Objective To explore the latent classification characteristics and their influencing factors of vicarious trauma among pediatric critical care nurses. Methods Using a convenience sampling method,a total of 319 pediatric critical care nurses from 12 hospitals in Shanxi province were selected from July to August 2024.General Information Questionnaire,Vicarious Trauma Scale for Medical Staff,Regulatory Emotional Self⁃Efficacy Scale,and Simplified Chinese Version of Event Related Rumination Inventory were used for the survey.The categories of pediatric critical care nurses' vicarious trauma were initially explored based on the latent profiles,and the influencing factors of the latent profiles were analyzed using unordered multinomial logistic regression. Results The score of Vicarious Trauma Scale for Medical Staff was 81.60±22.55.Vicarious trauma was divided into four latent profiles:mild trauma response group,emotionally dominant response group,significant negative trauma group,and balanced trauma response group.The regression analysis results showed that age,education level,years of working experience,reproductive status,death of a relative,rescuing a patient,death of a patient under care,regulatory emotional self-efficacy,and rumination were influencing factors of vicarious trauma among pediatric critical care nurses. Conclusions There is population heterogeneity among pediatric critical care nurses in vicarious trauma.Nursing managers can provide individualized interventions to nurses based on the influencing factors of different latent profiles to reduce the level of vicarious trauma among pediatric nurses.

Objective To explore the changing trend and influencing factors of colostomy disgust in patients with enterostomy half a year after operation,so as to provide reference for targeted intervention. Methods A total of 262 patients with enterostomy were followed up with the General Information Questionnaire,the Colostomy Disgust Scale(CDS),Self⁃Compassion Scale(SCS),and the Chinese version of the Acceptance and Action Questionnaire⁃2nd Edition(AAQ⁃II) 1 day before discharge and 1,3,6 months after discharge. Results Colostomy disgust of patients with enterostomy decreased gradually in the first half of the year after operation.Gender,complications,self⁃compassion,and experiential avoidance were the influencing factors of colostomy disgust.Experiential avoidance played a partial mediating role between self⁃compassion and colostomy disgust.The mediating effect accounted for 45.89% of the total effect. Conclusions Colostomy disgust of patients with enterostomy tends to decline half a year after operation.Medical staff could reduce patients' experiential avoidance by implementing self⁃compassion intervention to relieve their colostomy disgust.

Objective To explore the relationship between cognitive reserve and the risk of cognitive impairment after traumatic brain injury. Methods From September 2023 to August 20,2024,patients with TBI who were hospitalized in the department of neurosurgery or emergency medicine in tertiary grade A hospitals in Chongqing city were selected by convenience sampling method to conduct a cross-sectional investigation.General information was obtained by hospitalization or bedside assessment.Cognitive reserve level and cognitive function were assessed by the Cognitive Reserve Index Questionnaire and the Montreal Cognitive Assessment Scale,respectively.The incidence of cognitive impairment at different levels of cognitive reserve was visualized by bar chart.And the trend chi-square test was used to explore whether there was a trend.Restricted cubic spline(RCS) model was used to analyze the relationship between cognitive reserve and the risk of cognitive impairment after traumatic brain injury.Logistic regression model was used to analyze the predictive effect of cognitive reserve on cognitive impairment in patients with traumatic brain injury. Results A total of 408 TBI patients aged 18⁃87 years were investigated.The total score of Cognitive Reserve Index Questionnaire was 91(88,94).The total score of Montreal Cognitive Assessment Scale was 22(16,28).And 246 cases(60.3%) had cognitive impairment.The results of restricted cubic spline showed that there was a negative linear dose⁃response relationship between cognitive reserve and the risk of cognitive impairment in the total population and gender stratigraphy(P for overall<0.05,P for nonlinear>0.05).Logistic regression analysis and trend test results showed that after adjusting for confounding factors,the risk of cognitive impairment in the general population and gender stratification decreased with the increase of cognitive reserve. Conclusions Cognitive reserve could be an important predictor of cognitive impairment in patients with traumatic brain injury.And improving cognitive reserve level is expected to be one of the potential strategies for early cognitive intervention.

