Table of Content

10 March 2024, Volume 5 Issue 3 Previous Issue    Next Issue

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Latent class analysis of symptom characteristics in patients with post-sepsis syndrome CHEN Yuzhen, ZHENG Jianhuang, JIANG Zhizhao, ZHENG Xuelan, ZHENG Cuihong 2024, 5 (3):  197-204.  doi: 10.3761/j.issn.2096-7446.2024.03.001 Abstract ( 192 )   Save Objective To explore the latent classes of symptoms in patients with post-sepsis syndrome, and to analyze the factors affecting the different classes. Methods Convenience sampling method was used to select sepsis patients discharged from a tertiary Grade A general hospital in Fujian Province from January 2021 to July 2021. Questionnaire survey was conducted three months after discharge through outpatient department, telephone and wechat. The latent classes of symptoms were analyzed，and the influencing factors were identified by univariate analysis and multinomial Logistic regression. Results Among 347 discharged patients with sepsis, 216 cases (62.25% ) developed post-sepsis syndrome, and the incidence of cognitive impairment 67.12% ，anxiety 61.57% , depression 51.78%，and sleep disorder 78.70% three months after discharge. The incidence of disability of daily living was 56.48%. The symptoms of post-sepsis syndrome patients were “high symptom group”（25.93%），“cognitive daily living impairment group” （32.87% ） and “sleep disorder group” （41.20% ）. The odds of patients having a previous history and using more analgesics were greater in the “high symptom group”, the odds of having a higher APACHEⅡ score in the “high symptom group” and “cognitive-daily living impairment group” were greater, and the odds of having a higher level of social support in the “high symptom group” and “cognitive-daily living impairment group” were lower. The higher the use of hormone medication, the lower the risk of being classified as “sleep disorder group”. Conclusion The symptoms of patients with post-sepsis syndrome can be divided into three latent classes：“high symptom group” “cognitive-daily living impairment group” and “sleep disorder group”. There is heterogeneity in the latent classes of symptoms of patients with post-sepsis syndrome concerning previous history,analgesic drug use, hormone drug use, APACHEⅡscore and social support. The latent classes of symptoms can be predicted. Related Articles | Metrics

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Qualitative research on ICU nurses' cognitive experience of acute skin failure CHEN Xiangping, GONG Xiaoyan, ZHAO Linfang, LAO Yuewen, ZHANG Yi, HE Xuehua, WANG Kaili, DING Zhuyu, ZHUANG Yiyu 2024, 5 (3):  205-210.  doi: 10.3761/j.issn.2096-7446.2024.03.002 Abstract ( 219 )   Save Objective To explore ICU nurses’ cognitive experience of acute skin failure. Methods Study participants were recruited through purposive sampling. Semi-structured interviews were conducted with 12 intensive care nurses who met the inclusion criteria in the comprehensive intensive care unit of a tertiary Grade A hospital in Hangzhou from August to December 2022. Colaizzi phenomenological research method was used to analyze the interview data. Results Four themes were extracted，including perceived benefits of recognizing acute skin failure， expectation of establishing norms for the management of acute skin failure care，desire to have knowledge sharing across disciplines，and awareness of inadequate information support for ICU families regarding acute skin failure. Conclusion Nursing managers can promote the clinical practice of skin care for critically ill patients by emphasizing the cognitive management of acute skin failure by clinical nurses，formulating operative nursing management protocols for acute skin failure，and constructing information support program for peri-critical patients’ families regarding acute skin failure. It is also necessary to actively explore the multidisciplinary knowledge sharing model from the perspective of skin organ，promote innovative scientific research on skin care，and ultimately achieve high-quality development of skin care in the critical care field. Related Articles | Metrics

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Phase I cardiac rehabilitation care for patients after magnetically levitated left ventricular assist device implantation GUAN Yuzhen, LU Yanyan, WANG Weiyun, GENG Dandan, CHEN Qingqing, ZHANG Wei, SHAO Yongfeng 2024, 5 (3):  211-213.  doi: 10.3761/j.issn.2096-7446.2024.03.003 Abstract ( 112 )   Save To summarize the phase I cardiac rehabilitation nursing experiences for 7 patients after magnetically levitated left ventricular assist device implantation. In view of the severe postoperative conditions，decreased exercise capacity，and complex device management after magnetically levitated left ventricular assist device implantation，we provided comprehensive pre-rehabilitation assessment，respiratory and motor function training，device parameter and safety management，electrocardiogram and mean arterial pressure monitoring，and management of the percutaneous lead wound. After an active treatment and care of 35-61 days，the patients were discharged. The patients recovered well during follow-up of 3 months after discharge. Related Articles | Metrics

