Table of Content

10 September 2024, Volume 5 Issue 9 Previous Issue    Next Issue

Research Paper

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A nested case-control study of risk factors for ketoacidosis in patients with diabetes mellitus LIU Chenhong, ZHAO Yingna, LIU Yancun, YAO Ying 2024, 5 (9):  773-778.  doi: 10.3761/j.issn.2096-7446.2024.09.001 Abstract ( )   PDF (760KB) ( )   Save Objective To investigate the risk factors for ketoacidosis in patients with diabetes. Methods The subjects of this study were diabetic patients who voluntarily participated in the risk assessment of diabetic hyperglycemic crisis in the General Hospital of Tianjin Medical University since 2022. 200 patients who developed ketoacidosis as of July 2023 were recruited as case group. 200 patients who did not develop ketoacidosis during the follow-up period were matched 1 ∶ 1 according to sex and age,and selected as the control. Univariate and multivariate logistic regression model were used to statistically analyze the risk factors of ketoacidosis in diabetic patients. Results There were 106 males in the case group with an average age of（52.14±19.38） years,and 108 males in the control group with an average age of（52.17±19.39） years. Multivariate logistic regression showed that long hospital stay,history of acute infection,high random blood glucose,abnormal glycated hemoglobin,abnormal liver function,and abnormal renal function were risk factors for the development of DKA. Family history and dietary regularity were protective factors for DKA. Conclusion Family history,diet regularity,length of hospital stay,history of acute infection,random blood glucose,glycated hemoglobin,liver function and renal function are the influencing factors of ketoacidosis,which provides a reference for clinicians to identify ketoacidosis early. References | Related Articles | Metrics

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Construction of evaluation index system for core competencies of nurses in hospital emergency rescue for group burns XIA Yilan, DU Yong, LI Qian, LIU Rui, JIANG Bin 2024, 5 (9):  779-785.  doi: 10.3761/j.issn.2096-7446.2024.09.002 Abstract ( )   PDF (1114KB) ( )   Save Objective To construct evaluation index system for core competencies of nurses in hospital emergency rescue for group burns. Methods Based on literature review and reference to the core competency framework of nurses,guided by overall theory and combined with the practical experience of our hospital in participating in group burns treatment,a preliminary draft of evaluation indicators was formulated. From December 1,2023 to February 1,2024,the Delphi method was used for two rounds of expert consultation,and the weights of each indicator were calculated using the analytic hierarchy process. Results The response rate of the two rounds of questionnaires was 100%,the authority coefficient of experts was 0.889,and the coordination coefficients of expert opinions were 0.244 and 0.254（P<0.05）,respectively. Finally,an evaluation index system for core competencies of nurses in hospital emergency rescue for group burns was formed,which includes 5 primary indicators,15 secondary indicators,and 48 tertiary indicators,including burn specialty knowledge,burn nursing practice ability,emergency response ability,multidisciplinary collaboration ability,and critical thinking ability. Conclusion The evaluation index system for core competencies of nurses in hospital emergency rescue for group burns constructed in this study,with unified expert opinions,provides a tool for evaluating the capabilities of emergency rescue nurses,and also provides reference for further optimizing the training mode of emergency rescue nurses in the hospital and establishing an echelon of emergency rescue nurses in the hospital. References | Related Articles | Metrics

