Nutritional risk screening is the basis of clinical nutritional support therapy. The roles of nurses in nutritional risk screening were analyzed. The establishment of nurse-led multidisciplinary nutritional support team were suggested to facilitate the normalization of nutritional screening and intervention for inpatients. For patient at nutritional risk, nutritional support therapy can improve the clinical outcome and cost-effectiveness ratio.

Objective: To analyze the available evidences on aspiration prevention during enteral nutrition in critically ill patients with abdominal hypertension. Methods: We searched the data from Best practice (BMJ), Up To Date, Guidelines International Network (GIN), National Guideline Clearinghouse (NGC), Cochrane Library, PubMed, Web of Science, CNKI, WanFang Database, VIP to collect literatures including guidelines, evidence summary, best practice recommendations reports, expert consensus report, systematic reviews and original guideline. Results: Totally 17 articles were selected, including 8 systematic reviews, 3 guidelines, 2 evidence summaries, 4 best practice recommendations reports. Finally 20 items of evidences were summarized with regard to identifying risk factors of abdominal hypertension and aspiration, enteral nutrition management, abdominal hypertension management, airway management, drug management and clinical monitoring. Conclusion: It is expected to provide useful information for nurses to prevent aspiration of patients in clinical practice, and improve patients safety and satisfaction.

Dysphagia is one of the fatal symptoms for post stroke patients. Complications such as aspiration, pneumonia and malnutrition are the most common causes of death in stroke patients. Modified texture foods and thickened fluids were widely used in post-stroke dysphagia patients to prevent the complications. However, the effectiveness of such interventions can be affected by patient compliance and other factors. This paper reviewed the assessment tools for oral intake ability in patients with dysphagia, the classification of modified texture foods and thickened fluids, their application and challenges in clinical practice. It is expected to provide useful information about clinical interventions for post-stroke dysphagia patients.

Objective: To observe the change of skeletal muscle mass in patients with Head and Neck Cancer during radiotherapy and analyze its influencing factors. Methods: Patients with Head and Neck Cancer treated with radiotherapy in a cancer hospital in Beijing from March 2017 to September 2019 were recruited. The symptom section of Patient Generated Subjective Global Assessment (PG-SGA) was used to assess the Nutrition Impact Symptoms (NIS) of patients before (T1), during (T2) and at the end (T3) of the radiotherapy. Dietary intake was recorded by 24-hour dietary recall and skeletal muscle mass were measured by bioelectrical impedance analysis. Generalized Estimating Equations (GEE) were used to analyze the influencing factors of skeletal muscle mass of head and neck cancer patients during radiotherapy. Results: Totally 459 patients were completely investigated. At the three evaluation time points, the skeletal muscle mass was (26.31±5.08) kg, (25.60±4.83) kg, (24.62±4.68) kg respectively; the incidence of NIS was 38.1% (175/459), 93.2% (428/459), 95.4% (438/459) respectively; standard daily energy intake (stDEI) was (24.94±8.51) kcal/(kg·day), (20.47±9.14) kcal/(kg·day), (18.23±9.75) kcal/(kg·day) respectively, and standard daily protein intake (stDPI) was (0.98±0.39) g/(kg·day), (0.86±0.39) g/(kg·day), (0.84±0.51) g/(kg·day) respectively. With the progress of radiotherapy, the patient's skeletal muscle mass gradually decreased, NIS increased, and energy and protein intake declined. Changes in skeletal muscle mass of patients were closely related to whether they had undergone surgery before radiotherapy, dietary energy intake and NIS scores. Conclusion: Patients with radiation therapy have reduced skeletal muscle mass after treatment, and patients with non-surgical, insufficient dietary energy intake and NIS have a greater reduction in skeletal muscle mass. It is suggested that attention should be paid more to non-surgical patients, and nutrition-related symptoms management and dietary intervention should be strengthened to reduce the loss of skeletal muscle mass.