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Summary of the best evidence for home cardiac rehabilitation in patients undergoing transcatheter aortic valve replacement JIA Yingying, SONG Jianping, ZHANG Qian, PANG Linyan, NIU Shan 2024, 5 (3):  214-221.  doi: 10.3761/j.issn.2096-7446.2024.03.004 Abstract ( 131 )   Save Objective To extract，evaluate，and integrate evidence related to the management of home cardiac rehabilitation for patients undergoing transcatheter aortic valve replacement （TAVR），with the aim of providing a basis for home cardiac rehabilitation for TAVR patients. Methods We comprehensively searched domestic and international databases，guideline websites，and websites of cardiovascular-related associations for clinical guidelines， expert consensuses，evidence summaries，clinical decision-making，recommended practices，and systematic reviews related to home cardiac rehabilitation for patients with TAVR，with a timeframe from the establishment of the databases to November 1，2023. Two researchers independently evaluated the quality of the literature and extracted relevant topics and evidence. Results A total of 16 papers were included，including 5 expert consensus papers，7 guidelines，and 4 clinical decisions，and 26 pieces of best evidence were summarized in 7 aspects：rehabilitation risk assessment，home health education，home exercise rehabilitation，risk factor management，home anticoagulation management，home complication management，and home follow-up management. Conclusion The rehabilitation team can rigorously screen patients for participation in rehabilitation based on their condition and preference， incorporating the best evidence. The focus is on anticoagulation management，complication management，and follow- up management to enable dynamic monitoring of valve function，reduce the incidence of postoperative complications， and improve patient compliance with rehabilitation. Related Articles | Metrics

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Evidence summary of phase Ⅱ cardiac rehabilitation for patients with chronic heart failure WU Di, TAO Ming, CHEN Yongmei, CHEN Yu, WU Hemei, ZHANG Lu 2024, 5 (3):  222-229.  doi: 10.3761/j.issn.2096-7446.2024.03.005 Abstract ( 112 )   Save Objective To search and obtain the best evidence on phase II cardiac rehabilitation for chronic heart failure patients. Methods We searched all relevant databases and website for evidence of phase II cardiac rehabilitation for chronic heart failure，such as UpToDate，BMJ Best Practice，Guidelines International Network， American Heart Association，PubMed，Web of Science，CNKI. Evidence types included clinical decision-making， evidence-based guideline，expert consensus，systematic review，and summary of best evidence. Two researchers evaluated the quality of the included literature and extracted evidence that met quality standards. Results A total of 19 articles were included，including 8 guidelines，2 clinical decisions，3 expert consensuses，4 systematic reviews and 2 evidence summaries. 30 pieces of best evidence were summarized into 10 aspects，including multidisciplinary team collaboration，venue and configuration，evaluation，exercise，medicine，nutrition，psychology，risk factors management，health education，and compliance supervision. Conclusion This study summarized the best evidence for phase Ⅱ cardiac rehabilitation in patients with chronic heart failure，provide an evidence based reference for clinical medical staff to formulate comprehensive management plans of phase Ⅱ cardiac rehabilitation in patients with chronic heart failure，and conduct high quality phase Ⅱ cardiac rehabilitation. Related Articles | Metrics

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Progress in the application of exercise rehabilitation in children with congenital heart disease after surgery JIN Hongcheng, ZHU Jihua, TANG Xiaomin, CHUI Linbo, JIANG Weihong 2024, 5 (3):  230-234.  doi: 10.3761/j.issn.2096-7446.2024.03.006 Abstract ( 212 )   Save Exercise rehabilitation is tailored to the characteristics of the disease and the child’s functional status， it involves carrying out active and passive exercise guided by mechanical principles，to improve physical function and fitness. The exercise tolerance and cardiopulmonary function of children with congenital heart disease are lower than those of normal children，and there will be varying degrees of decline after surgery. Exercise rehabilitation is a safe and effective way to promote rapid recovery. This article reviews the implementation process and influencing factors of exercise rehabilitation in children with congenital heart disease，and the exercise rehabilitation can enhance the cardiopulmonary function，improve exercise endurance，improve the quality of life and promote rapid recovery. But the evaluation indicators of exercise tolerance，individualized exercise prescription，out-of-hospital support system and follow-up management of children still need to be further studied and improved. Related Articles | Metrics

