University. Data was collected by field observation and informal interview for 13 nurses and analyzed by three-level coding method of qualitative research.Results:The work content of the observation subjects could be divided into 3 items including entrance health education, donor management, bacterial fluid management and clinical nursing. It still needed being improved in donor management, health education, nursing of naso-jejunal tube, intestinal preparation, infusion of bacterial fluid, observation of complications and follow-up.Conclusions:It still needs further development in nursing for chronic constipation with fecal microbiota transplantation. It is urgent to establish donor follow-up team, conduct professional training for nurses, rely on mobile medical platform to improve quality of fecal microbiota transplantation, so as to promote the recovery of patients.
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Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.
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Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.
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Pertussis, or whooping cough, is a highly contagious respiratory disease.Despite the implementation of the universal immunization program, pertussis remains a significant public health problem.Existing pertussis vaccines have a poorly controlled effect, and new vaccines are needed to protect against pertussis disease, as well as to prevent infection and transmission of Bordetella pertussis.The development of new pertussis vaccines requires an in-depth study of pertussis′s pathogenesis and immune mechanism, especially the protective immune mechanism.With the further understanding of the protective immune mechanism, the mucosal vaccine has been paid more attention, and new approaches, such as nasal immunization, outer membrane vesicles, and live attenuated vaccine have been adopted.This paper summarizes pertussis′s immune mechanism and mucosal immunity to provide ideas for the research and development of new pertussis vaccines.
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Objective:To understand the status quo of nutrition knowledge, attitude and behavior of nurses in class A tertiary hospital and its influencing factors, and to provide reference for the development of reasonable and standard nutrition training courses.Methods:The knowledge, attitude and behavior of nutrition of 207 nurses in 28 class A tertiary hospitals from 17 provinces cities on October 25-26, 2019 were investigated Questionnaire on Nutritional Knowledge, Attitude and Behavior Cognition of Nurses.Results:The scores of nurses′ nutritional knowledge, attitude and behavior were (69.70 ± 2.92), (82.76 ± 4.97) and (64.90 ± 4.77) respectively. There were significant differences in nurses′ nutritional knowledge, attitude and behavior at different ages, nursing ages, whether they had children, the highest educational background, department rotation, technical titles, administrative positions, employment methods, article publication, whether they had participated in nutrition training courses and in different regions ( F values were 6.80-60.95, t values were 2.94-7.08, all P<0.05). The main factors affecting nutrition knowledge were region, nursing age, the highest educational background, department rotation and whether they had participated in nutrition training courses ( t values were -6.88-6.73, all P<0.05). The main factors affecting nutritional attitude were region, nursing age and the highest educational background ( t=-2.22, 6.84, 3.21, all P<0.05). The main factor affecting nutritional behavior was nursing age ( t=5.45, P<0.05). Conclusions:Nurses′ nutritional attitude level is excellent, but their mastery of nutritional knowledge and nutritional nursing behavior level need to be improved. Reasonable, scientific and feasible nutritional training courses should be formulated according to the influencing factors of their nutritional knowledge, attitude and behavior, so as to improve nurses′ nutritional knowledge, belief and behavior level and improve the nutritional status and prognosis of hospitalized patients.
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Objective:To understand the current situation of the ideological and political cognition of the postgraduate courses for the master degree of nursing and the analysis of the demand for the ideological and political curriculum of the community nursing, and provide preliminary experience for the integration of ideological and political elements into the teaching practice of community nursing.Methods:Using phenomenological research method, the semi-structured interviews were conducted with 15 full-time nursing master degree postgraduates from Tongji University in Shanghai. Colaizzi 7-step analysis was used to analyze the data.Results:Under the mode of curriculum ideological and political education, the cognition and needs of nursing master students can be summarized into four themes: the deficiency of curriculum ideological and political cognition, changes in professional cognition, recognition of the role and importance of curriculum ideological and political education, expectations and needs of community nursing curriculum ideological and political education.Conclusion:Nursing students with master′s degree have a vague understanding of "curriculum ideological and political". In the future, they can add diversified teaching methods starting from professional quality, humanistic care and patriotism education, so as to make the community nursing curriculum ideological and political concept more popular, and strive to cultivate senior nursing talents with both ability and morality.