Objective: To study the effect of nursing team management in parenteral nutrition management of preterm infants via PICC. Methods: A total of 507 preterm infants who underwent parenteral nutrition using PICC in the neonatal intensive care unit of one Children's Hospital in Beijing were selected as the subjects. Totally 240 premature infants admitted from January 2013 to December 2015 were included in the control group and implemented with routine care. The 267 premature infants admitted from January 2016 to December 2018 were included in the observation group and performed team nursing management. The incidence of PICC catheter-related complications were compared between the two groups. Results: The median catheter indwelling time (19 days) in the observation group was significantly longer than the control group (16 days) (Z=-2.947, P=0.003). The incidence of PICC catheter complications in the observation group (2.25%) was significantly lower than the control group (9.58%) (χ2=13.651, P<0.001). Conclusion: Team management of the nutrition of the premature infants with PICC can reduce the incidence of PICC catheter-related complications and improve the quality of life in preterm infants.

Objective: To investigate the status quo of uses of medication among institutionalized old people in Chongqing. Methods: Using the stratified sampling method, a total of 203 old people from 12 nursing facilities in Chongqing were investigated with questionnaires including demographic information, status quo and knowledge-attitude-practice of uses of medication. Results: Types of medication, ways of taking medication, affordability of healthcare cost, and side effects of medication of the elderly varied among nursing facilities, as well as attentions that the staff paid to the status of uses of medication among the elderly. Scores for belief of uses of medication among the elderly in nursing homes which provided medical services were significantly higher than those in the other two types of nursing facilities, namely, nursing homes which did not provide medical services and senior apartments. Scores for medication adherence among the elderly in nursing homes which provided medical services were significantly higher than those in nursing homes which did not provide medical services. The belief of the uses of medication and the frequency of taking medication, as well as staff's attentions were the main factors influencing medication adherence. Conclusion: There are big differences in the status quo of uses of medication among the elderly in different nursing facilities. The medication safety for the elderly in nursing homes which provided medical services is relatively better. It is necessary to promote the transformation and development of nursing facilities to those which incorporate the internet, medical care and pension.

Objective: The purpose of the study was to assess the influencing factors associated with medication adherence related to immunosuppressive treatment in patients who underwent kidney transplant in China, therefore to provide evidence for clinical interventions to improve adherence. Methods: Following a multi-center cross-sectional approach, a self-designed demographic information questionnaire and the Basel Assessment of Adherence with Immunosuppressive Medication Scale were used to collect information from the recipients who underwent kidney transplant for more than 3 months. Results: A convenient sample of 819 patients with kidney transplant were included in the study, of which 359 were classified as non-adherent (43.8%). Among them, the most frequently reported event related to non-adherent was not taking medication on time, followed by missed medication taking. The independent influencing factors of medication adherence to immunosuppressive treatment were the length of time after kidney transplant, donor type, complications after kidney transplant, and the duration of dialysis. Conclusion: The medication adherence to immunosuppressive treatment among patients with kidney transplant is relatively low. Patients with a longer post-transplant years, living donor, having complications and with shorter duration of dialysis should receive more attention in adherence screening, therefore to assist them with medication management in the follow up period.

Objective: To investigate the status quo and analyze influencing factors of self-management behaviors in elderly patients with Chronic Heart Failure (CHF). Methods: Random cluster sampling was used in 102 hospitals in five regions of East China, West China, South China, North China and Central China to recruit 6,124 elderly CHF patients to finish a survey on self-management behaviors. Results: The average score for self-management behaviors among elderly CHF patients was 49.00 (43.00, 54.00). The score rate, which was achieved by dividing the median score by the full score and multiplying 100%, was 61.25%. It was at the lower-middle level. Factors such as age, ethnicity and educational level affected patients' self-management behaviors (P<0.05). Conclusion: The self-management behaviors of elderly CHF patients is at the lower middle level. It is affected by age, ethnicity and educational level. Nursing staff should take the characteristics of patients into account when developing systematic and individualized self-management education programs for elderly CHF patients.

Objective: To investigate the level and influencing factors of discharge readiness of patients with first catheter for peritoneal dialysis in rural areas. Methods: Totally 155 peritoneal dialysis patients with first catheter in rural areas from nephrology department of a tertiary Grade-A hospital in Zhengzhou were investigated during November 2018 to May 2019 with discharge preparation scale, quality of discharge guidance scale and social support rating scale on the day of discharge. Results: The average score of patients' discharge readiness was 6.33±0.85, with a lower middle level. The results of correlation analysis showed that the patient's discharge readiness was positively correlated with the quality of discharge guidance and social support. The related factors of patient's discharge readiness included gender, age, education level, occupation, number of complications, serum creatinine level, quality of discharge guidance and social support (R2=0.842). Conclusion: The level of discharge readiness of peritoneal dialysis patients with first catheter in rural areas needs to be improved urgently. Targeted health education for the patients should be implemented according to the different characteristics of patients in rural areas. It is necessary to improve the discharge guidance skills and effects, to create a multi-support system for patients.