Special Planning-Mental Health Promotion for Nurses

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Latent profile analysis of vicarious traumatization in emergency department nurses and comparison of vicarious posttraumatic growth among different classes HU Anni, ZHU Hongmei, XU Min, JIA Juanhua, GE Liuna, HAN Jiangying 2024, 5 (9):  786-792.  doi: 10.3761/j.issn.2096-7446.2024.09.003 Abstract ( )   PDF (1167KB) ( )   Save Objective To explore the latent classes and influencing factors of vicarious traumatization in emergency department nurses,and compare the levels of vicarious posttraumatic growth according to their classifications. Methods A total of 498 emergency department nurses from 20 public general hospitals in Anhui Province were selected by convenient sampling method from March to May 2022. The general data questionnaire,the Vicarious Traumatization Questionnaire and the Posttraumatic Growth Inventory were used for questionnaire investigation. Results The vicarious traumatization of emergency department nurses could be divided into three categories：low trauma group（15.5%）,medium trauma group（53.0%） and high trauma-impaired life belief group（31.5%）. Nurses with different categories had differences in vicarious posttraumatic growth scores（F=3.736,P=0.025）. Logistic regression results showed that personality,whether to participate in public emergency response training,and nurse-patient relationship were influencing factors of the latent categories of vicarious traumatization. Conclusion Vicarious traumatization for emergency department nurses could be divided into three categories,the higher the degree of vicarious traumatization,the higher the level of vicarious posttraumatic growth. Nursing managers should pay special attention to emergency department nurses who are introverted,have not participated in emergency training for public emergencies,and have poor nurse-patient relationships,and take targeted intervention measures to reduce the occurrence of vicarious traumatization. References | Related Articles | Metrics

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The mediation effect of recovery experience in the relationship between leisure crafting and work engagement among ICU nurses LIU Qingwei, GAI Yubiao, GUO Xiaojing, ZHANG Yuchen, ZHAO Yuxiao 2024, 5 (9):  793-798.  doi: 10.3761/j.issn.2096-7446.2024.09.004 Abstract ( )   PDF (937KB) ( )   Save Objective On the basis of the theory of resource conservation,this study explored the mediating role of ICU nurses‘ recovery experience between leisure crafting and work engagement,so as to enhance the work engagement level of ICU nurses. Methods From January to March 2023,a questionnaire survey was conducted among 227 ICU nurses from three tertiary Class A general hospitals in Shandong Province using convenience sampling method. The survey tools included the general information questionnaire,the Leisure Crafting Scale （LCS）,the Recovery Experience Questionnaire（REQ）,and the Utrecht Work Engagement Scale-9（UWES-9）. Results The total effect of ICU nurses‘ leisure crafting on work engagement was 0.490（P<0.001）,the direct effect was 0.174（P=0.007）. Recovery experience partially mediated the relationship between leisure craft and work engagement,the indirect effect value was 0.316（95%CI：0.231~0.414）,and the mediating effect accounted for 64.49% of the total effect. Conclusion ICU nurses proactively and systematically plan their leisure time to supplement individual resources and improve the recovery experience,which can have a positive effect on work engagement. References | Related Articles | Metrics

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The mediating role of hospital ethical climate in the relationship between ethical support system and emergency triage nurses‘ moral courage KANG Yun, SHAO Yan, PENG Guihai, MA Juhua, LI Longti 2024, 5 (9):  799-805.  doi: 10.3761/j.issn.2096-7446.2024.09.005 Abstract ( )   PDF (1054KB) ( )   Save Objective To explore the mediating role of hospital ethical climate in the relationship between ethical support system and the moral courage of emergency triage nurses,and to provide practical insights for clinical practice to enhance the ethical standards and decision-making abilities of emergency triage nurses. Methods From October to December 2023,396 emergency triage nurses were selected from three tertiary hospitals in Shiyan City through convenience sampling. Based on the theory of social support,it was hypothesized that the hospital ethical climate mediated the impact of ethical support systems on the moral courage of emergency triage nurses. Data were collected using a general information questionnaire,Emergency Triage Nurses‘ Ethical Support System Perception Questionnaire,Hospital Ethical Climate Scale,and Moral Courage Scale for Nurses. Structural Equation Modeling（SEM） was utilized for data analysis and hypothesis testing. Results Descriptive analysis indicated that the scores for emergency triage nurses‘ perceptions of the ethical support system,hospital ethical climate,and moral courage were （83.35±10.01）,（100.64±13.49）,and （81.52±10.56）,respectively. Correlation analysis showed strong positive correlations between scores of the ethical support system and hospital ethical climate（r=0.833,P<0.01）,and moral courage（r=0.820,P<0.01）. The hospital ethical climate also had a strong positive correlation with moral courage scores（r=0.887,P<0.01）. SEM analysis indicated excellent fit indices,the hospital ethical climate significantly mediated the relationship between perceptions of the ethical support system and moral courage,with an indirect effect value of 0.492,95%CI of 0.489-0.685,and a relative effect of 51.52%. Conclusion The hospital ethical climate significantly mediates the relationship between ethical support system and the moral courage of emergency triage nurses,underscoring the critical role of the hospital ethical climate in enhancing professional ethical standards in nursing. References | Related Articles | Metrics

