Diabetes Specialist Nurses (DSN) play an important role in improving the quality of care for patients with diabetes, but the training and use of DNS in China are still need to be improved. This paper systematically expounds the role definition, current training situation, work status and future development direction of DSN in China, to provide reference for the construction of diabetes specialist nurse team suitable for China's national conditions.

Objective: To explore the barriers to clinical application of evidence-based practice of insulin injection site selection and rotation. Methods: The semi-structured questions was made guided by the theoretical framework of PARIHS. Colaizzi was used for data analysis. Results: There are three themes namely evidence, organizational environment and facilitating factors. There are two sub-themes in evidence. (1) parts of the evidence were made without fully consideration of the clinical situation; (2) parts of the evidence were made without taking patients' will as consideration. There were five sub-themes under the theme of organizational environment. (1) health education materials were necessary; (2) doctors were not involved in this practice change while their supports were needed; (3) the head nurse needed to further clarify the specific role of leadership in evidence transformation; (4) the change would bring an increase in workload, but it was acceptable; (5) the rotation of insulin injection site was the biggest difficulty. There were two sub-themes under the theme of facilitating factors. (1) nurses agreed it was meaningful to implement the practice; (2) the standardized process system was a strong guarantee for the change implementation. Conclusion: Standard procedures, health education materials, rotation tools and patients' will need to be all taken into consideration to promote the application of the evidence-based practice of insulin injection site selection and rotation.

Objective: To explore the effects of a multidisciplinary cooperative blood glucose management model in patients with COVID-19 and diabetes. Methods: The blood glucose of patients with COVID-19 and diabetes isolated was managed by a multidisciplinary cooperative blood glucose management team. Results: There were significant differences in the changes of fasting blood glucose and 2hpostprandial blood glucose before and after the intervention. No severe hypoglycemia was observedin all patients. Conclusion: The multidisciplinary cooperative blood glucose management model can effectively control the blood glucose level of patients with COVID-19 and diabetes. Such an experience is worth of promotion.

Objective: To construct a case management studio for diabetes and evaluate its effects in order to provide reference for advanced nursing practice in diabetes management. Methods: The case management studio is led by a specialist nurse in diabetes. Multidisciplinary professionals are included in the studio. The hospital provides supports from the aspects of policy, setting and equipment, talent training and information construction. The team members work together to develop the rules and regulations, service contents and process, case management program, and quality evaluation index system. The studio aimed to provide patients with systematic and professional care to paitents with diabetes. Besides, the talent cultivation schedule and research plan are also developed. Results: For two years since the studio established, the number of outpatients increased by 28.3%, the number of cases receiving care from the studio increased by 47.4%, and the number of patients serviced increased by 29.0%. A total of 621 individual management files have been established, and the detection rate of HbA1c and the good control rate of HbA1c have been significantly increased. The defective rate of HbA1c control has been significantly decreased, and the satisfaction level with medical service has been increased (P<0.05). Diabetes case managers have been cultivated for the hospital, medical consortium community and all provinces and cities across the country. The teaching achievements and academic research output have been improved based on the data from the studio. Conclusion: The case management studio for diabetes can meet the needs of patients with diabetes and effectively improve the medical quality and satisfaction of patients. It is conducive to the cultivation of advanced practice nurse and the development of academic research. It can promote the nursing disciplines development, and provide a new direction for the career development of nursing staff. The studio is worth of promotion in diabetes management.

Hypoglycemia risk identification and risk minimization are the important issues that need to be solved urgently in glucose control. So far, many hypoglycemia prediction models have been developed in and out of China. This paper reviewed the risk factors, modeling methods, types of prediction models and their predictive significance of hypoglycemia. We aimed to provide reference for the construction of hypoglycemia risk assessment tools for hospitalized patients in China. By this way, we can hopefully identify high-risk groups, formulate prevention and control measures, reduce the occurrence of hypoglycemia and accidents, and improve the prognosis of patients.