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Objective:To construct nursing quality evaluation indicator system for comprehensive stroke center, so as to provide reference for standardized nursing quality evaluation of comprehensive stroke center.Methods:From September 2018 to December 2019, based on the theory of Donabedian′s structure-process-outcome quality model, literature review, semi-structured interview, Delphi method and analytic hierarchy process were used to determine nursing quality evaluation index system and index weight for comprehensive stroke center.Results:A total of 16 experts from comprehensive stroke center were consulted for two rounds. The clinical working time was 24.63±10.08 years, and the effective recovery rates of two rounds were 100%. The authority coefficient of experts was 0.888, and the coordination coefficients W of two rounds were 0.229 and 0.283 respectively.Finally, a nursing quality evaluation indicator system for comprehensive stroke center was constructed, including 3 first-level indicators, 13 second-level indicators and 46 third-level indicators. Conclusions:The established nursing quality evaluation indicator system for comprehensive stroke center covers the whole process of stroke emergency, stroke unit, and follow-up, which is scientific and reliable, and provides an evaluation tool for daily nursing quality monitoring and continuous quality improvement in comprehensive stroke centers.
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In recent years, it has been gradually recognized that muscle weakness is a prominent and common problem in intensive care unit (ICU). It is estimated that more than 1 million patients worldwide develop ICU-acquired weakness (ICU-AW) each year. Its etiology is complex and the prognosis is poor. Respiratory muscle paralysis may even occur in severe cases, resulting in prolonged mechanical ventilation and hospitalization, increasing the hospital mortality of ICU patients, and leading to chronic disability. The pathogenesis of ICU-AW is not yet fully understood. Early recognition and diagnosis are difficult, and standard treatment strategies are lacking. This review focuses on the pathogenesis of muscle atrophy and muscle dysfunction, analyzes the advantages and disadvantages of current diagnostic methods for ICU-AW, and discusses the important significance of rehabilitation for the recovery of neuromuscular function in patients with ICU-AW on this basis, in order to improve clinicians' diagnosis and treatment of patients with ICU-AW, reduce mortality and improve prognosis.
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Objective:To explore the relationship between the preoperative fear of pain(FOP) and postoperative pain in patients with lung cancer undergoing video-assisted thoracoscopic surgery, with a view to provide a basis for psychological and behavioral intervention in perioperative pain.Methods:One hundred lung cancer patients underwent thoracoscopic surgery from August 2018 to December 2019 were recruited. The FOP was collected by the Chinese version of the fear of pain questionnaire-Ⅲ before operation. And postoperative pain including rest pain and cough pain was collected after surgery. The correlation analysis and relative risk coefficient was used to evaluate the relationship between preoperative FOP and postoperative pain.Results:Both rest pain and cough pain were positively correlated with FOP with the correlation coefficients of 0.404 and 0.489 (both P <0.05). Patients with a high level of FOP before surgery were more likely to report severe pain when coughing after surgery, which was 3.643 times (95% CI value was 1.585-8.372) higher than the patients with non-high level preoperative FOP. Conclusions:Patients with a high level preoperative FOP may report higher pain after surgery. Screening and identification of such patients are needed for further cognitive behavioral intervention.
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Objective To explore the comprehensive intervention mode of compliance with analgesics for home-based patients with moderate or severe cancer pain and to improve the medication compliance of home-based patients with cancer pain. Methods A self-designed questionnaire was designed to investigate the influencing factors of taking analgesics for home-based patients with moderate or severe cancer pain, 143 home-based patients with moderate to severe cancer pain were conveniently selected from Hospice Unit of Zhongnan Hospital of Wuhan University, from February 2016 to December2017. To investigate the subjective, objective and psychological factors affecting patients' compliance with analgesics, comprehensive interventions such as health education, behavioral intervention, cognitive intervention and psychological counseling were carried out. Before and after the intervention, Morisky′s self-report questionnaire on medication compliance, pain digital grading (NRS score), and pain relief degree were assessed. Using self control design method and comparing the compliance of patients taking analgesics, number of complete compliance and non-compliance in patients taking analgesics and NRS score and pain relief before and after 8 weeks of intervention. Pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after comprehensive intervention were evaluated. Results The main factors affecting patients' medication compliance with analgesics were fear of morphine addiction(16.37％, 37/226), single use of drugs and insufficient dosage (15.93％, 36/226), and fear of adverse drug reactions(13.72％, 31/226). The scores of NRS decrease in patients with different influencing factors were compared, with statistical difference (F=5.367, P=0.006). There were significant differences in the number and compliance of patients with complete compliance and non-compliance before and after 8-week-comprehensive intervention (χ2=25.583, P=0.000; t =-7.387, P=0.000). There were significant differences in pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after 8-week-comprehensive intervention (χ2=76.572, 62.998, all P=0.000). Conclusions Comprehensive intervention on subjective, objective and psychological factors affecting the medication compliance of home-based patients with moderate or severe cancer pain can improve the medication compliance of patients to take analgesics and alleviate pain.