Objective To explore the influence of music intervention guided by soundscape theory on procedural pain⁃related behaviors and electroencephalogram characteristics in neonates. Methods A total of 96 term neonates undergoing radial artery blood sampling in the neonatal intensive care unit of a tertiary grade A general hospital in Guangzhou city from April to December 2024 were selected as the research subjects.They were randomly divided into control group and intervention group by the envelope method,with 48 cases each.Based on the soundscape theory,the intervention group received 50 dB of soothing music starting 5 minutes before radial artery puncture until 10 minutes after needle withdrawal, while the control group received 0 dB of soothing music over the same period.The Behavioral Indicators of Infant Pain score,heart rate,and blood oxygen saturation,and electroencephalogram(EEG) before,during,and after arterial puncture were compared between the two groups. Results Compared to the control group,the intervention group showed significantly lower pain scores at 90 and 120 s after puncture(P<0.05),higher oxygen saturation at 120 s after puncture(P<0.05),and a smaller difference in EEG amplitude changes before and after puncture(P<0.05). Conclusions Music intervention guided by soundscape theory could relieve pain,improve blood oxygen saturation fluctuations,and decrease the amplitude of EEG physiological changes in neonates.

Objective To understand the postoperative health distress of liver transplant patients,and to establish the core domains of the liver transplantation⁃specific patient⁃reported outcome measurement system. Methods From June 2023 to June 2024,a research group was set up.A first draft of core domains was initially formed through literature analysis,patient interviews,and content analysis of medical records.Through Delphi expert consultation,the suitability of each field was evaluated and revised from the importance of each field and the degree of suitability for patient self⁃report two aspects,to form patient⁃reported outcomes measurement system⁃liver transplantation core domains. Results A total of 19 experts were consulted.100% of questionnaires were returned in the three rounds of correspondence.The authority coefficients of the experts were 0.91.The Kendall's harmony coefficients in each round were 0.423,0.192,and 0.205 respectively.The coefficients of variation for each evaluation concept were 0.08⁃0.42,0.13⁃0.39,and 0.05⁃0.20.After three rounds of consultation,the core domains of self⁃reported outcome measurement for liver transplant patients were finally clarified,including physiological health,psychological health,social health and overall health four dimensions,covering 22 measurement concepts. Conclusions The core domains of self⁃reported outcome measurement for liver transplant patients established are scientific and reasonable,which could help promote the establishment of a liver transplant specific patient⁃reported outcome measurement system.

Objective To explore the application effect of multi-component exercise combined with nutritional intervention based on interactive achievement theory in elderly diabetes patients complicated with sarcopenia. Methods A total of 124 elderly diabetes patients complicated with sarcopenia treated in a tertiary grade A hospital in Shanxi province from August to December,2023 were selected as the study subjects.They were randomly divided into test group and control group by random number table method.62 cases each.The control group received routine nursing measures.The test group received the multi⁃component exercise combined with nutrition intervention constructed by the research group.Calf circumference,grip strength,physical function,muscle mass,and quality of life between two groups were compared before intervention and at 3 and 6 months after intervention. Results After intervention,the test group had better grip strength,calf circumference,physical function,muscle mass,and quality of life than the control group(P<0.05). Conclusions The multi-component exercise combined nutrition intervention based on interactive achievement theory was scientific and reliable.The application of this program could effectively improve the related indicators of sarcopenia in elderly diabetes patients complicated with sarcopenia,improve the quality of life of patients,and provide useful reference for clinical nursing practice.

Objective To explore the key components of long-term care insurance policy in China to provide insights for enhancing the formulation and implementation of future policy documents. Methods Utilizing the TF⁃IDF word vector model to conduct text mining research on over 1 600 Chinese long-term care insurance policy documents from the CLIP Database. Results Using multidimensional scaling analysis,the policy text content was sorted out three policy threads:political promotion,service models and content,and standard formulation. Conclusions The government needs to innovate institutional supply,encourage data-driven provision,and enhance crisis learning awareness.