Objective: To identify the exercise programs for liver transplantation recipients in different periods after operation. Method: We searched databases like National Guideline Clearinghouse, Cochrane Library, National Institute of Health and Care Excellence, CNKI, and WanFang Data for information on exercise and fatigue management after liver transplantation. Two researchers independently evaluated literature using JBI evidence grade and quality evaluation methods, and extracted evidences. The preliminary exercise program was then formulated. The Delphi method was used to further test the scientificity and feasibility of the exercise program. Results: Four different periods (1 month, 1-3 months, 4-12 months, and >1 year after liver transplantation) of general principles and detailed exercise schedules have been constructed. Conclusion: The exercise program is scientific and reasonable. It can be referred by health professionals and patients.

Objective: To study the willingness and the related factors of the "Internet +" long-term care among disabled elders at home in Qingdao. Methods: A self-designed questionnaire was used to investigate 360 disabled elders at home in Qingdao from January to April, 2021. Results: Totally 213 (60.5%) disabled elders were willing to use "Internet +" long-term care. Logistic regression analysis showed that those who were younger, with certain degree of education background, with acceptable for higher monthly nursing expenses, and with better self-assessment of health were more willing to use "Internet +" long-term care (P<0.05). Conclusion: The willingness to use "Internet + " long-term care for the disabled elders at home in Qingdao was at a moderate level. Attention should be paid to the age, education level, monthly acceptable nursing expenses and self-assessment of health status when developing "Internet +" long-term care programs to increase the using willingness of the disabled elders.

Objective: To translate the Minimal Eating Observation and Nutrition Form-Version II (MEONF-II)into Chinese version and to evaluate its reliability and validity. Methods: The MEONF-II was translated based on Brislin translation model. A total of 144 elderly patients in the surgical ward of a tertiary hospital in Shanghai were surveyed to test the reliability and validity of the scale. Results: The Cronbach's alpha coefficient of the Chinese version of the MEONF-II was 0.731. The interrater reliability was 0.947. The I-CVI was 1.00 and the S-CVI/UA was also 1.00. The calibration validity was -0.696 (P<0.001). Conclusion: The Chinese version of MEONF-II has good reliability, validity, and strong applicability, can be used for nutritional screening of elderly surgical inpatients and can provide a reliable tool for clinical practice.

Objective: To construct a standard for nurse-led ostomy clinics in the tertiary hospital in China. Methods: The first draft was initially formed on the basis of literature review and qualitative interviews. Two rounds of experts consultation were conducted with 24 experts using the Delphi expert consultation method. Results: The expert active coefficients of the two rounds of expert consultation were 80% and 100% respectively, while the expert authority coefficients were 0.918 and 0.915 respectively. The Kendall's coefficient of concordance of the two rounds of expert consultation were 0.268 and 0.270 (P<0.001 respectively). The final construction standards for nurse-led ostomy clinics in the tertiary hospital includes five items (position management, environmental layout, facilities and equipment, goods setting and specialty management) in the first level, 18 items in the second level, and 46 items in the third level. Conclusion: The standard for nurse-led ostomy clinic in the tertiary hospital is practicable. It is expected to provide guidance for the development of nurse-led ostomy clinics.

Objective: To develop a questionnaire about the pregnancy weight management and protective motivation, and test its psychometric properties. Methods: Based on the protective motivation theory, an initial questionnaire was formed through literature analysis, semi-structured interviews and Delphi expert correspondence. Purposive sampling method was used to investigate 381 pregnant women, and the questionnaire was evaluated by item analysis method, content validity, structure validity, internal consistency reliability, combination reliability, and test-retest reliability. Results: The final pregnancy weight management and protective motivation contained six dimensions and thirty-two items; explorative factor analysis extracted seven common factors and retained six common factors, explaining 63.236% of variance contribution. Confirmatory factor analysis showed that χ2/df=1.331, RMSEA=0.047, CFI=0.942, IFI=0.927, TLI=0.917. The content of the questionnaire validity index was S-CVI/UA=1.00, S-CVI/AVE=0.92, and the I-CVI of each item was 0.83 to 1.00, and the overall Cronbach's alpha coefficient was 0.894. The Cronbach's alpha coefficient of each dimension was 0.652 to 0.920 respectively. The overall test-retest reliability of the questionnaire was 0.947, and the test-retest reliability of each dimension was 0.846 to 0.956. The combined reliability coefficient of each dimension was 0.563 to 0.915, respectively, and the squared variance extraction was 0.305 to 0.624. Conclusion: The pregnancy weight management and protective motivation questionnaire has good reliability and validity, so it can be used to evaluate the level of protective motivation for weight management in pregnant women in China, and it can predict the likelihood of pregnant women adopting weight management health behaviors to a certain extent. It provides basis and reference for the formulation and evaluation of weight management plan.