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Objective@#To explore the comprehensive intervention mode of compliance with analgesics for home-based patients with moderate or severe cancer pain and to improve the medication compliance of home-based patients with cancer pain.@*Methods@#A self-designed questionnaire was designed to investigate the influencing factors of taking analgesics for home-based patients with moderate or severe cancer pain, 143 home-based patients with moderate to severe cancer pain were conveniently selected from Hospice Unit of Zhongnan Hospital of Wuhan University, from February 2016 to December 2017. To investigate the subjective, objective and psychological factors affecting patients' compliance with analgesics, comprehensive interventions such as health education, behavioral intervention, cognitive intervention and psychological counseling were carried out. Before and after the intervention, Morisky′s self-report questionnaire on medication compliance, pain digital grading (NRS score), and pain relief degree were assessed. Using self control design method and comparing the compliance of patients taking analgesics, number of complete compliance and non-compliance in patients taking analgesics and NRS score and pain relief before and after 8 weeks of intervention. Pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after comprehensive intervention were evaluated.@*Results@#The main factors affecting patients' medication compliance with analgesics were fear of morphine addiction(16.37%, 37/226), single use of drugs and insufficient dosage (15.93%, 36/226), and fear of adverse drug reactions(13.72%, 31/226). The scores of NRS decrease in patients with different influencing factors were compared, with statistical difference (F=5.367, P=0.006). There were significant differences in the number and compliance of patients with complete compliance and non-compliance before and after 8-week-comprehensive intervention (χ2=25.583, P=0.000; t=-7.387, P=0.000). There were significant differences in pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after 8-week-comprehensive intervention (χ2=76.572, 62.998, all P=0.000).@*Conclusions@#Comprehensive intervention on subjective, objective and psychological factors affecting the medication compliance of home-based patients with moderate or severe cancer pain can improve the medication compliance of patients to take analgesics and alleviate pain.
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Objective To investigate the effect of narrative education on emotional and clinical ability of baccalaureate nursing students practicing in ICU. Methods A total of 42 baccalaureate nursing students practicing in ICU between January 2016 and September 2016 were treated as the control group and received traditional teaching, their counterparts practicing in ICU between October 2016 and June 2017 were served as the observation group (41 cases) and subject to narrative education. The Self-rating Anxiety Scale(SAS),the Self-rating Depression Scale(SDS) were filled out by both groups before and after practicing in ICU, and assessed the comprehensive ability after ICU practice. Results The scores of SAS and SDS after practicing were (49.47 ± 12.37),(50.25 ± 11.86)points in the observation group and (54.32 ± 12.51), (55.79 ± 11.34) points in the control group, and the difference was significant(t=10.822, 12.310, P<0.05). The total scores and personal quality, theoretical knowledge level, clinical nursing ability, judgment thinking ability, communication and cooperation ability was (88.45 ± 13.54), (23.21 ± 4.73), (18.42±3.45), (17.91±3.62), (8.56±0.83), (8.34±0.67) points in the observation group , and (73.13± 11.35), (19.13±4.52), (15.45±3.21), (15.76±3.54), (6.17±0.19), (5.17±0.18) points in the control group, and the difference was significant (t=3.226-8.665, P<0.05 or 0.01). Conlusions The narration education can reduce the psychological burden of baccalaureate nursing students practicing in ICU and can improve the comprehensive ability of them.
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Objective To explore the key issues and future trends of transitional care. Methods CNKI, the Wanfang Database, VIP and SinoMed from 2002 to 2018 were searched with words of"Transitional Care", and BICOBM2.0 was used to extract high frequency words and form the co-word matrix, and gCLUTO1.0 was used to do cluster analysis, to create matrix visualization and mountain visualization. Results A total of 5376 articles were retrieved, and 12931 subject terms were extracted, and 29 high frequency key words were obtained. The key issues of these studies were: transitional care used in anxiety and depression;transitional care used in rehabilitation;transitional care used in improving the quality of life of old people with chronic diseases; transitional care used in improving the self-care ability and of health behavior of people with chronic diseases;information technology used in transitional care. Conclusion Researches of transitional care in China are developing rapidly and the fields are growing well. The research on anxiety, depression, rehabilitation of stroke and quality of life has been mature, and there still have expansion capacity for transitional care in self-care ability, health behavior and informatization.
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Objective To explore the experience of the family caregivers of the old hip fracture patients with cognition impairment. Methods By using purpose sampling method,11 participants which treating from January to April 2017 were applied semi-structured in-depth interview,and then analysis the material. Results Four themes were analyzed about the caring demands of the family caregivers, including existing heavier caring burden,inadequate knowledge and skills,positive face to the caring task, desire to caregiver support system. Conclusions The family caregivers of the old hip fracture patients with cognition impairment exist heavier caring burden, the medical service institutions should call on national policy support and economic aid for caregivers, care about the mental health of caregivers and improve their coping ability, as well as provide professional knowledge and skills guidance and build a perfect caregiver support system at the same time in order to reduce the burden of caregivers early.