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Nurses‘ experiences of near-miss events：a qualitative meta-synthesis YU Ran, MA Xinxuan, GAN Qingwen, LIAN Zerong, SUN Xiaoxuan, LING Hua 2024, 5 (9):  806-811.  doi: 10.3761/j.issn.2096-7446.2024.09.006 Abstract ( )   PDF (1008KB) ( )   Save Objective To systematically evaluate near misses experienced by nurses to inform better management of the situation. Methods A computerized search of PubMed,Cochrane Library,Web of Science,Embase,PsycInfo,Scopus,China National Knowledge Infrastructure,Wanfang,VIP,and China Biomedical Literature Database for qualitative studies on nurses‘ experience of near miss events was conducted with a timeframe of the establishment of the database to December 30,2023. The quality of the included literature was evaluated using the 2016 Australian Joanna Briggs Institute（JBI） Center for Evidence-Based Health Care qualitative research quality assessment tool,and the results were integrated using meta-integration methods. Results A total of 7 articles were included,and 26 findings were distilled and grouped into 6 categories,resulting in 3 integrative findings,including reasons why near miss events occur,a dual emotional experience caused by near miss events,and ways of coping with near miss events. Conclusion Nursing administrators should pay more attention to the negative emotional experience that near miss events bring to nurses,improve the process of reporting near miss events,and establish a no-blame,nonpunitive management system,so as to promote nurses to report near miss events proactively and protect patient safety. References | Related Articles | Metrics

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Visualization analysis of the hotspots and development trends of second victim research in nursing field ZHOU Hongting, ZHUANG Yiyu, WANG Xinan, HUANG Liebin 2024, 5 (9):  812-818.  doi: 10.3761/j.issn.2096-7446.2024.09.007 Abstract ( )   PDF (1818KB) ( )   Save Objective To analyze the current status,research hotspots,and development trends of second victim research in the nursing field,both domestically and internationally. Methods The relevant literature on second victims in the nursing field were searched in the Web of Science Core Collection database and the China National Knowledge Infrastructure,from the establishment of the database to November 20,2023. CiteSpace （6.2.R4） analysis software was used to conduct bibliometric analysis. Results A total of 169 foreign-language articles and 74 Chinese articles were included. Several core research teams focusing on second victims in the nursing field have been established internationally,but no unified efforts have been formed domestically. The research on the influencing factors,support needs and intervention models of the second victim in foreign countries were relatively mature,while most of the domestic studies focused on the quantitative research on the experience and support status of the second victim,qualitative research mainly investigated the psychological and emotional experience of nurses after experiencing adverse events,and there was limited research exploring the support needs of nurses and the ways to obtain support. There are few systematic constructions based on support policies and hospital-based intervention projects. Conclusion Cross-regional,cross-institutional,and cross-team collaboration in China needs to be strengthened. The research hotspots in both domestic and international contexts exhibit similarities and diversification. Medical institutions at all levels should further study the needs of the second victims in their own countries and promote the establishment of a non-punitive hospital patient safety culture. Future research can gradually explore the development of a second victim support system suitable for the healthcare situation in China. References | Related Articles | Metrics