Objective: To explore the symptoms experienced by patients with rectal cancer while carrying a prophylactic ileostomy. Methods: Through phenomenological research method of qualitative research, using semi-structured interview outline, 17 subjects were interviewed in depth. The data were collated and analyzed using Colaizzi method. Results: Four themes were obtained through data analysis. They were the coexistence of complex symptoms (special symptoms of anal and ileostomy, large amount of excretion from the stoma and sleep disturbance), negative self-perceptions (impaired self-esteem, remorse guilt), derived adaptive behavior (seeking supportive information, changing dietary structure), induced internal drive (decreased sensory stimulation, positive expectation). Conclusion: Nursing staff should timely evaluate the symptoms and self-management status of patients during prophylactic ileostomy, and establish targeted intervention measures to improve patients' quality of life during the period of carrying prophylactic ileostomy.

Objective: To investigate the prevalence of cognitive frailty in Maintenance Hemodialysis patients and to analyze the influencing factors. Methods: A total of 452 Maintenance Hemodialysis patients in 3 hospitals of Lianyungang were selected as the study subjects. The Frailty Phenotype, Mini-Mental State Examination and Clinical Dementia Rating were used to screen for cognitive frailty. The relevant clinical data were collected, and the influencing factors of cognitive frailty were analyzed. Results: Ninety-three patients (20.6%) had cognitive frailty. Logistic regression analysis showed that advanced age, female, larger waist circumference, malnutrition and depression were risk factors for cognitive frailty. Higher education level and serum creatinine level were protective factors for cognitive frailty (P<0.05). Conclusion: The prevalence of cognitive frailty in Maintenance Hemodialysis patients is high. Medical staff should pay more attention to this population, identify early and take targeted intervention.

Objective: To explore the application of case manager-led TAVI perioperative management program in patients with aortic stenosis. Methods: Forty-two patients undergoing TAVI surgical treatment were selected from November 2019 to November 2020.Case management program was carried out by forming TAVI perioperative multidisciplinary team, case management path and intervention plan. Six Minute Walk Test (6MWT), Borg Scale and SF-12 were used to measure heart function and quality of life of patients before the surgery, before discharge, one month after and three months after the surgery. Results: Six Minute Walk Distance one month and three months after the surgery was significantly longer than that before discharge (P<0.05). There was statistical significance in terms of cardiac function in different time points (P<0.05). Quality of life of patients was significantly increased after the surgery compared with that before the surgery (P<0.05). Conclusion: The implementation of case manager-led TAVI perioperative management program is helpful to promote the recovery of cardiac function and improve the quality of life of patients.

Objective: To analyze the effect of elastic band resistance exercise on muscle mass, muscle strength and physical performance in the elderly at risk of sarcopenia. Methods: A total of 60 elderly people who met the inclusion criteria and were assessed as at risk of sarcopenia in a nursing home were selected. According to the different oors, we divided them into the experimental group and the control group with 31 in the experimental group and 29 in the control group. The control group received routine care, while the experimental group also took part in elastic band resistance exercise training 3 times a week for 12 weeks (36 training sessions in total). The body composition analyzer, hand-dynamometer, five-times sit-to-stand test, timed up and go test and Berg balance scale were used to evaluate and compare muscle mass, muscle strehgth and physical performance of 2 groups befere and after intervention. Results: After the intervention, 26 of the 31 subjects in the experimental group finished 33 or more training sessions and the exercise compliance rate was 83.87%. During the intervention, no exercise-related adverse events in the subjects of experimental group occurred. After 12 weeks of intervention, the total muscle mass, skeletal muscle index, grip strength and the score of Berg balance scale in the experimental group were higher than those in the control group (P<0.05 respectively). The time of five-times sit-to-stand test and timed up and go test in the experimental group was less than that in the control group (P<0.05). Conclusion: Elastic band resistance exercise is feasible in the elderly at risk of sarcopenia, which can increase muscle mass and muscle strength of the elderly at risk of sarcopenia and improve their physical performance.