Objective To explore grip strength change trajectory of community⁃dwelling elderly people and its relationship with cognitive function. Methods Based on the grip strength and cognitive function data of community⁃dwelling elderly people from the China Health and Retirement Longitudinal Study(CHARLS) in 2011,2013,and 2015,group⁃based trajectory model(GBTM) was used to establish the grip strength change trajectory of community-dwelling elderly people.Multiple linear regression was used to analyze the relationship between grip strength trajectory and cognitive function. Results A total of 1 245 community⁃dwelling elderly people were included.GBTM analysis results showed that there were four grip strength trajectories among community⁃dwelling elderly people:extremely low level group,low level group,medium level group,and high level group.Multiple linear regression analysis results showed that after adjusting for confounding factors,compared to the extremely low level group,the grip strength of elderly people in the low level group,medium level group,and high level group were positively correlated with their cognitive function;The area under the receiver operating characteristic curve for predicting cognitive function using grip strength trajectory was 0.622(95%CI 0.587⁃0.657). Conclusions The grip strength trajectory of community-dwelling elderly people could be divided into four categories:extremely low level group,low level group,medium level group,and high level group,which have certain predictive value for the cognitive function of community⁃dwelling elderly people.Low grip strength in the elderly is a risk factor for cognitive decline.Therefore,early identification of the development trajectory of grip strength in the elderly is particularly important.

Objective To summarize the best evidence for hammock positioning nursing in preterm infants,and to provide an evidence-based foundation for clinical practice. Methods Following the "6S" evidence model,related literature were searched from NGC,GIN,NICE,QCG,BMJ Best Practice,UpToDate,JBI,Cochrane Library,PubMed,Web of Science,EMbase,CINAHL,CBM,CNKI,WanFang Data,and websites of relevant associations such as the World Prematurity Association,RANO,and International Neonatal Society.The retrieval period spanned from the establishment of the database to August 3,2024.The AGREE Ⅱ,AMSTAR 2,and JBI evaluation tools were used to assess the quality of the literature,which was then graded according to the JBI evidence grading system. Results A total of 12 articles were included,comprising 2 guidelines,5 systematic reviews,2 evidence summaries,and 3 randomized controlled trials.Totally 21 pieces of evidence were extracted from six aspects:assessment of hammock position,training and guidance,timing of hammock care,production and installation of hammocks,placement of hammock positions for premature infants,physiological monitoring and safety management during hammock care. Conclusions This study provided high⁃quality evidence-based support for the clinical implementation of hammock position nursing for premature infants,which helps to standardize nursing practice.Through continuous optimization of clinical practice,hammock position nursing is expected to become an important means to improve the quality of premature infant care.

Objective To test the reliability,validity and cross⁃group measurement invariance of the Treatment⁃Induced Neuropathy Assessment Scale. Methods Convenience sampling method was used to conduct a questionnaire survey on 392 patients in the inpatient and outpatient departments of tumor-related departments of 2 tertiary grade A hospitals in Tianjin and Nanchang from March to July 2024. Results The Chinese version of TNAS included 9 items and 2 subscales.The critical ratio t value of each item was 14.169⁃20.374(P<0.001).The correlation coefficient r between the score of each item and the total score of the scale was 0.690⁃0.845(P<0.001).Confirmatory factor analysis(CFA) supported the two⁃factor model,and each indicator reached the ideal fitting standard.The factor loading of each item of the scale was 0.776⁃0.900.The CR of the two subscales were 0.910 and 0.912 respectively.The AVE were 0.629 and 0.778 respectively.The absolute value of the correlation coefficient between the two subscales was 0.574.The Chinese version of TNAS showed a positive correlation with EORTC QLQ⁃CIPN 20(r=0.460,P<0.001).The Cronbach's α coefficient of the Chinese version of the TNAS was 0.910.The Cronbach's α coefficients of the two subscales were 0.912 and 0.915 respectively.The retest reliability was 0.802.The Chinese version of the TNAS had measurement invariance across groups in the equivalence test(P>0.05). Conclusions The Chinese version of the TNAS has good reliability,validity and measurement invariance across groups,and could be used to identify the severity of neuropathy in various cancer treatments.