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Training practices for nursing students to prevent and respond to workplace violence：a scoping review ZHOU Chunqing, FENG Xinyi, MA Xiaoqin 2024, 5 (9):  818-824.  doi: 10.3761/j.issn.2096-7446.2024.09.008 Abstract ( )   PDF (1129KB) ( )   Save Objective To sort out and analyze the content,methods and effects of training practice on prevention and response to workplace violence among nursing students at home and abroad,so as to provide reference for further research. Methods Relevant studies in PubMed,Web of Science Core Collection,CINAHL Complete,Embase,Science Direct,Cochrane Library,CNKI,Wanfang,VIP and SinoMed were systematically searched. The search time limit was from January 1,2000 to October 26,2023. The included literature was analyzed and discussed. Results A total of 2 258 related literatures were obtained from literature retrieval,and 23 were finally included after screening,including 17 in English and 6 in Chinese. The training content mainly focuses on the theoretical knowledge and violence degradation skills related to workplace violence. The training methods are mainly divided into two categories：traditional training methods and student-centered training methods. The outcome indicators can be divided into two aspects：experience evaluation and effect evaluation. Most studies have reported different degrees of improvement and increase in effects. Conclusion The content of workplace violence training is not comprehensive,and the training methods are diversified. However,there are few relevant assessment and evaluation indicators,and the long-term effect needs to be further verified. It is suggested that in the future,the training content can be further enriched and improved according to the educational needs of nursing students at different stages,the methods can be further innovated and diversified,and the specific scale can be developed,so as to develop a specialized training program in line with the specific situation of China. References | Related Articles | Metrics

Guideline and Standard

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Expert consensus on safe interhospital transport of critically ill children National Clinical Research Center for Child Health/Nursing Department, Children‘s Hospital, Zhejiang University School of Medicine, Nursing Department, Children‘s Hospital, Capital Medical University, Nursing Department, Children‘s Hospital of Fudan University, PICU, Shanghai Children‘s Medical Center, Shanghai Jiao Tong University School of Medicine, PICU, Children‘s Hospital, Chongqing Medical University, Emergency Department, Guangzhou Women, Children's Medical Center, Emergency Department, Children‘s Hospital of Soochow University, Nursing Department, Ningbo Women, Children‘s Hospital（Writing committee：ZHU Jihua, LIU Lili, HU Jing, CHEN Wenqiong, TAO Yi, YU Biyan, YU Zhen, CEN Huiping, CHEN Yaru, LI Shuaini） 2024, 5 (9):  825-829.  doi: 10.3761/j.issn.2096-7446.2024.09.009 Abstract ( )   PDF (835KB) ( )   Save Objective To form a consensus of nursing experts on the safe interhospital transport of critically ill children（hereinafter referred to as the "consensus"） to standardize the care of interhospital safe transport of critically ill children. Methods An expert "consensus" group was established to determine clinical research questions,review the relevant literature on inter-hospital safe transport nursing of critically ill children,use evidence-based methods to form a first draft of consensus,and use Delphi expert consultation and online expert meetings to discuss,revise and improve the consensus,and form the final draft of "consensus". Results The consensus included 8 aspects,including contraindications,transport initiation,pre-transport preparation,transport handover,transport monitoring,transport intervention,family support,evaluation and recording. Conclusion This consensus is scientific and practical,and provides guidance for the practice of interhospital safe transport nursing for critically ill children. References | Related Articles | Metrics

Emergency Care Research

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Nursing care for a liver cancer patient with septic shock induced by immune-related colitis after immunotherapy DING Jinling, YANG Lei, SHEN Xiao, JIANG Xiajuan 2024, 5 (9):  830-833.  doi: 10.3761/j.issn.2096-7446.2024.09.010 Abstract ( )   PDF (700KB) ( )   Save This case report summarizes the nursing experience provided to a liver cancer patient who developed septic shock due to immune-related colitis after immunotherapy. In response to the critical and rapidly progressing condition of the patient,early implementation of goal-directed therapeutic strategies for fluid management,personalized assessment of inferior vena cava diameters based on bedside ultrasound to avoid fluid resuscitation related injuries,implementation of immunotherapeutic toxicity management interventions,positive psychological interventions based on the Five Elements of Happiness and implementation of personalized nutrition were taken. The patient was hospitalized for 7 days and was discharged after recovery. After one week of follow-up after discharge,the patient‘s condition was good. References | Related Articles | Metrics