Airborne is the main transmission way of COVID-19, and air disinfection is an effective way to reduce the airborne load and transmission capacity of the virus. The main measures for the prevention and control of COVID-19 epidemic include finding and isolating patients, strengthening the control of transmission ways, and protecting susceptible populations. Outpatient clinic is a place with various patients, which has a potential risk of virus transmission, and outpatient air disinfection is one of the important measures to reduce the risk of nosocomial infection and epidemic outbreak. This article summarizes and reviews the current common air disinfection methods and their effects, and aims to provide a reference for hospitals to select appropriate air disinfection ways according to their own conditions, and to achieve the purpose of best regular epidemic prevention and control.

Objective: To analyze the effect of Swiss ball proprioception training in the early rehabilitation of patients after Total Knee Arthroplasty (TKA). Methods: A total of 81 patients after TKA who met the criteria were included in the study and assigned randomly into intervention group (n=41) and control group (n=40). The control group received routine rehabilitation training, and the intervention group received Swiss ball proprioception training. The Hospital of Special Surgery (HSS), Berg Balance Scale (BBS) and Visual Analogue Scale (VAS) were used for evaluation. Results: One month and three months after surgery, the HSS and BBS scores of the intervention group were higher than those of the control group (P<0.05), and there was no statistic difference in VAS scores (P>0.05). Conclusion: Swiss ball proprioception training can enhance muscle strength, improve balance function, enhance joint stability of patients after TKA, and do not increase additional pain.

Objective: To evaluate and integrate the best evidences on the prevention and management of Heel Pressure Injuries. Methods: We searched the BMJ Best Practice (British Medical Journal Best Practice), Cochrane Library, Joanna Briggs Institute Library, Registered Nurses' Association of Ontario (RNAO), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), and PubMed, Embase, CNKI, WanFang Data, CBM as well as the Pan Pacific Pressure Injury Alliance (PPPIA), European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Ulcer Advisory Panel (NPUAP), Wound Ostomy and Continence Nurses Society (WOCN) as a supplement to collect literatures including guidelines, evidence summaries, recommended practice, systematic reviews and expert consensus on the prevention and management of Heel Pressure Injuries. The JBI evidence appraisal and recommendation system was used to evaluate the quality of studies and the level of evidences. Results: A total of 12 papers were brought into this study, including 1 guideline, 6 evidence summaries, 3 systematic reviews, 1 consensus and 1 practice recommendation. Finally 23 pieces of best evidences were summarized, covering such 6 aspects as risk assessment, diagnostic assessment, "floating" heel (pressure redistribution), heel protection (dressing, protective device), treatment, and establishment of an interdisciplinary team. Conclusion: Medical staff should choose the best evidences to carry out clinical prevention and management of heel pressure injuries according to the individual situation of patients, in order to improve the standardization and effectiveness of the heel pressure injuries management.

Objective: To use Meta-analysis method to evaluate the effects of mobile medical intervention on medication compliance of hypertension patients. Methods: Computer search was conducted on PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data, and VIP Data to collect randomized controlled trials focused on the effects of mobile medical treatment on medication compliance in patients with hypertension. The retrieval time was from January 1, 2000 to January 24, 2021. After two researchers independently screened the literature, extracted the data and evaluated the bias risk of the included study, RevMan 5.3 software was used for Meta-analysis. Results: A total of 17 studies were included, including 3449 patients. Meta-analysis results showed that the different effect sizes were analyzed by two kinds of data, and the good medication compliance rate of hypertension patients was taken as the outcome index in the count data, RR=1.41, 95%CI (1.32, 1.50), P<0.05; In the measurement data, medication compliance scale score of hypertensive patients was used as an outcome index, SMD=0.74, 95%CI(0.40, 1.08), P<0.05. Conclusion: Mobile medical mode can improve the medication compliance of patients with hypertension and is beneficial to the control of blood pressure.