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Emergency nursing of a patient with out-of-hospital cardiac arrest rescued by the first eyewitness guided by remote video GUAN Qinling, LI Yao 2024, 5 (3):  235-237.  doi: 10.3761/j.issn.2096-7446.2024.03.007 Abstract ( 109 )   Save To summarize the emergency nursing experience of a patient with cardiac arrest who was successfully discharged from hospital after public aid-prehospital first aid-in-hospital treatment. Aiming at the problems of unknown causes of sudden death，critical condition，no rescue experience of the first witness，needs of rapid recovery of vital signs，avoidance of brain injury and neurological dysfunction，a remote rescue team was established and early and rapid identification of the disease was performed to minimize the first aid blank period through remote control，unified command，division of labor and cooperation. Hemodynamic monitoring and volume management，multi- dimensional optimal target body temperature management，prevention of microcirculation disorders and other measures were implemented after spontaneous circulation recovery. After 2 hours of active rescue and meticulous nursing，the patient was transferred to EICU for further treatment，and was discharged smoothly 16 days later. After 6 months of follow-up，the patient was in good condition. Related Articles | Metrics

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First aid and nursing of a child with influenza A combined with recurrent episodes of A-S syndrome LI Yang, XIANG Yujun, GAO Tingting, LI Jiahuan 2024, 5 (3):  238-240.  doi: 10.3761/j.issn.2096-7446.2024.03.008 Abstract ( 131 )   Save To summarize the first aid and nursing experience of a child with influenza A combined with recur- rent episodes of A-S syndrome. For the child with malignant arrhythmia，critical and rapid progress of the disease， weadopted rapid diagnosis of A-S syndrome，track maintenance team resuscitation，establishment of multidisciplinary team to develop scientific diagnosis and treatment and nursing plan. After 15 d，the condition was stable and the patient was discharged. After follow-up within half a year，the child had a good prognosis. Related Articles | Metrics

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Perioperative care of a patient with ovarian cancer with cerebral infarction as the first symptom ZHANG Li, LI Ying, CHEN Jie, YANG Changjie, SONG Xinying, REN Lanlan 2024, 5 (3):  241-243.  doi: 10.3761/j.issn.2096-7446.2024.03.009 Abstract ( 118 )   Save To summarize the perioperative nursing experience of a patient with ovarian cancer with cerebral in- farction as the first symptom. In view of the patient’s critical and complex condition，being prone to thrombosis and bleeding during perioperative period，the increasing risk of postoperative complications，the patient’s psychological re- habilitation，limbs rehabilitation and other problems，the establishment of a multidisciplinary cooperation team was adopted to manage the whole process. We fully assessed the condition before surgery and formulated a nursing plan，did a good job of medication care during bridging anticoagulation，actively prevented pulmonary embolism and new cerebral infarction，used traditional Chinese medicine enema method to prevent postoperative intestinal obstruc- tion，encourage family members to participate in patient psychological care to promote recovery. Through active treatment and nursing，the patient was discharged from the hospital on the 9th day after surgery. After 6 months of follow-up，the recovery was good. Related Articles | Metrics

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Overall management of skin failure and mucosal injury after Stanford type A aortic dissection surgery WANG Feifei, WENG Fengxia, SANG Ming, JIANG Chunyan, MA Qingna, WEI Jianhua 2024, 5 (3):  244-247.  doi: 10.3761/j.issn.2096-7446.2024.03.010 Abstract ( 93 )   Save This study summarized nursing experience of a patient with Stanford type A aortic dissection，who suffered from skin failure and mucosal injury after surgery. The patients had acute skin failure，diffuse gastrointestinal mucosal injury，and oral and nasal mucosa instrument-related pressure injury. Throughout the nursing process，we identified and addressed relevant risk factors in a timely manner，and implemented a phased turnover strategy to optimize the skin care program.，offered customized nutritional plans and specialized care for managing incontinence- related dermatitis，prioritized the protection of the oral and nasal mucosa to prevent device-related pressure injuries. Following 53 days of treatment in ICU，the patient had significant improvement in the condition of skin and mucosa，and was discharged from the hospital on the 70th day post-surgery. Related Articles | Metrics