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Emergency care for a patient with penetrating neck injury involving carotid artery damage and spinal cord injury WANG Tingting, ZHOU Shuaishuai, FANG Jue, WANG Yuwei 2024, 5 (9):  834-836.  doi: 10.3761/j.issn.2096-7446.2024.09.011 Abstract ( )   PDF (576KB) ( )   Save This article summarized the emergency care experience for a patient with penetrating neck injury,involving carotid artery damage and spinal cord injury. Faced with significant blood loss and airway compression due to hematoma from the neck injury,a multidisciplinary team approach was adopted for collaborative treatment. Carotid artery compression for hemostasis,airway management for combined spinal cord injury,hemodynamic stabilization,and prevention of hypoperfusion-related cerebral infarction were implemented. Following emergency treatment and nursing care,the patient‘s condition stabilized and underwent emergency surgery. The patient was successfully discharged 14 days postoperatively. References | Related Articles | Metrics

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Nursing practice for early extubation after tracheostomy of earthquake victims LAN Xuhong, GUO Longfei, PENG Caili, JIANG Youfei, TANG Xuemei, ZHANG Liqin, FU Caihong, ZHENG Xiaoming, ZHOU Hongfang, ZHANG Zhigang 2024, 5 (9):  837-839.  doi: 10.3761/j.issn.2096-7446.2024.09.012 Abstract ( )   PDF (557KB) ( )   Save To summarize the nursing experience of early extuation after tracheostomy in 4 cases of earthquake casualties with respiratory obstruction in Jishishan County,Gansu Province. Scientific airway humidification before extubation,fine balloon management,early wearing of speech valve were implemented. During extubation,the risk of extubation should be evaluated comprehensively,the extubation test should be carried out step by step and multi-disciplinary extubation was carried out. Sequential ventilation transition was provided after extubation. After 22~26 days of standardized diagnosis and treatment and meticulous nursing,the 4 patients were discharged from the hospital,and all of them recovered well during 2 months of follow-up. References | Related Articles | Metrics

Critical Care Research

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Postoperative nursing of a child with radical treatment of pulmonary atresia and fusion of aortopulmonary collateral arteries LI Xiaoyan, LI Shuaini, LI Ran, TANG Xiaomin 2024, 5 (9):  840-842.  doi: 10.3761/j.issn.2096-7446.2024.09.013 Abstract ( )   PDF (572KB) ( )   Save This paper summarized the postoperative nursing of a child with radical treatment of pulmonary atresia and fusion of aortopulmonary collateral arteries. In response to the complex surgical procedures,long duration of extracorporeal circulation,poor compliance of the right ventricle after surgery,application of artificial valved blood vessels,delayed closure of the chest in the pediatric patient and other problems,the following nursing measures were taken,including strictly control of the intake and output to maintain the stability of right heart function,implementation of early dynamic anticoagulation management to maintain the patency of artificial valved blood vessels,paying attention to delayed chest closure and respiratory care,strengthening of nutritional support and psychological care. After careful treatment and nursing,the child recovered well and was discharged. Following up for six months,the child‘s right ventricular outflow tract was patency and the cardiac function recovered well. References | Related Articles | Metrics

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Nursing care of a child with congenital pulmonary arteriovenous fistula undergoing double lung transplantation BAO Xiangying, ZENG Fei, LAN Meijuan 2024, 5 (9):  843-845.  doi: 10.3761/j.issn.2096-7446.2024.09.014 Abstract ( )   PDF (555KB) ( )   Save To summarize the nursing experience of double lung transplantation in a child with congenital pulmonary arteriovenous fistula. Focusing on the characteristics of pulmonary arteriovenous fistula and the difficulties of lung transplantation,in response to the reconstruction of pulmonary circulation and the remodeling of heart function after transplantation,the problems of transplant lung expansion,lung rehabilitation management and fluid management,the patient was systematically managed. And observation and identification should be strengthened according to the particularity of the child. After comprehensive and systematic management and rehabilitation,the patient recovered well,the transplanted lung function was normal,and the patient was discharged smoothly. References | Related Articles | Metrics

