It has been a focus on occupational stressors of nurses and ways in which they may be reduced. This article summarized the main stressors and preventive interventions and puted forward some suggestions and prospects for nurse stress management.

Objectives: To investigate the inner experience of psychiatric nurses after violence by patients in order to provide basis for developing psychological decompression measures. Methods: Twelve psychiatric nurses who were hurt by patients were deeply interviewed using the phenomenology study method of qualitative study. Collected information was analyzed using Giorgi method. Results: The inner experience of injured nurses included panic, sense of role conflict, grievance, helplessness, and oppression within 2 days from being hurt; helplessness and depression and craving for care and attention in 7~14 days after being hurt; feeling of tiredness and comprehension and adaptation to profession in 30~60 days after being hurt. Conclusion: The nursing administrators should pay attention to the inner experience of injured nurses and provide effective emotional support and coping guidance to maintain the psychosomatic health of psychiatric nurses.

Objective: To explore the psychological state and psychological adjustment of psychiatric nurses suffered from workplace violence. Methods: 183 nurses from tertiary grade A psychiatric hospitals in Beijing were selected. The survey questionnaires include POMS, SAS, SDS, GWB and self-developed questionnaire. Results: ① There were 82.0% of the nurses suffered from workplace violence within one year, 54.1% suffered more than three types of injuries within one year; 69.4% were injured by workplace violence within one month, 36.6% suffered more than 3 types of injuries; 70.0% were injured more than 3 times in one year. ② According to whether injured in a month, we divided the nurses into two groups. The scores of nurses in SAS, anger, fatigue, depression, panic, POMS and happiness index were significantly different between the two groups (P<0.05). ③Our study analyzed the correlation between the objective data of the nurses' workplace violence and the factors of the scales, and the results showed that working years and the score of SAS, fatigue were positive correlated, and working year and energy, self-related mood were negative correlated; age and the score of SAS, fatigue were positive correlated, and age and self-related mood was positive correlated; injured times positively correlated with the score of SDS, the score of SAS, anger, fatigue, depression, panic and POMS total score, and negatively correlated with happiness index; the injured types in a month positively correlated with the score of SAS, anger, fatigue, depressive, panic and POMS total score, and negatively correlated with happiness index. Conclusion: The mood and psychological state were bad after facing workplace violence in psychiatric nurses. To improve the mental state of psychiatric nurses, the managers should strengthen the counseling and adjustment, and provide targeted training and coping methods for psychiatric nurses suffered from workplace violence.

Objective: To analyze the effect of group psycho-education for stress management on anxiety and coping style of nurses. Methods: 40 nurses in psychiatric department and neurology department were recruited in the group psycho-education stress management program. The results of Self-Rating Anxiety Scale (SAS) and Simplified Coping Style Questionnaire (SCSQ) were compared before and after the session. Results: After the stress management program, the score of SAS was significantly lowered (P<0.05). The score of positive coping was higher than the score before. The score of negative coping was lower (P<0.05). Conclusion: The group psycho-education stress management program helped nurses relieve anxiety and improved the coping style of nurses.

Objective: To examine the reliability and validity of the Huaxi Emotional-Distress Index (HEI) in nurses, and to determine the application value in nurses. Methods: A total of 330 nurses were chosen by random cluster sampling and were tested by the Huaxi Emotional-Distress Index on the network of scientific research platform. The reliability and validity were assessed and verified by project analysis, exploratory factor analysis and Cronbach’s α coefficient. Results: HEI was comprised of two factors which explained 70.4% of the total variance. The Cronbach’s α coefficients of the scale and its two factors were 0.917, 0.915 and 0.691, respectively. Conclusion: HEI has good internal consistency reliability and structural validity in nurses and can be used to measure the negative emotion of nurses.

Objective: The aim of the study was to improve mental health status of the nurses in a psychiatric hospital by using the Psychological Pressure Relieving Technique. Methods: 60 nurses with at least 30 positive items on SCL-90 were recruited and randomly assigned into intervention group and control group, with 30 nurses in each group. The intervention group was administrated with the Psychological Pressure Relieving Technique. The Symptom Check List (SCL-90), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI) and Social Support Rating Scale (SSRS) were rated on all subjects before and after the treatment. Results: After the intervention, the SAS scores were significantly lowered in both groups (P<0.05, respectively). Compared with baseline, the SAS, SDS, PSQI and SSRS scores in intervention group were significantly decreased at post-treatment (P<0.05, respectively). Conclusion: Psychological Pressure Relieving Technique can reduce the psychological stress, anxiety and depression, and improve sleep quality of the nurses in psychiatric hospitals, which may increase the quality of nursing.