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Personalized nursing care for a patient with Tropheryma whipplei pneumonia FU Jinyan, DU Jiajia, LI Chunmei, ZHAO Chunyan 2024, 5 (3):  248-250.  doi: 10.3761/j.issn.2096-7446.2024.03.011 Abstract ( 96 )   Save To report on the nursing experience of a middle-aged foreign male patient with Tropheryma whipplei pneumonia. The incidence rate of the disease in Europe is only three per million，and it is even rarer in China. The patient’s condition worsened gradually after onset and was treated at two hospitals in Yunnan Province. In addition，differences in medical system，culture，habits，and other factors increased the difficulty of nursing. The nursing focus included oxygen therapy care，infection prevention care，fever care mainly focused on physical cooling， customized dietary plans based on patient needs，family participatory care，skin care，medication care，cross-cultural care，and follow-up management. After treatment and care，the patient’s condition improved steadily and was discharged from the hospital. The patient’s condition did not worsen further during follow-up calls. Related Articles | Metrics

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Evaluation of using real-time feedback technique of cardiopulmonary resuscitation to guide external chest compressions while wearing personal tertiary protective equipment LI Yangyang, WANG Fang, PENG Fei, JIANG Zhuojuan, YU Hehua 2024, 5 (3):  251-254.  doi: 10.3761/j.issn.2096-7446.2024.03.012 Abstract ( 67 )   Save Objective To explore the effect of real-time feedback technology on improving the quality of external chest compression of rescuers wearing personal tertiary protective equipment. Methods Twenty medical staff in emergency department were selected as subjects by convenience sampling method. A pre-post self comparison design was used. Subjects wearing tertiary personal protective equipment first performed routine chest compressions without feedback on a cardiopulmonary resuscitation（CPR） simulator(the routine compression group). After full rest， external chest compressions under feedback were performed(the feedback compression group). The quality of external chest compressions and physiological indicators（including heart rate，systolic blood pressure，diastolic blood pressure， and blood oxygen saturation） before and after external chest compressions in the two groups were observed and recorded. Results The compression frequency of subjects in the routine compression group was （133±12） times per minute，which was higher than that in the feedback compression group （113 ±5），and the difference was statistically significant （P=0.001）. The pressing depth of the routine compression group was （4.5±1.0） cm，which was shallower than that of the feedback compression group （5.8 ±0.8） cm，and the difference was statistically significant （P=0.027）. The comprehensive compliance rate of the routine compression group was only 6.2%，which was significantly lower than 91% in the feedback compression group，and the difference between the two groups was statistically significant（P=0.001）. There was no significant difference in the physiological index data between the two groups before and after chest compression （P>0.05）. Conclusion Real-time feedback technology can effectively improve the quality of external chest compression of rescuers wearing personal three-level protection equipment and has no effect on the physiological indicators of rescuers. Related Articles | Metrics

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Mediating effect of perceived social support on the relationship between work pressure and presenteeism in ICU nurses LI Guifang, ZHANG Guizhen, HUANG Jia, YANG Xingyu, LI Jiaying 2024, 5 (3):  255-261.  doi: 10.3761/j.issn.2096-7446.2024.03.013 Abstract ( 126 )   Save Objective To explore the mediating role of perceived social support on the relationship between work pressure and presenteeism in ICU nurses. Methods A total of 403 ICU nurses from secondary and above hospitals in Ningxia Hui Autonomous Region were selected by convenient sampling method in February 2023，and evaluated by general demographic data questionnaire，Perceived Social Support Scale，Chinese Nurses Stressor Scale， and The Stanford Presenteeism Scale. AMOS 23.0 software was used to establish a model and conduct path analysis. Results The scores of work pressure，perceived social support and presenteeism were （99.45 ±19.22）， （58.94 ±15.04） and （17.33 ±4.49），respectively. The results of structural equation model showed that the work pressure of ICU nurses had a positive predictive effect on presenteeism （β=0.16，P<0.01），and perceived social support had a negative predictive effect on presenteeism （β=-0.04，P<0.01）. There was a partial mediating effect between work pressure and presenteeism in ICU nurses （indirect effect size was 0.016），and the effect contribution was 9.09%. Conclusion The current situation of ICU nurses’ presenteeism in Ningxia is quite severe. ICU nurses’ perceived social support plays a partial mediating role between work pressure and presenteeism. Managers can mobilize ICU nurses to fully tap and use their perceived social support resources to relieve their work pressure and reduce hidden absenteeism from the perspective of work resources. Related Articles | Metrics