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Nursing care for a patient with decompensated cirrhosis who suffer from septic shock caused by skin infection WEN Li, YAO Xiaoyan, BAO Qi 2024, 5 (9):  846-848.  doi: 10.3761/j.issn.2096-7446.2024.09.015 Abstract ( )   PDF (566KB) ( )   Save This paper summarized the nursing experience of a patient with decompensated liver cirrhosis who suffered from septic shock caused by nonspecific skin and soft tissue infection. The key points of nursing were as follows：implementing fluid resuscitation guided by the target mean arterial pressure,strengthening nutritional management to accelerate wound repair,preventing bleeding and thrombosis during the decompensation period of liver cirrhosis,strengthening management of hospital infection to prevent nosocomial infection. After 45 days of personalized treatment and nursing,the skin grafts of both lower limbs survived,no nosocomial infection occurred,and the patient recovered and was discharged. References | Related Articles | Metrics

Evidence Synthesis Research

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Summary of the best evidence for postoperative complication prevention and management of patients with left ventricular assist device implantation HUANG Aoli, ZHU Xujing, YANG Qiaozhen, CHEN Xia 2024, 5 (9):  849-855.  doi: 10.3761/j.issn.2096-7446.2024.09.016 Abstract ( )   PDF (973KB) ( )   Save Objective To search,evaluate and summarize the evidence on postoperative complication prevention and management of patients with left ventricular assist device（LVAD） implantation,and to provide reference for clinical work. Methods The PIPOST model was used to establish evidence-based problems,and the search strategy was formulated to search Chinese and English databases,guide websites,professional association websites for the guidelines,clinical decisions,expert consensuses,systematic reviews,and original studies according to the "6S" model. The date of the search was from inception of the database to May 1,2023. Two researchers independently conducted literature quality evaluation,evidence extraction,and summarization. Results A total of 18 articles were included,including 1 clinical decision-making,10 expert consensuses,3 guidelines,and 4 cohort studies. Finally,29 items of best evidence were summarized in 6 themes,including circulatory system monitoring and management,device-related monitoring and management,wound management and infection monitoring,digestive system monitoring and management,thrombosis prevention and management,neural system monitoring and management of LVAD patients. Conclusion This study summarized the best evidence in detail for postoperative complication prevention and management of LVAD implanted patients,which is scientific and practical,and can provide evidence-based basis for medical staff to carry out postoperative complication prevention and management of LVAD patients. References | Related Articles | Metrics

Review

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Research progress and enlightenment of obstetric high dependency care WANG Jinyan, LI Xin 2024, 5 (9):  856-859.  doi: 10.3761/j.issn.2096-7446.2024.09.017 Abstract ( )   PDF (626KB) ( )   Save In recent years,the proportion of pregnant women with advanced maternal age and high-risk has increased,and the incidence of pathological pregnancy is increasing. The obstetric high dependency care model,which can provide strict monitoring and high level of care for critically ill pregnant women,has made some progress in foreign countries. This paper summarized the background and concept of the obstetric high dependency care,the setting of obstetric high dependency unit and the allocation of staff,the clinical practice and effect evaluation. Combining the national conditions of our country,this paper puts forward the prospect that obstetric high dependence care can be further developed to improve the level of care for critically ill pregnant women in China. References | Related Articles | Metrics

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Research progress on postoperative cardiopulmonary rehabilitation of children with congenital heart disease LU Qingqing, ZHOU Jun, WANG Wenmei 2024, 5 (9):  860-864.  doi: 10.3761/j.issn.2096-7446.2024.09.018 Abstract ( )   PDF (699KB) ( )   Save Cardiopulmonary rehabilitation is the key to improving the quality of life and survival of children with congenital heart disease after surgery. The concept of cardiopulmonary rehabilitation and its scope of application in children with congenital heart disease in this article were discussed. We reviewed pre-cardiopulmonary rehabilitation assessments（cardiopulmonary function assessments,exercise assessments,and early nutritional risk assessments）,and comprehensive cardiopulmonary rehabilitation interventions（exercise rehabilitation,nutrition management,and targeted health education methods and contents）,aiming to provide a reference for the clinical formulation of personalized rehabilitation programs. References | Related Articles | Metrics