Objective: To systematically review the experience of women with Gestational Diabetes Mellitus (GDM). Methods: Database including PubMed, The Cochrane Library, Embase, ISI WOK, PsycINFO, CNKI, CBM, Wanfang data, and VIP were searched from inception to November 2020, to collect qualitative studies on the experience of pregnant women with GDM. The JBI Critical Appraisal Tool for qualitative studies in Australia was applied to evaluate the quality of the included studies. The integrating methods were used to integrate the results. Results: A total of 14 studies were included. Fifty-six complete findings were grouped according to their similarities to form eight categories. These categories resulted in three synthesized findings: pregnant women suffer psychological shock once the diagnosis of GDM and then acquire the motivation to cope after self-adjustment; women with GDM expect to obtain more support because of the shortage of coping capacity and resistance resources; they actively adjust coping strategies and initially attempt to establish healthy lifestyle behaviors. Conclusion: Health professionals should pay attention to the changes from the psychological adjustment to behavior for pregnant women with GDM in the process of self-management, such patients are in desperate need of effective and sufficient individualized guidance. We should also encourage family members and community resources to provide support to the patients to improve their pregnancy outcomes and reduce the risk of type 2 diabetes.

Objective: To investigate nurses' perceived caring from managers, job burnout and turnover intention of nurses, and analyze the relationship between caring and the other two variables. Methods: A total of 539 nurses from a tertiary grade A hospital in Beijing were included by convenience sampling. The Chinese version of Caring Assessment Tool-administration (CAT-admin), Maslach Burnout Inventory (MBI) and turnover intention scale were used to collect the data. Results: The total score of CAT-admin was (139.29±27.92). The total score of MBI was 38.00 (22.00,55.00), including 19.00 (11.00, 30.00) in emotional exhaustion dimension, 2.00 (0, 5.00) in depersonalization dimensions and 14.00 (6.00, 22.00) in personal accomplishment dimensions; the total score of turnover intention was (14.57±3.67). The perceived caring from managers was negatively correlated with job burnout (r=-0.45, P<0.05) and turnover intention (r=-0.22, P<0.05). Conclusion: The nurses showed serious job burnout and strong turnover intention, and the caring from managers need to be improved. Nursing managers should provide corresponding humanistic care according to the needs of nurses, so as to reduce their job burnout and turnover intention, so as to keep the nurses engaged in nursing profession steadily.

Objective: To evaluate the effects of a narrative nursing training program for clinical nurses. Methods: From September to October 2019, 56 clinical nurses from a tertiary Grade A hospital in Nanchang were selected as research participants for a narrative nursing training program. The training content included a total of five themes: the origin of narrative nursing, the core technology of narrative nursing, the carrier of narrative nursing, the inspiration and changes brought by narrative nursing, and the summary and evaluation. The training program adopted interactive teaching, created simulated situations, and carried out practice activities such as role-playing, reflective writing, and expressive art related to "narration". The Narrative Competence Scale (NCS) and the feedback questionnaire were used to evaluate the effects of clinical nurses' narrative nursing training. Results: After the training, the average total scores of clinical nurses' medical narrative ability and the average scores of each dimension were significantly higher than those before the training, and the differences were statistically significant (P<0.001). The analysis of the feedback questionnaire showed that 96.43% of clinical nurses believed that the training program was scientific and the training content was practical, which was helpful to guide the narrative nursing practice. Conclusion: The narrative nursing training program can improve the narrative nursing ability of clinical nurses.

Objective: To investigate the status of Mild Cognitive Impairment (MCI) in non-dialysis outpatients with Chronic Kidney Disease (CKD) and explore its influencing factors. Methods: Totally 214 outpatients with non-dialysis CKD were investigated from December 2018 to January 2020 using Montreal Cognitive Assessment (MoCA) Questionnaire. Convenient sampling method was performed. The MCI status was evaluated and the influencing factors were explored. Results: The average MCI score of the CKD patients was 24.24±3.95. Totally 117 (54.7%) CKD patients were diagnosed as MCI. Binary logistic regression analysis showed that old age, CKD stage, education level, occupation status, regular exercise and payment of medical expenses were influencing factors of MCI in CKD patients. Conclusion: More than half of pre-dialysis CKD patients have developed MCI. Therefore, nursing staff should pay attention to the screening of MCI in CKD patients, and carry out targeted intervention, in order to reduce the adverse prognosis caused by MCI.