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Practice of combined teaching method in improving the effectiveness of standardized training for ICU nurses SUN Xiumei, NIU Yaru, YANG Fangfang, SHEN Yanling 2024, 5 (3):  261-266.  doi: 10.3761/j.issn.2096-7446.2024.03.014 Abstract ( 110 )   Save Objective To explore the effect of combined teaching method in standardized training of ICU nurses. Methods 40 standardized trained nurses rotating in ICU from February 2022 to February 2023 were set as the experimental group，and the combined teaching method was adopted. The 40 standardized trained nurses rotating in ICU from January 2021 to January 2022 were set as the control group，the traditional teaching method was used. Both groups were taught for 3 months. The results of theoretical assessment，skills assessment，nursing rounds and satisfaction of teaching were compared between the two groups after teaching，the scores of independent learning ability and post competency were compared before and after teaching. Results After teaching，the scores of theoretical，skills and nursing rounds of experimental group were higher than those of control group （t=2.580，P= 0.012；t=2.351，P=0.022；t=2.311，P=0.024）. The score of independent learning ability and the post competency of the experimental group were improved than that of the control group（t=3.426，P=0.001；t=5.411，P<0.001）. The teaching satisfaction of experimental group was higher than that of control group （t =2.847，P=0.006）. Conclusion The combined teaching methods can improve the comprehensive scores of ICU trained nurses，improve the independent learning ability and post competence level，and teaching satisfaction is high. Related Articles | Metrics

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Evidence summary of nutritional management in adults with moderate and severe burns DENG Yunyun, TAN Huiyi, YAO Yiming, YOU Yulin 2024, 5 (3):  267-275.  doi: 10.3761/j.issn.2096-7446.2024.03.015 Abstract ( 116 )   Save Objective To search and summarize the best evidence of nutrition management in adult patients with moderate and severe burns. Methods Domestic and foreign databases and official websites of relevant associations were systematically searched until December 31，2022，and the quality of literature was evaluated and evidence was extracted. Results A total of 24 literature were included，including 8 guidelines，4 clinical decisions，6 systematic reviews，5 evidence summaries，and an expert consensus. A total of 31 pieces of evidence were summarized into 8 categories，including early risk identification and overall assessment of nutrition，establishment of interdisciplinary nutrition management team，nutrition intervention objects and timing，selection of nutrition intervention approaches and matters needing attention，formulation of individualized nutrition management plan，energy demand monitoring， dynamic monitoring，on-the-go evaluation，discharge guidance and health education. Conclusion Medical staff should select the best evidence according to the actual situation of patients in the process of evidence application，reduce the incidence of malnutrition in burn patients and improve the quality of nursing. Related Articles | Metrics

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Summary of the best evidence for vasoactive drug infusion in adult patients WANG Fang, ZHANG Shuzeng, NIE Anliu, SU Xiangfen 2024, 5 (3):  275-282.  doi: 10.3761/j.issn.2096-7446.2024.03.016 Abstract ( 395 )   Save Objective To summarize the best evidence for safe infusion of vasoactive drugs in adult patients，and to provide evidence support for clinical nursing work. Methods We searched UpToDate，BMJ Best Practice，Joanna Briggs Institute library，Cochrane Library，National Guideline Clearinghouse，Centers for Disease Control and Preven- tion，National Institute for Health and Care Excellence，Guideline International Network，CINAHL，Embase，Registered Nurses’ Association of Ontario，UK Intensive Care Society，American Intravenous Nurses Society，PubMed，Web of Science，CNKI，Wanfang Database，VIP，Chinese Nursing Association，SinoMed，Yimaitong to collect guidelines，expert consensuses，group standards，systematic reviews，evidence summaries and original study on vasoactive drug infusionin adult patients. The retrial limit was from January 1，2013 to March 10，2023.Literature quality evaluation and ev- idence screening were conducted independently by two researchers with evidence-based nursing research back- ground，and the evidence was classified and integrated by the team after summary. Results A total of 12 litera- tures were included，and 29 pieces of evidence were summarized from five dimensions：training and education，evalu- ation，vascular access selection，infusion scheme and complications management. Conclusion This study summarizes the best evidence of vasoactive drug infusion in adult patients，which can provide medical staff with scientific infu- sion regimen，ensure patient safety and improve the quality of care. Related Articles | Metrics

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Research progress of diaphragmatic function management in ICU patients with mechanical ventilation JI Li, WU Hui, JING Chenyang, HE Guobao, WANG Tuohong, FAN Luo 2024, 5 (3):  283-288.  doi: 10.3761/j.issn.2096-7446.2024.03.017 Abstract ( 263 )   Save This article reviews the origin and development，importance，management strategies，and challenges and countermeasures faced during the management of diaphragm function in mechanically ventilated patients in the ICU，with the aim of providing a reference for the clinical implementation of standardized management of diaphragm function in mechanically ventilated patients in the ICU. Related Articles | Metrics