Objective To explore the application effect of analgesia and sedation nursing based on eCASH concept in neurosurgical critically ill patients. Methods A purposive sampling method was used to select 68 patients admitted to the neurosurgical intensive care unit from January to December 2022 as study subjects.All cases were divided into control group of 33 cases and test group of 35 cases.The control group received routine analgesic and sedative nursing,while the test group received analgesia and sedation nursing based on the eCASH concept.The analgesic and sedative treatment effects,intracranial pressure,mechanical ventilation time,neurosurgical intensive care unit hospitalization time and cost,muscle strength recovery,and incidence of complications between the two groups of patients were compared. Results After intervention,the test group patients had a lower dosage of analgesic and sedative drugs,shorter recovery time after stopping sedatives,shorter hospitalization time in mechanical ventilation and neurosurgery intensive care unit,and lower incidence of complications/adverse events compared to that of the control groups patients(P<0.05).Muscle strength recovery was better than that of the control group cases(P<0.05).The time to achieve sedative goals was longer than that of the control group patients(P<0.05). Conclusions Based on the eCASH concept,analgesia and sedation nursing could help improve the effectiveness of analgesia and sedation treatment for patients in the neurosurgical intensive care unit,reduce intracranial pressure,shorten mechanical ventilation and hospitalization time in neurosurgical intensive care unit.It could reduce the occurrence of complications/adverse events,and promote the recovery of patients' muscle strength as well.

Objective To construct an upper limb exercise program after permanent pacemaker implantation,providing reference for early exercise rehabilitation. Methods Literature on upper limb exercise intervention after permanent pacemaker implantation were searched.Through literature research and discussions within our research group,an initial pool of project items was formed.And expert inquiry questionnaire was compiled.Using the Delphi method,15 experts were subjected to 2 rounds of inquiry to screen for project items. Results A total of 22 articles were included.The effective recovery rates of both rounds of inquiry was 100%.And the expert authority coefficient was 0.93.The Kendall harmony coefficients for item importance and feasibility were 0.275⁃0.467 and 0.211⁃0.438,respectively(P<0.05).The upper limb exercise program after permanent pacemaker implantation constructed in this study included 4 primary items,15 secondary items,and 44 tertiary items. Conclusions The upper limb exercise program for permanent pacemaker implantation constructed in this study has strong clinical practicality and could provide reference for clinical practice.

The rules for the allocation of the burden of proof in medical care damage disputes directly affect the outcome of the judgment and are closely related to the interests of the parties.In medical care damage litigation,according to the current substantive law,the burden of proof of the perpetrator,the result of the damage,fault and the facts of the causal relationship is borne by the patient.However,due to the subjectivity of fault facts and the complex professionalism of causal relationships,patients face difficulties in proving fault and causal factors.In order to solve the above problems and reduce the burden of proof on patients,this paper localized the theory of apparent proof and the theory of loss of opportunity,and proposes a mitigation scheme for the burden of proof in medical care damage disputes.

Objective To carry out SWOT analysis of applied network ethnography research in the field of nursing in China,so as to provide strategies for further promoting nursing research. Methods SWOT method was used to analyze the application of network ethnography in nursing field in China and put forward strategies. Results The advantages of applying netnography in the field of nursing in China were:expanding research perspectives and promoting all⁃round development;flexible data collection and authentic data sources;in⁃depth exploration of sensitive topics and discussion of emotional connotations;promoting in⁃depth research in nursing and deepening clinical practice.The disadvantages were:the authenticity and reliability of data are affected by the nursing context;severe challenges in ethics and privacy protection;the complexity of research design and implementation and the professional ability requirements.The opportunities were:national policy support leading the application of netnography in the field of nursing research;technological development providing technical support for netnography research;the transformation of citizens' lifestyles providing the possibility of online network research;the development of modern medical concepts promoting the further deepening of nursing research.The challenges were:the quality of network data;the need to improve relevant policies on privacy protection and ethical norms. Conclusions Our country should develop and improve national policies,provide Internet information technology support,optimize research design and methodology,establish and improve laws and regulations on network ethical review,and promote interdisciplinary integration and innovative practice.