Objective: To evaluate the effect of automatic control of tracheal tube cuff pressure on Ventilator Associated Pneumonia (VAP) prevention. Methods: We searched the Cochrane Library, Pubmed, EMBASE, CBM, VIP, CNKI and WANFANG database. We also searched the bibliographies of relevant papers and review literatures. The two independent reviewers searched and extracted literatures, captured citations, and assessed methodological quality of all included studies. RevMan 5.3 software was then used to perform Meta-analysis and sensitivity analysis. Results: A total of 5 RCT and 1 qRCT articles were recruited. Meta-analysis showed that compared to intermittent measure the cuff pressure of tracheal tube, automatic control cuff pressure could maintain the target pressure range to 20~30 cmH2O and decrease the incidence of abundant aspiration [RR=0.53, 95% CI (0.40, 0.69)], and VAP [RR=0.56, 95%CI (0.42, 0.75)]. However, no significant difference was found in mechanical ventilation duration [MD=-1.96, 95% CI (-5.82, 1.89)], ICU length of stay [MD=-1.22, 95% CI (-6.08,3.63)], and ICU mortality [RR=0.94, 95% CI (0.68, 1.28)]. Conclusions: Automatic control of tracheal tube cuff pressure could effectively maintain cuff pressure in proper range in order to reduce the incidence of abundant aspiration and VAP. However, there was no significant effect on duration of mechanical ventilation, ICU length of stay, and ICU mortality.

Objective: To explore the level of pregnancy stress and its influencing factors among didymous elderly pregnant women. Methods: Totally 168 didymous elderly pregnant women who took part in the antenatal examination were recruited and investigated using 36-item Pregnancy Stress Rating Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and demographic questionnaire. Results: The mean scores of pregnancy stress, perceived social support, positive coping, and negative coping were 50.54±16.92, 69.68±9.05, 1.88±0.50, and 1.10±0.48, respectively. Dimensions of perceived social support and positive coping were significantly negatively correlated with pregnancy stress. Negative coping was positively correlated with pregnancy stress. Pregnancy complications, negative coping, and perceived social support could explain 55.1% of the pregnancy stress variance. Conclusion: Didymous elderly pregnant women were at a moderate level of pregnancy pressure. Nurses should vigorously strengthen prenatal education and provide targeted nursing and guidance for didymous elderly pregnant women to reduce their pregant pressure and help them get through pregnancy and childbirth stages.

Objective: To explore the incidence and risk factors of symptomatic Venous Thromboembolism (VTE) after total knee and hip arthroplasty. Methods: We prospectively observed 982 patients who underwent total knee and hip arthroplasty in the department of orthopaedics in our hospital from January 2015 to June 2016. Symptomatic VTE was diagnosed by doppler ultrasonography. We investigated the incidence and risk factors of symptomatic VTE, the diagnostic time of VTE, the variation of D-Dimer, and the vital signs and the chief complaint of the patients. Results: Totally 18 symptomatic VTE patients was diagnosed during hospitalization and the incidence was 1.8% (18/982) with 15 patients of symptomatic Deep Vein Thrombosis (1.5%) and 3 patients of symptomatic Pulmonary Embolism (0.3%). Logistic regression analysis indicated that the risk factors were age over than 72 (OR=2.768), the long hospitalized stay (OR=4.540) and medical history of cerebral infarction (OR=4.012), (P<0.05). Most patients diagnosed DVT and PE within the 7 days after surgery. D-Dimer of symptomatic VTE patients had a large variation and was apparently higher than normal range within the 7 days after surgery. VTE patients complained of pain or swelling in lower limb, and had the vital sign changes of SpO2 decreasing and transient loss of consciousness. Conclusion: The patients who are older than 72, long hospitalized stay and medical history of cerebral infarction are the high risk population of symptomatic VTE. Nurses should observe the clinical manifestation, the changes of vital sign and D-Dimer within 7 days after surgery, which is helpful to indentify VTE in early stage.

Objective: To establish a scientific, objective and practical knowledge system in nuclear emergency for nurses. Methods: The preliminary knowledge indicators were formulated based on literature review, related regulations and the emergency nursing rescue process in nuclear accident. Then, the indicators were determined by two rounds of Delphi consultation. Results: The nuclear emergency knowledge system included 3 first-level indicators, 12 second-level and 48 third-level indicators. The experts' authority and reliability were high. Conclusion: The knowledge system could provide a scientific tool for evaluating the nurses' nuclear rescuer knowledge level. It is also helpful for nurses' training.