Objective: To develop and evaluate validity and reliability of discharged premature infants' parents coping ability questionnaire. Methods: The questionnaire was preliminarily developed by literature analysis, semi-structured interview and Delphi consulting method. Convenience sampling method was used and totally 257 caregivers of premature infants were recruited. The questionnaire was evaluated by item analysis, correlation analysis, exploratory factor analysis, content validity, structure validity, internal consistency reliability and split-half reliability. Results: The questionnaire with 55 items was preliminarily developed, and 15 items were deleted after questionnaire evaluation. Eight common factors were extracted by exploratory factor analysis, and the cumulative explanatory variation was 59.864%. The common factors extracted as questionnaire dimensions are parenting skills, role adaptation of parents, parent-child relationship, family function, positive coping, negative coping, support, health care knowledge of premature infants.The Croanbach's alpha was 0.916 for overall questionnaire and 0.724-0.906 for each dimension. The split-half reliability was 0.845 for overall questionnaire and 0.712-0.897 for each dimension. The content validity of the whole questionnaire (S-CVI) was 0.946, and the content validity (I-CVI) of each item was 0.824-1.000 with the corrected Kappa value 0.823-1.000. Conclusion: The questionnaire has good reliability and validity, which could be used as a tool to evaluate discharged premature infants' parents coping ability and to reflect the problems and confusion of parents to a certain extent, and to provide references for the formulation and evaluation of transitional care program for premature infants.

Objective: To investigate the characteristics of mastery in young and middle-aged patients with peritoneal dialysis and to explore its influencing factors. Methods: Following convenient sampling, a total of 238 young and middle-aged patients with peritoneal dialysis were investigated by using the general information questionnaire, Personal Mastery Scale (PMS), Herth Hope Index (HHI) and the Revised Piper Fatigue Scale-Chinese Version (RPFS-CV). Multiple linear regression was used to explore the main influencing factors of mastery among these patients. Results: The mean score of the PMS was 26.02±3.81. Multiple linear regression analysis showed that patients' educational background, monthly income per family member, the level of serum creatinine, hope, and degree of fatigue were the influencing factors for mastery among these patients (P<0.05). Conclusion: The level of mastery in young and middle-aged patients with peritoneal dialysis is moderate but still needs to be improved, more attention should be paid to those patients with low educational level, low income with high serum creatinine level; health providers should provide guidance to patients and assist them to establish life hope during clinical practice, and encourage them to participate in moderatephysical activities, decrease the degree of fatigue by adapting physical, mental and traditional Chinese medicine therapies, therefore to promote their mastery level.

Objective: To investigate the prevalence of cognitive frailty in elderly diabetic patients in community and to analyze the influencing factors. Methods: A survey was conducted in 260 elderly diabetic patients from a community health service center in Zhengzhou by convenience sampling using the general information questionnaire, Frailty Phenotype, Montreal Cognitive Assessment and Clinical Dementia Rating. Results: Totally 255 valid questionnaires were collected. A total of 28 elderly patients with diabetes suffered from cognitive frailty, and the prevalence was 11.0%. The results of multivariate logistic regression analysis showed that old age (75 or older) and depression were risk factors of cognitive frailty, while regular exercise was protective factor (P<0.05). Conclusion: The prevalence rate of cognitive frailty in community elderly diabetic patients is relatively high. Community health care workers should pay attention to the assessment of cognitive frailty for community elderly diabetic patients, and take targeted overall intervention in time to prevent or slow down the onset and development of cognitive frailty.