Objective To explore the effect of resistance training based on modified comprehensive geriatric assessment(CGA) of elderly patients with chronic heart failure and sarcopenia. Methods A total of 80 elderly patients with chronic heart failure and sarcopenia admitted to Ganzhou People's Hospital from July 2023 to July 2024 were selected as the research subjects.They were randcomly divided into control group and test group by random number table method,with 40 cases each.The control group received routine intervention,while the test group received resistance training intervention based on modified comprehensive geriatric assessment.Physical activity status,exercise endurance,quality of life,cardiac function indicators,skeletal muscle function related indicators,and nutritional indicators were compared between two groups. Results After 8 weeks of intervention,the Simplified Physical Fitness Scale(SPPB) scores,6-minute walk test(6MWT),and Activities of Daily Living(ADL) scores in the test group were higher than those in the control group.The Minnesota Heart Failure Quality of Life Scale(MLHFQ) scores was lower than that in the control group(P<0.05).The left ventricular ejection fraction(LVEF) and the ratio of peak e to peak a of forward mitral flow(E/A) were higher than those in the control group.The left ventricular end diastolic diameter(LVEDD) was shorter than that in the control group(P<0.05).The skeletal muscle mass index,walking speed,grip strength,and the duration of 5 sit up tests were better than those in the control group(P<0.05).The body mass index(BMI),upper arm muscle circumference (AMC),lower leg circumference,and triceps skinfold thickness(TSF) were better than those in the control group(P<0.05). Conclusions Resistance training based on modified comprehensive geriatric assessment could improve the physical condition and exercise endurance of elderly patients with chronic heart failure and sarcopenia,enhance their quality of life and cardiac function,and improve skeletal muscle function and nutritional status.

Objective To develop a virtual simulation teaching program for individual nutritional intervention in hospitalized patients and to evaluate its application effectiveness. Methods A total of 169 nursing undergraduate students from a university of grade 2022 were selected as research group.A virtual simulation experiment teaching of nutritional intervention for hospitalized patients was conducted in the course of clinical nutrition.A total of 196 nursing undergraduate students of grade 2021 were selected as control group,which were received regular teaching.The teaching effect was evaluated after the teaching activity completed. Results The school platform recorded a cumulative of 1 028 accesses with 78 hours of usage time.Per⁃user login attempts ranged from 2 to 9 times,while the practical training score averaged 95.42±10.37 points.Student satisfaction rating reached full marks(10/10).The provincial platform served 760 distinct users with 35 cumulative usage hours.Individual login frequencies spanned 1 to 5 attempts,yielding a training score of 91.33±12.68 points.User evaluation also achieved a perfect 10⁃point score.The stage test scores of the nursing undergraduate students in research group(30.17±4.12) were significantly higher than that of the nursing undergraduate students in control group(26.96±3.33).There was a statistically significant difference between them(P<0.001).A total of 77.30%⁃5.89% of nursing undergraduates acknowledged that the virtual simulation teaching program facilitates learning engagement,enhances self⁃directed learning capabilities,and cultivates the learning mindset.Through virtual simulation training,82.21%-91.41% of students achieved mastery of core nutritional competencies including risk screening,assessment,intervention,and monitoring.The overwhelming majority expressed satisfaction with the system's functional design,reporting consistently positive learning experiences. Conclusions The virtual simulation experiment teaching could effectively improve the academic performance of nursing undergraduate students and enhance the quality of clinical nutrition teaching.

Objective To explore the application effect of narrative interviews in modified electroconvulsive therapy for patients with depressive disorders. Methods A total of 140 patients with depressive disorders who underwent modified electroconvulsive therapy and admitted to a tertiary grade A hospital from January 2021 to September 2023 were selected as the research subjects.They were randomly divided into observation group and control group by random number table method,70 patients each.The control group received routine nursing care.The observation group received narrative interviews based on the routine care.Hamilton Depression Scale⁃17(HAMD⁃17) was used to compare the depression status of the two groups before intervention and at 4 and 8 weeks after intervention. Results The control group completed the study with 63 cases.The observation group completed the study with 61 cases.There were statistically significances in terms of time effect,between⁃group effect,and interaction effect of HAMD⁃17 scores(P<0.05). Conclusion Narrative interviews could effectively improve the depressive mood of modified electroconvulsive therapy for patients with depressive disorders and enhance their treatment effect.