Objective: To construct a clinical Enteral Nutrition (EN) nursing quality evaluation index system for evaluating EN nursing care quality scientifically. Methods: The authors set up a preliminary draft of EN nursing quality evaluation index system, and then consulted 15 experts by Delphi method. Results: The index system was determined after two rounds of experts' consultation. It included 3 first-level, 10 second-level and 33 third-class indicators. Conclusion: This index system could provide a scientific, reliable, practical and effective method for evaluating clinical EN nursing quality.

Quality management is an important topic in long-term care facilities. Web of Science database (SCI-E, SSCI) was used to retrieve data on quality management in long-term care facilities. Specifically, the number of publications, top productive countries, regions and institutions, highly cited articles, citation analysis, and journals involved in publishing articles on quality management in long-term care facilities were reviewed and analyzed. 1524 publications were retrieved. This bibliometric study can help researchers understand publishing on this topic better and improve further studies.

Objective: To establish the online teaching platform based on MOOC service in fundamental nursing Education, which can promote active learning therefore improve teaching quality. Methods: We completed construction of online teaching platform though 4 steps: class application, portal and resources construction, e-leaning creation. Then we apply it into fundamental nursing education by creating video tasks and test tasks. Results: From September 2015 to February 2016, 43 video tasks or test tasks were completed through the online platform. The number of visits was 39 528. Totally 672 topic were shared in the discussion. Conclusions: It could break the challenges on traditional teaching which only focus on classroom teaching but ignore the extracurricular learning. However, facility improvements, honesty education, as well as the integration of classroom and network teaching are the main problems for online teaching.

Objective: To explore the characteristics of the interpersonal relationship of intern nurses in a general hospital. Methods: Totally 278 intern nurses were investigated using convenience sampling method. Interpersonal Comprehensive Diagnostic Scale (ICDS) and Interpersonal Competence Questionnaire (ICQ) were applied to assess interpersonal characteristics of the subjects. Results: There were significant differences in interpersonal distress between the intern nurses with different gender, educational backgrounds and clinical practice durations (P<0.05). There were significant differences in interpersonal competence between the nurses with different gender (P<0.05). The interpersonal distress was negatively correlated with the interpersonal competence (P<0.01). Conclusion: Schools and hospitals should provide interpersonal relationship education for intern nurses.

Objective: To explore the status quo of professional identity level and its related factors among operating room nurses. Methods: Method of stratified cluster sampling with a total of 187 operating room nurses from 10 hospitals in Jiangsu province were recruited and surveyed with the Work Empowerment Scale and Professional Identity Rating Scale. Results: The total score of work empowerment was 15.37±2.32. The mean score of professional identity was 98.37±11.32. There were significant positive correlations between two scores.Regression analysis showed that the factor scores of work empowerment such as opportunity, information, formal power and informal power could independently explain 41% of the variance for nurses' professional identity after controlling demographic variables. Conclusion: Hospital administrators should focus on the shortcomings of work empowerment and take effective measures to improve nurses'professional identity and promote the development of nursing.

Objective: To establish factor type orthopedic patient classification system, and to guide the scientific allocation of nursing human resources in orthopedic departments. Methods: According to the original RMT-PCS scale, we designed a new factor type orthopedic patient classification scale to classify the orthopedic patients. We got the nurse-allocation ratios of every type of patients through the formula, so according to the investigation results of the six wards, the amount of needed nurses was obtained. Results: The factor type orthopedic patient classification system divided all patients into four types according to the Nursing Hours Per Patient Day (NHPPD), the nurse-allocation ratios were 0.30, 0.48, 1.04, 2.01 respectively. The formula to calculate the needed nurses was "needed number=(the patients number of type one 0.30) + (the patients number of type two 0.48) + (the patients number of type three 1.04) + (the patients number of type four 2.01)". The results showed that the actual amount of nurses was far less than the number required in clinical practice. Conclusions: The factor type orthopedic patient classification system could classify the patients objectively and guide the allocation of nursing human resources scientifically and conveniently.

Objective: To investigate the status of nurses' career identity, job burnout and turnover intention, and the influencing factors of turnover intention. Methods: A total of 792 nurses were surveyed using general information questionnaire, Career Identity Scale, Maslach Burnout Inventory and turnover intention scale. Results: The mean score of career identity was 5.30±0.92, the score of emotional exhaustion was 2.82±1.23, the score of depersonalization was 1.77±1.39, the score of personal accomplishment was 4.01±1.18, and the score of turnover intention scale was 15.59±3.35. Multiple stepwise regression analysis indicated that major influencing factors for nurses to quit their job included employment way, coherence, self-potency, emotional exhaustion. Conclusion: The nurses' career identity is low and the job burnout is serious, which seriously affects the level of nurses' turnover intention. The education and health departments should take steps to change the situation and status of nurses, improve the nurse's career identity and reduce the job burnout in order to decrease the nurses' turnover intention and improve stability of nurses.