Objective: To test the Nurse' Disaster Nursing Competency Evaluation Tool's reliability and validity for clinical nurses. Methods: Based on the ICN Framework of Disaster Nursing Competencies, the Nurses' Disaster Nursing Competencies Evaluation Tool was developed by literature review and Delphi expert consultation. A total of 723 nurses were selected by convenience sampling to examine the reliability and validity of the tool. Results: The nurses' disaster competencies evaluation tool contained four first-level indexes, nine second-level indexes and 55 third-level indexes. The result of the clinical measurement showed that Cronbach's α coefficient of the whole tool was 0.974; the test-retest reliability after two weeks was 0.999. In addition, content validity index of the scale was 0.93; the correlation coefficient between first-level indexes and the whole tool ranged from 0.805 to 0.951; the construct validity was validated by factor analysis and the four factors' cumulative variance contribution rate was up to 56.529%. Conclusion: The Nurses' Disaster Nursing Competency Evaluation Tool has good reliability and validity. It can be applied to measure the clinical nurses' disaster nursing competency.

Objective: To investigate the effect of cardiac rehabilitation with spouses’ participation on the patients undergoing PCI and the spouses. Methods: A total of 71 pairs of patients and their spouses admitted to the Department of Cardiology of a Grade A tertiary hospital in Luoyang City were enrolled and randomly divided into two groups, namely 35 pairs in the intervention group and 36 pairs in the control group. The control group was offered traditional health education and rehabilitation guidance, while the patients and spouses in the intervention group received rehabilitation exercise with spouses’ participation. The intervention time was set to three months. Total cholesterol (TC) was measured before and after intervention, and the physical activity level of patients and spouses was evaluated by IPAQ. Besides, the quality of life of patients was evaluated by SAQ and the differences between the two groups were compared. Results: No significant differences were observed in TC, physical activity and life quality between the two groups before intervention. After intervention, TC of patients and spouses in the experimental group was lower than those of the control group with the difference being statistically significant (P<0.05); the constituent ratio of high and medium level physical activity in the experimental group was higher than that of the control group and the difference was statistically significant (P<0.05); the scores of physical restriction, frequency of angina, satisfaction and disease perception in the experimental group were significantly higher than those of the control group (P<0.05). Conclusion: The rehabilitation program with the participation of spouses can significantly reduce TC of patients and their spouses, and improve their physical activity and quality of life.

Objective: To evaluate and analyze the quality of domestic nursing experts' consensus literature in the past decade. Methods: CNKI, Wanfang Database, and other database were searched by computer, and the gray literature was supplemented. The search time was from January 1, 2009 to June 30, 2019. Two researchers screened the domestic nursing experts' opinion and professional consensus literature for nearly ten years, and JBI evidence-based health care center's experts' opinion and professional consensus evaluation tools was used to evaluate the authenticity and quality of literature while the four basic concepts meta-paradigms of nursing keyword analysis was conducted. Results: A total of 16 domestic nursing experts' consensuses were included. As for the results of quality evaluation, for item 1 (source of opinion), item 4 (conclusion basis of analysis, logic of expression) and item 5 (whether referenced literature), the evaluation results were all "Yes". For item 2 (influence of experts), 93.7% of the experts' consensus evaluation results were "Yes", with 6.3% was "No". For item 3 (whether centered on the interests of research-related people), 93.7% of the experts' consensus evaluation results were "Yes", with 6.3% was "Unclear". For the item 6 (whether the opinion was inconsistent with previous literature), 12.5% of the experts' consensus evaluation results were "Yes", with 87.5% was "No". In the keywords analysis of 4 nursing basic concepts keyword, the "human being" related keywords were mostly nursing staff and patients (31.9%, 29.8%) and the "health" related keywords were mostly physical health, health promotion and prevention (40.0%, 28.6%). The "environment" related keywords appeared the least, among which medical institutions were the most (71.4%) and the "nursing" related keywords were the most in the four meta-paradigms. Conclusion: For the source of content of nursing experts' consensus in China is substantive and authentic more real and reliable, less attention was paid to the attributes of nursing. High-quality experts' consensus based on the basic concepts meta-paradigms of nursing are important directions for future attention, in order to play its role as a supplement to evidence-based guidelines better.