Objective To investigate the serum 25⁃hydroxyvitamin D levels and influencing factors in infants and young children aged 0⁃3 years in Yuncheng city. Methods A total of 1 803 infants and young children who underwent physical examinations at Yuncheng Maternal and Child Health Hospital from June 2019 to June 2023 were selected as the research subjects.Venous blood was collected and serum 25⁃hydroxyvitamin D levels were detected by using an AB company high⁃performance liquid chromatography tandem mass spectrometer(AB4500).Univariate analysis was used to investigate the influencing factors of serum 25⁃hydroxyvitamin D levels. Results The serum 25⁃hydroxyvitamin D level of 1 803 infants and young children was(35.256±9.090) ng/mL.Univariate analysis results showed that maternal education level,feeding method,outdoor activity duration,age,and daily 25 hydroxyvitamin D supplementation dose had an impact on the serum 25 hydroxyvitamin D levels of infants and young children(P<0.05). Conclusions Serum 25 hydroxyvitamin D levels in infants and young children aged 0⁃3 years in Yuncheng city are low⁃normal.The higher the mother's education level,the more reasonable outdoor activities,timely addition of complementary foods,and reasonable supplementation of 25 hydroxyvitamin D are beneficial for the healthy growth of infants and young children.

Objective To review the application and methods of ecological momentary assessment(EMA) on symptom managemet of with breast cancer patients,so as to provide reference for future researchers to use EMA in patients with breast cancer. Methods According to the scope review methodology,CINAHL,Cochrane Library,EMbase,PsycINFO,PubMed,Web of Science,WanFang Database,VIP,CNKI and CBM were searched.The retrieval period spanned from the establishment of the database to July 30,2024.The retrieved documents were screened and summarized. Results A total of 20 papers were included.The research objective focused on the relationship between breast cancer symptoms and physical activity,the relationship between breast cancer patients and their spouses,the relationship between breast cancer symptoms and insomnia,cognitive function and fatigue of breast cancer,and EMA feasibility.The outcome indicators included six categories:emotional symptoms,physical symptoms,psychosocial factors,behavioral factors,cognitive function and feasibility.EMA data collection mainly relied on smartphone and accelerometers,mostly through random or fixed signal prompts,1 to 6 times a day,with an interval of 0.5 to 11.0 hours,lasting for 5 to 28 days.The participation rate were 29.1%⁃100.0%.The response rate was 57.0%⁃100.0%.The churn rate was 0⁃44.9%.The reward was 15⁃130 dollars. Conclusions EMA is feasible in the management of breast cancer symptoms,and can accurately capture changes in symptoms of breast cancer patients at different points in time.In the future,more standardized EMA reporting guidelines can be further developed to explore the potential of EMA in breast cancer clinical care interventions and other areas to provide a scientific basis for the development of personalized treatment.

This article reviewed the formation process of biofilms,the characteristics of wound biofilm infections,methods for identifying and detecting wound biofilms based on clinical manifestations and laboratory techniques,and promising new methods for bedside biofilm detection,with the aim of helping wound care providers to identify the presence of biofilms at an early stage accurately and to administer comprehensive biofilm management regimens.

This article reviewed medication⁃related problems,nursing assessment tools for home medication management of elderly patients,the contents,assessment methods,advantages and disadvantages of each assessment tool were compared,to provide reference for nursing staff to develop and reasonably select home medication management nursing assessment tools for elderly patients in China.

This review summarized the proposal and calculation method of the weight⁃adjusted⁃waist index(WWI),its correlation with various diseases,differences from other body measurement tools,as well as its advantages and limitations.It aimed to provide a reference for clinical healthcare professionals to identify obesity more simply and conveniently,and to study the weight⁃adjusted⁃waist index and its associated diseases.

This review summarized the biomechanical mechanisms of heel pressure injuries,as well as the application and advantages of three-dimensional finite element analysis in the prevention of such injuries.It provided a reference for early detection and personalized prevention of heel pressure⁃related injuries.

This article reviewed the origin,concept,theoretical models,and assessment tools of family resilience.The aim was to provide a reference for researchers in developing family resilience assessment tools that align with China's cultural background,as well as for clinical staff in selecting suitable assessment tools.

This review summarized the current status and factors affecting the growth and development in children with hematological diseases after allogeneic⁃hematopoietic stem cell transplantation.The aim was to provide a basis for medical staff to provide individualized health education and monitoring for children and their families in clinical practice.

This study reviewed the clinical factors,laboratory indicators,genetic testing,and predictive models related to renal scarring after urinary tract infection.The aim was to provide references for clinical medical staff to identify high-risk patients early,to intervene promptly,and to reduce the risk of renal scarring.