In this paper, the authors reviewed the nursing autonomy's influencing factors and interventions, in order to provide references for the development of nurses' autonomy.

Objective: To establish inpatient care risk assessment early warning monitoring biography reporting system, to evaluate, warn, monitor, and intervene, ultimately to reduce the occurrence of nursing adverse events. Methods: The hospital computer network was used to evaluate and data entry all newly admitted patients and all hospitalized patients. The system automatically screens high-risk inpatients and alerts nursing staff. According to the risk level, different nursing interventions are implemented accordingly. Closely monitor through hospital level, unit level and nursing quarters level, implement nursing interventions in advance. Results: The application of Inpatient care risk assessment early warning monitoring Biography reporting system for 1 year, nurses' qualified rate in the risk control of reporting number increased significantly (P<0.05); The number of reported nursing adverse events associated reduced significantly (P<0.05). Conclusion: The application of an Inpatient care risk assessment early warning monitoring Biography reporting system will improve nursing foresight significantly, and catch the great attention of nursing staff and managers, reduce the occurring of the nursing adverse events.

Objective: To investigate the physical activity and correlated factors of the elder with hypertension in community. Methods: The International Physical Activity Questionnaire (IPAQ) was used to evaluate the physical activity of the elder with hypertension. The influence factors were analyzed through the Logistic regression. Results: The Metabolic Equivalent Tasks (METs) of male patients in leisure physical activity were higher than those of famale patients, while METs of female patients in household physical activity were higher than those of male patients. There were 48.1% hypertensive patients with lower physical activity level, 38.2% patients having moderate physical activity, and 13.7% patients with higher physical activity. The Logistic regression showed that age, BMI, the presence of cardiovascular diseases and self-rated health were influence factors of physical activity in the elder patients with hypertension. Conclusion: The elder patients with hypertension had lower physical activity level in community. Healthcare providers should take effective measures to improve elder patients' physical activity, which may prevent the development of complications related to hypertension.

This paper expounded the concept and content of Intelligent Health Management System, analyzed the main functions and deficiencies. The author put forward coping strategies for the development of intelligent health management system in China.

Objective: To investigate the level of Self-Perceived Burden and influencing factors in patients after Percutaneous Coronary Intervention. Methods: Totally 383 patients after percutaneous coronary intervention were investigated with the general information questionnaire, the Self-Perceived Burden Scale (SPBS), the medical coping modes questionnaire (MCMQ) and the social disability screening schedule (SDSS). Results: The total score of SPBS was 27.25±6.22. The patients with heavy burden, moderate burdenand minor burden were 2.87%, 22.45% and 63.71% respectively. 10.97% of the patients had no obvious burden. Multiple regression analysis showed that coping styles of resignation, the overall level of social support were main predictors of Self-Perceived Burden in patients after Percutaneous Coronary Intervention (P<0.05). Conclusion: The patients after Percutaneous Coronary Intervention experienced Self-Perceived Burden. Nurses should take proper measures to alleviate the patients' Self-Perceived Burden and improve their quality of life.

Objective: To evaluate the effects of fathers' involvement and support on breast feeding. Methods: From May 2015 to October 2015, a convenience sample of 175 parents of infants were included in this study, the control group (n=86) received routine care. The intervention group (n=89) received both routine care and intervention provided to encourage fathers' involvement. Results: Scores of breastfeeding attitude in intervention group were higher than that in control group after intervention (P<0.05). The mean scores of Breastfeeding Self-Efficacy Scale (BSES) and breastfeeding rate in the intervention group when discharged, 6 weeks, and 4 months after delivery, were all higher than those in the control group (P<0.05). The satisfaction level with husband's involvements in intervention group 4 months after delivery was higher than that in control group (P<0.05). Conclusion: Through effective intervention on strengthening fathers' engagement and support could improve the practice of breastfeeding. Health care staff can develop programmes to involve fathers in breast feeding.

Hypertension is affecting a wide range of people, lack of disease management can cause a variety of serious complications, which would be a great burden to the patients, families and the society. Therefore, there is an urgent need for effective self-management support and personalized medical interventions. In this article, the concept of self-management, the impact factors, and intervention strategies were discussed, in order to provide references for further research on self-management in patients with hypertension.