Objective: To systematically assess the clinical efficacy of High Flow Nasal Cannula (HFNC) after extubated in patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). Methods: The PubMed, Web of science, Cochrane Library, CNKI, Wan Fang, VIP Databases and CBM were retrieved for all published Randomized Controlled Trials (RCT) or cohort studies about HFNC therapy in extubated AECOPD patients. The control group was treated with Noninvasive Positive Pressure Ventilation (NPPV). Results: Ten researches were included, of which six were Chinese and four were English. A total of 869 subjects were included. The results of Meta-analysis showed that HFNC had a significant advantage over NPPV in terms of reducing ICU hospital stay, respiratory rate, and complication rate. There were no significant statistical differences in PaCO2, oxygenation index, mortality and reintubation rate between NPPV and HFNC. Conclusion: Current evidence suggests that HFNC is superior to NPPV in reducing respiratory frequency, ICU hospital stay, and the incidence of complications in patients with AECOPD after extubation. In the future, more high-quality, multi-center RCT studies are needed to further evaluate the effect of HFNC on AECOPD patients after extubation.

Objective: As a measurable and objective indicator, the Reaction Time can effectively reflect the work execution capacity of nurses in the ICU. This study compared the differences of Reaction Time and analyzed its influencing factors among nurses in ICU before and after their working shifts. Methods: Following convenient sampling, using a self-developed questionnaire, and the Psychomotor Vigilance Task, related information were collected from a total of 118 nurses in 6 ICUs from two local hospitals in the current study. Results: The Reaction Time of ICU nurses appeared to be significantly longer after their working shift (after day shift 296.75 ms, after night shift 310.25 ms) than before they started their shift (before day shift 290.64 ms, before night shift 288.44 ms), and the Reaction Time after night shift (310.25 ms) was longer than that (296.75 ms) of day shift (P<0.05). Among nurses with sleep disorders, their Reaction Time before night shift (299.64 ms) and after night shift (363.33 ms) were both longer than that among those without sleep disorders (before night shift 285.56 ms, after night shift 306.40 ms) (P<0.05). Gender, number of children, length of employment in hospital, length of working shifts, whether or not consumed caffeine drinks and desserts all had relative impacts on the Reaction Time among nurses in the ICUs before and after their working shifts, respectively (P<0.05). Conclusion: It is recommended to use the Reaction Time reasonably to improve the scheduling, identify related protective and risk factors, and improve the performance of nurses in the ICU.

This paper provides a comprehensive review of the literature on the concept, status quo, evaluation tools, influencing factors and coping strategies of nurses' spiritual care ability, and to provide a reference for future related research.

Objective: To develop Nursing Informatics Competency Scale with good reliability and validity which not only reflects the characteristics of nursing discipline but also can be used under Chinese cultural context. Methods: The mixed method was used to construct the evaluation index system of nursing informatics competency, subsequently the prototype of Nursing Informatics Competency Scale was formed. Different statistical methods were used to test the reliability and validity of the scale. Results: The Nursing Informatics Competency Scale consisted of 5 dimensions and 32 items. The Cronbach's?α of the scale was 0.947; the exploratory factor analysis showed that the scale had good construct validity. The Content Validity Index (CVI) was 0.957; the confirmatory factor analysis showed an adequate model fit (χ2/df=0.293, AGFI=0.82, RMSEA=0.06, RMR=0.04, CFI=0.91). Conclusion: The Nursing Informatics Competency Scale had good reliability and validity which could provide an objective, scientific and reliable evaluation tool for assessing the competency of nursing informatics for nurses in hospitals.

Objective: To develop a software for the handover of critically ill patients in the emergency department and evaluate its application effects. Methods: Design a software for critically ill patients in the emergency department based on SBAR (Situation, Background, Assessment, and Recommendation) model, and embed it into the emergency information system. The quality of handover, the time spent on writing the handover notes, omissions and corrections occurred in the handover notes, and nurses' satisfaction were used to evaluate the effects of the new handover procedure. Results: It was found that compared to the control group, the observation group had higher average score of the Handover Evaluation Scale, less time spent on writing the handover notes, fewer errors and corrections occurred in the handover notes, and higher nurses' satisfaction towards the handover procedure. All the differences were statistically significant (P<0.05). Conclusion: The use of a handover software designed based on the SBAR model in the emergency department standardizes the content of nurses' handover procedure, avoids the omissions and duplicates of handover notes, shortens the time spent on writing the handover notes, and ultimately improves the quality of handover and nurses' satisfaction towards the handover procedure.

