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 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 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 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 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 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.

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 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.

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.

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.