Postpartum depression (PPD) is a common mental disorder that has effect on physical and mental health of puerperas and the growth and development of infants. Screening susceptible population in pregnancy and timely intervention to high-risk pregnant women are important for the prevention and treatment of PPD. This study reviewed prenatal biological and psychosocial factors influencing PPD, in order to provide some suggestions for prenatal prediction of PPD.

This article summarized overseas and domestic research of measurement tools about stroke self-management in order to provide instruction for the measurement of self-management and intervention outcome among stroke patients, to improve stroke patients' quality of life and enhance their self-management level, and to provide references for developing suitable stroke self-management measurement tool in the future. The study found that stroke self-management measurement tool was in primary developmental stage and there was still a big space for the tool development.

This paper reviewed the current use, the influence, and the influencing factors of physical restraints in ICU adults patients, ultimately provide evidence and reference for management of physical restraint in adult patients in ICU.

Objective: Discuss the effect of implementing transitional care to reduced the rate of repeated abortion. Methods: Totally 122 women with abortion were randomly selected and divided into intervention group and control group with 61 of each. Intervention group had PAC, the control group had the routine nursing care. We compared their knowledge to contraceptive measures after after 1 month, and the usage of contraceptive tools as well as rate of repeated abortion after 6 months. Results: The rate of knowledge is higher in the intervention group than controlled group after 1 month. The rate of usage of contraceptive tools is 96.7% which is higher than the controlled group (85.2%), and the rate of repeated abortion is 1.6% in the intervention group which is lower than controlled group (9.8%) after 6 months, P<0.05. Conclusion: Transitional care after artificial abortion women has following positive effects: improve knowledge of contraception, promote contraception, lower repeated abortion rate, improve the level of reproductive health, and protect women's physical and mental health.

Objective: To normalize the management and prevention of noninvasive ventilator pressure ulcers, of elderly patients with terminal pneumonia. Methods: In accordance with the 2 cases of noninvasive ventilator pressure ulcers of elderly patients with terminal pneumonia, a comprehensive analysis of the causes was used to develop the usage specification and operation procedure, then compared nursing practice and the rate of noninvasive ventilator pressure ulcers before and after the implementation of measures. Results: There was significant difference in the nursing practice and the rate of pressure ulcer. Conclusion: In consideration of the particularity of noninvasive ventilator pressure ulcers of elderly patients with terminal pneumonia, to formulate the usage specification and operation procedure of noninvasive ventilator can effectively prevent noninvasive ventilator pressure ulcers, that is the focus of the elderly specialist clinical nursing work and the important measures to ensure the quality and safety of nursing for the aged.

As a new medical cultural model, Shared Decision-Making gets more and more attention in academia. Shared Decision Making is a process which clinicians/patients and their relatives decide treatment together. In other words, medical staff tells patient about the advantages and disadvantages of the various treatments, patient weighs the pros and cons, and medical staff and patient make decision together after fully communication. On the basis of reviewing related literatures, this article summarized the research status of Shared Decision-Making and aimed at providing a preference for theoretical research and clinical practice.

Objective: The objective of this study was to identify the impact of oral care practices on oral health status of patients in intensive care unit and the incidence rate of ventilator-associated pneumonia. Method: This clinical trial recruited 100 participants who were randomly assigned to a control group (receiving oral care by nurses) and an intervention group (receiving systematic care by the researcher) during 2015-2016. Beck Oral Assessment Scale was used to determine the required number of times for receiving oral care with regard to patient’s oral health in the intervention group. Each care included adjusting endotracheal tube cuff pressure, brushing with toothpaste, using antiseptics and moistening the lips. The oral cavity was examined using BOAS and Mucosal-Plaque Score, and Clinical Pulmonary Infection Score was used for detecting pneumonia. Results: The BOAS scoring showed significant differences between the two groups from the first to fifth day (P<0.001). The mucosal-plaque index was significantly different between the two groups from the third day to fifth day (P<0.001). The incidence rate of pneumonia on the third and fifth day was 10% (5) and 14% (7) in the control group, and 4% (2) and 10% (5) in the intervention group, respectively. The Fisher test did not show significant difference (P=0.538), however, the incidence rate in the intervention group reduced compared with the control group. Conclusion: Although following a systematic oral care program could not significantly decrease the incidence of ventilator-associated pneumonia in critically ill patients compared to the conventional oral care practices, it significantly improved the oral health and mucosal-plaque index.