Objective: The electronic medical record system based on Pediatric Early Warning Score (PEWS) was constructed to form the PEWS assessment-alert-disposal process and analyse its effects. Methods: Relying on the information platform of the hospital, the content and framework of the PEWS-based electronic medical record system was designed. A total of 300 pediatric patients in the hospital were selected and randomly assigned to the manual evaluation group and the electronic medical record system evaluation group, with 150 cases in each group. The time for evaluation, evaluation accuracy and nurses' satisfaction with the two methods were compared between the two groups. Results: The time to have electronic medical record system evaluation (31.18±3.76) s was shorter than that of manual evaluation (55.64±5.01) s. The accuracy rate of electronic medical record system group and manual evaluation group was 100.0% and 82.7% respectively. Meanwhile, the satisfaction rate of nurses using electronic medical record system was 97.8%, which was significantly higher than that of manual evaluation (80.0%). Conclusion: The application of PEWS-based electronic medical record system can improve nurses' work efficiency, accuracy rate of condition evaluation and nurses' satisfaction.

Objective: To investigate the status quo of nursing interruption events during the course of administration by nurses, so as to provide basis for developing preventive strategies of nursing interruption events. Methods: Nurses' drug delivery process was divided into three phases according to the time of clinical practice: doctor's order processing, drug allocation and bedside drug administration. Structured observation method was employed to observe the frequencies, sources, types and consequences of nursing interruption events during the three phases in the Department of Cardiology from September 2018 to February 2019. The interruption time, medication errors caused by the interruption and the influencing factors of interruption were analyzed. Results: After 270 hours of observation, 3424 nursing interruption events occurred, with an average of 12.68 times per hour. The distribution of event types in the three phases and the distribution of consequences were statistically significant (P<0.001). The average interruption time was (28.01±10.99) seconds each time, and the total interruption time of drug administration was 26.65 hours, accounting for 9.87% of the total observation time. There was no statistical difference in the average interruption time of the three phases (P=0.209). During the time of interruption, there were 39 potential incidents of medication errors, with the incidence of 11.39‰. The sources of interruption events were as follows: family members, environment, doctors, patients, colleagues, nurses themselves and others, of which 2340 were low priority events, accounting for 68.34%. Conclusion: Nursing interruption events occur frequently, come from many sources, have complex causes and common negative outcomes. There are high proportions of low priority events, which actually reflect patients' needs. Interruption also has time cost, and can directly lead to medication errors. It is of great importance to provide predictive services for patients to avoid or reduce unnecessary interruptions during the process of nursing medication, so as to meet patients' needs, save the wasted time, and ensure the safety of drug administration.

This article reviews and summarizes the concepts, evaluation, status quo, influencing factors and interventions on the post-traumatic growth of patients with digestive system malignant tumors. Gap and future direction on studies of the post-traumatic growth of patients with digestive system malignant tumors are proposed, so as to provide a reference for the medical staff to carry out the related psychological nursing work.

This article reviews the causes, the related mechanisms, the harm of perioperative insulin resistance among breast cancer patients and the precautionary measures for Insulin Resistance in Enhanced Recovery After Surgery (ERAS) mode. The aim is to provide a reference for better management of perioperative Insulin Resistance in breast cancer patients.

This paper reviewed the basic qualification, main functions and training requirements of the case manager of Acute Myocardial Infarction in China and abroad. Also introduced the evaluation of the two case management models of Acute Myocardial Infarction, namely hospital-based and family-based mode. This paper aimed to provide reference for the practice of case management of Acute Myocardial Infarction in China.

The catheter exit-site care is essential to prevent exit-site infection in Peritoneal Dialysis patients. This paper summarized the research progress of the content, importance, as well as the current status of catheter exit-site care practice. It could provide basis for improving exit-site care practice for Peritoneal Dialysis patients.