This article introduces the definition and theoretical basis of art therapy, as well as the intervention model, intervention elements, and effect analysis of the application in the elderly with cognitive impairment. By explaining the application and research progress of art therapy in the elderly with cognitive impairment in recent years, it provides a reference for subsequent interventions.

Exercise rehabilitation is one of the important approaches to reduce the adverse health outcomes of patients with coronary heart disease, however, their participation rate is low and adherence to exercise is poor. This article reviews the patients' participation in exercise rehabilitation and its associated factors, including patients' demographic characteristics, comorbidity, symptoms related to the disease, psychosocial behaviors, and their health care providers. The paper identifies the main influencing factors of participation in exercise rehabilitation for patients with coronary heart disease, which contributes to develop tailored interventions for these factors by health care professionals.

Objective: To investigate the changes of family caregivers' care burden in patients with colorectal cancer after operation, in the middle of chemotherapy, after chemotherapy and 3 months after chemotherapy. Methods: A longitudinal study design was used to conduct a questionnaire survey including general self-efficacy, social support, family caregiver task, ways of coping and caregiver reaction assessment questionnaire on 185 family caregivers of colorectal cancer patients who met the recruiting criteria in 7 tertiary hospitals located in Beijing, Inner Mongolia, Hebei, Henan and Jiangsu at four time points. Results: The family caregivers of patients with colorectal cancer generally had the burden of care, and the two dimensions of "time disturbed" and "financial difficulties" had a greater impact on caregivers; the burden of care first increased and then decreased during the follow-up period, and was more serious in the mid-term of chemotherapy. The factors that increased the burden of care included living with patients, few people for sharing, caregivers' lacking of general self-efficacy, social support and care ability, less positive coping and more negative coping. Conclusion: The care burden of family caregivers increased first and then decreased with time. Clinical staff should focus on improving caregivers' self-efficacy, social support, care ability and coping styles.

Online intervention is a feasible method to provide support to caregivers. This article introduces the form, content and effect of online interventions on self-efficacy for family caregivers of dementia patients, aims to provide more reference for future related research.

Objective: To construct a nurse-led postoperative wound management model and apply it to the clinical practice. Methods: We established mechanisms for nurse-led surgical wound management and constructed a three-level nursing management team. We developed a scientific guideline, identified the principle of surgical wound management and the responsibilities of the personnel involved. The nurses' compliance rate to the guideline, the satisfaction of doctors, nurses and patients towards the model, infection rate of type I surgical wound, as well as the knowledge and wound dressing change skills of nurses were evaluated after the implementation of the model. Results: The annual nurses' compliance rates to the guideline between 2016 and 2019 were greater than 90.0%. From 2015 to 2019, the infection rates of type I surgical wounds were 0.19%-0.42%, respectively, which were lower than the national hospital infection control standard (≤1.5%). The satisfaction of doctors, nurses and patients towards nurse-led surgical wound management was 96.48%, 80.01%, 94.38% respectively. Nurses' knowledge of surgical wound management had improved significantly (P<0.001) after the training. One hundred percent nurses reached the standards of wound dressing change skills. Conclusion: The nurse-led surgical wound management model can meet the clinical needs of surgical wound management, provide patients with safe and high-quality wound care, expand the scope of nurses' work, and enhance the connotation of nursing work.

It is of vital importance to have a correct perception of missed nursing care and its research status in the course of improving nursing quality and ensuring patient safety. This paper summarizes the concept, assessment tools and influencing factors of missed nursing care. In order to improve the quality of nursing care and patient safety.

In this review, we examined the concept and the application of telemedicine in the context of Home-Based Palliative Care, and analyzed the issues and strategies in fostering the application of telemedicine in Home-Based Palliative Care. The aim of this review was to provide references for the application of telemedicine in Home-Based Palliative Care in China.

This article introduces the definition, assessment tools of family functioning, the current status of family functioning in children with chronic diseases and the influences of family functioning on the prognosis of the disease. It also summarizes factors influencing family functioning from the children's, parental and social support perspectives. Findings could provide a theoretical basis for medical personnel to improve family functioning in children with chronic diseases, and provide a reference for future research on family functioning of children with chronic diseases.