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It introduced the definition of the caregiver and at home and abroad,and also reviewed influencing factors of family caregiver′s burden of the elderly patients. At last, it put forward the essentiality to perfect the nursing intervention and improve caregivers' coping capacity, as well as the transitional care model and the linkage"hospital-community-family",and improve national legislation and policy support in order to structure the social support system at the same time, so as to provide reference for study of reducing the family caregiver′s burden of the elderly patients.
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Objective To investigate the influences of interleukin 17A gene promoter -152G/A (IL-17A -152G/A) and interleukin 17F gene exon 7488 T/C (IL-17F 7488T/C) single nucleotide poly-morphisms on children bronchial asthma and serum total IgE ( TIgE) levels. Methods Genotype distribu-tion of IL-17A-152G/A and IL-17F 7488T/C in 224 children with asthma and 150 healthy subjects was de-tected by polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP) analysis. Some samples were selected for PCR product sequencing and verification. IMMAGE800 specific protein analyzer from the Beckman Coulter test system was used to automatically detect serum TIgE levels in all subjects. Re-sults Three genotypes of AA, AG and GG were detected at IL-17A -152G/A locus in both asthma and control groups. Differences in genotype frequency distribution were statistically significant between the two groups (P<0. 05). Subjects carrying the variant allele A at IL-17A-152G/A locus were more likely to have asthma than those without (P<0. 05). Three genotypes of TT, TC and CC were detected at IL-17F 7488T/C locus in both asthma and control groups, but differences in the frequency distribution of genotype and al-lele were statistically significant between the two groups (P<0. 05). There was a significant difference in se-rum TIgE levels between asthma and control groups (P<0. 05). In asthma group, patients of AA genotype at IL-17A -152G/A locus had higher serum TIgE levels than those of AG genotype (P=0. 001) and GG geno-type (P=0. 001). No significant difference in serum TIgE levels was found among healthy subjects of the three genotypes in control group. No significant difference in serum TIgE levels was observed among the sub-jects of TT, TC and CC genotypes at IL-17F 7488T/C locus in asthma or control group (P>0. 05). Conclu-sion IL-17 gene polymorphism was correlated with the incidence of asthma in children in Guiyang area. IL-17A -152G/A polymorphism was an important candidate gene for asthma in Guiyang area and the variant al-lele A at -152G/A locus was correlated with increased serum TIgE levels. IL-17F 7488T/C polymorphism was also an important candidate gene for asthma in Guiyang. Children carrying the variant allele C at IL-17F 7488T/C locus showed a lower risk for asthma in Guiyang. IL-17F 7488T/C polymorphism had no influence on serum TIgE levels.
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Objective To optimize the cerebral ischemia-reperfusion process for acute ischemic stroke patients,so as to reduce the time of in-hospital delays.Methods A multi-disciplinary management team was established to design the flowchart of the cerebral ischemia-reperfusion process for acute ischemic stroke patients.By applying Healthcare Failure Mode and Effect(HFMEA) management mode,intervention was conducted and its effect was analyzed.Results After implementation of the HFMEA intervention,the door to needle time(DNT)was reduced from 88 (42,140) minutes to 45 (37,59) minutes(P＜0.001);the ratio of patients with the DNT＜60 minutes increased from 20％ to 87.7％(P＜0.001);the door to cerebral ischemia-reperfusion time was shortened from 207(169,227) minutes to 165(155,185) minutes (P＜O.05).There was no significant difference in the incidence and mortality of symptomatic cerebral hemorrhage between before and after intervention (P＞0.05).Conclusion Utilization of HFMEA to optimize the emergency cerebral ischemia-reperfusion process can effectively reduce the in-hospital delays of acute ischemic stroke patients.
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Diaphragm is the principal respiratory muscle.Diaphragm dysfunction resulting from mechanical ventilation,chronic cardiopulmonary disease,medicine,cardio-thoracic surgery,septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay.Traditionally,the method of assessment of diaphragm structure and function was invasive,lacking specific,and was difficult to be used bedside.A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate,safe and noninvasive method of quantification of diaphragm structure and function.This article reviews the related researches of technique and the clinical applications of ultrasonography in the evaluation of diaphragmatic structure and function,which may possibly result in timely identification of patients with diaphragm dysfunction and improve the assessment of recovery from diaphragm weakness.