Objective: To investigate the relationship between the status of stigma and the acceptance of disability in patients with hemiplegia due to cerebral hemorrhage. Methods: Following convenient sampling, hemiplegic patients with cerebral hemorrhage admitted to the neurosurgery department of the affiliated hospital of North China University of Science and Technology, between September 2018 and May 2019, were enrolled in the current study. Patients' socio-demographic information were collected using a self-designed general data questionnaire, patients' stigma due to cerebral hemorrhage hemiplegia was evaluated by the Stigma Scale for Chronic Disease, and disability acceptance were assessed using the Acceptance of Disability Scale-Revised. Results: Patients' education level, gender, occupation type, medical expenses, number of functional disorders, cerebral hemorrhage site, degree of dependence, neurological function classification, hemiplegic site and limb numbness had significant impact on patients' stigma due to cerebral hemorrhage hemiplegia (P<0.05). The mean scores of stigma in patients with cerebral hemorrhage, and disability acceptance were 80.52±8.32 and 70.62±14.10, respectively. Correlational analysis showed that the total score of patients' stigma was negatively correlated with the total score of disability acceptance (ra=-0.748, P<0.001). Under the subdimensions of disability acceptability, the extended dimension, subordinate dimension, inclusive dimension and transformation dimension were negatively correlated with stigma (r1=-0.657, r2=-0.653, r3=-0.484, r4=-0.384, P<0.001). Conclusion: The stigma of hemiplegic patients with cerebral hemorrhage was moderately high, which was negatively correlated with disability acceptance. Health care providers should implement psychological measures adequately for patients to reduce their stigma and improve their disability acceptance ability.

Objective: To explore the social participation level and its associated factors of disabled patients with stroke in 3 different disease stages disease of 6, 12, and 18 months. Methods: From June 2018 to March 2019, a total of 210 disabled patients with stroke within 3 months, 12 months and 18 months respectively in the Fifth Affiliated Hospital of Harbin Medical University were selected with 70 patients in each disease stages. A set of questionnaires including Self-made General Situation Questionnaire (SGSQ), modified Rankin Scale (mRS), Impact on Participation and Autonomy questionnaire (IPA), Self-rating Depression Scale (SDS), General Self-Efficacy Scale (GSES), National Institute of Health Stroke Scale (NIHSS), and Family Care Index Assessment Form (APGAR Questionnaire) was used. Results: It was showed that patients with a course of disease at 6, 12, and 18 months after stroke were mostly moderately or severely disabled. Those with moderate disabilities accounted for 24.30%, 44.30%, and 30.00%, for 6 months, 12 months, and 18 months respectively. Those with severe disabilities accounted for 48.60% and 40.00%, 52.90% for 6 months, 12 months, and 18 months respectively. IPA scores were (44.41±14.99), (42.43±13.08), (48.60±14.03) for these 3 different disease durations. The IPA scores among 3 coures were significantly different (P<0.05). The IPA scores of 12 and 18 months were significantly different (P<0.05). Multiple regression showed associated factors with the social participation level of disabled patients with stroke at 6, 12, and 18 months were disabled level and depression; marriage, depression, and NIHSS score, and disabled level and depression, respectively (all P<0.05). Conclusion: The social participation level of disabled patients with different disease duration after stroke needs to be improved. Associated factors with social participation level are different among patients with different disease duration. Targeted interventions are needed to improve the social participation level of patients with stroke.

This article reviewed the concept, characteristics, mechanism of action, evaluation tools, research progress and intervention methods of subjective health complaints, and summarized the implications of subjective health complaints for clinical practice in China. This review provides evidence for reducing level of subjective health complaints, improving the health care personnel's awareness of subjective health complaints and offering effective health care for patients.

Objective: To investigate P-wave ratio of the ECG-aided tip accurate localization and the effect of body position change on P-wave ratio of PICC cavity electrograph in premature infants. Methods: 289 premature infants who were admitted to the neonatal intensive care unit of a hospital in Bengbu from January 2018 to March 2019 and met the indications of PICC catheterization were selected as the research subjects. After placement the catheter, the child’s limb was placed in position 1 and position 2 (natural position) respectively to receive ECG-aided tip localization. Chest X-ray was taken at the position 2 after fix the PICC. The ratio of P-wave in the ECG at the two positions was compared, and the relationship between the P-wave ratio and the tip position was studied at position 2. Results: When the PICC was placed in the basilica vein, elbow median vein, iliac vein, cephalic vein, and superficial vein, the difference in the P-wave ratio of the ECG in the two positions was statistically significant (P<0.01). The 95% confidence interval for P-wave ratio was 0.64-0.67 when the tip of PICC catheter was at T4-T6. The sensitivity and specificity of the ECG-aided tip localization were 94.9% and 100.0%. Conclusion: The ECG-aided tip localization in premature infants has high sensitivity and specificity. When the P-wave ratio is between 0.64-0.67, the tip of PICC catheter is 95% likely to be in the best position. The position change is the influence factor of the inner electrogram positioning of PICC cavity in premature infants.