The journal of Chinese Nursing Management has witnessed the reform and development of nursing in China since its inception 20 years ago. It is proposed that the construction of academic journals should adhere to the correct political direction, play an importance role in guidance of public opinion and lead professional values; close to the needs of clinical practice, pursue high-level academic quality and maintain a green academic environment; focus on the construction of nursing specialty, encourage scientific and technological innovation actively and promote the cultivation of nursing professionals.

Using time axis as a framework, this article reviewed the literature and summarized the past twenty years' history of Chinese nursing management based on the significant events including the incubation of the "fifteenth" strategic nursing career development plan, the implementation of consecutive strategic nursing career development plans, the implementation of the nurses ordinance, the promotion of quality nursing service, and the emergency rescue of the public emergencies, etc.

This article reviews the breakthroughs and progress made in discipline theory, specialty nursing, organizational system and team building during the development of the nursing discipline in China, and explores the direction and positioning of the high-quality development of the nursing discipline in the background of Healthy China.

This review describes the development of higher nursing education in the past 20 years in China, and reports the current status. Moreover, this paper analyzes the opportunities and challenges of the development of higher nursing education in the new area. Nursing educators should seize the opportunity and make concerted efforts to facilitate the development of higher nursing education in China.

By searching domestic and foreign literature and combining with the practice of clinical nurses, this paper expounds the positive effect of academic journals on clinical nurses, analyzes the difficulties of reading academic journals in clinical practice, and explores the ways and methods of obtaining academic journal papers, so as to promote nurses' scientific literacy and promote the innovation and development of nursing discipline.

Objective: To formulate an early rehabilitation exercise plan for patients implanted with Dynesys dynamic stabilization system and evaluate its application effect. Methods: Based on the early rehabilitation exercise plan for spine patients at the University of Copenhagen School of Medicine and related literature, an early rehabilitation exercise plan for patients implanted with Dynesys dynamic stabilization system was constructed. Patients who received Dynesys dynamic stabilization system implanted from January 2017 to November 2019 in a tertiary grade A hospital in Henan province were divided into observation group and control group by random number table. Observation group (78 patients) received early rehabilitation exercise plan, and control group (75 patients) implemented routine exercise plan. Results: The differences in lumbar function JOA score, pain score, self-care ability, time to get out of bed for the first time after surgery, and first defecation time after surgery were statistically significant (P<0.05). There was no statistically significant difference in drainage tube extubation time between two groups (P>0.05). Conclusion: Early rehabilitation exercise plan can improve the lumbar function of patients implanted with Dynesys dynamic stabilization system, reduce pain levels, improve self-care ability, and promote the recovery of gastrointestinal function, thereby improving the quality of life of patients.

Objective: To translate the Palliative Care Self-Reported Practices Scale (PCPS) and to test the reliability and validity of the Chinese version of the PCPS. Methods: The Chinese version of PCPS was formed by adopting forward translation, back translation, cross-cultural semantic equivalence assessment and pilot study. The reliability and validity of the Chinese version of PCPS were tested by means of questionnaires among 284 clinical doctors and nurses through convenience sampling. Restults: The Chinese version of PCPS consisted of 6 dimensions and 18 items. Item analysis showed that the CR value of each item ranged from 10.797 to 18.109, and item-total correlation ranged from 0.625 to 0.815. The item-level content validity index ranged from 0.83 to 1.00, and the average scale-level content validity index was 0.99. The confirmative factor analysis showed that model yielded a reasonable fit: χ2/df=2.822, RMSEA=0.080, CFI=0.950, NFI=0.926 and IFI=0.951. The Cronbach's α coefficient of overall score was 0.948 and the Cronbach's α coefficient of each dimension was from 0.827 to 0.906. The test-retest reliability of total scale was 0.855. Conclusion: The Chinese version of PCPS has good reliability and validity, which can be used as an effective tool to evaluate a wide range of practices experienced by doctors and nurses in providing palliative care in China.

Objective: To investigate the changes in symptoms of Nasopharyngeal Carcinoma (NPC) patients with concurrent radiotherapy and chemotherapy at different treatment stages and explore its influencing factors. Methods: Totally 111 NPC patients with concurrent radiotherapy and chemotherapy were included. The M.D. Anderson Symptom Inventory Head and Neck module, Cancer Fatigue Scale and Cancer Loneliness Scale were performed at one day before radiotherapy (T1), 15th radiotherapy (T2), 30th radiotherapy (T3), and one month after discharge from the hospital (T4). Results: The scores of the four different stages of symptom distress in patients were T1 (1.48±0.42), T2 (2.89±0.44), T3 (2.55±0.44), T4 (1.98±0.39). The interference scores were T1 (1.47±0.87), T2 (2.79±0.56), T3 (2.36±0.96), T4 (1.77±0.68). The factors affecting symptom distress were the place of residence, the presence or absence of family members, the stage of radiotherapy and chemotherapy, cancer loneliness, and cancer fatigue. Conclusion: NPC patients with concurrent radiotherapy and chemotherapy show dynamic changes of symptoms in different treatment stages. The patients have high level of symptom distress during radiotherapy and chemotherapy. Clinic nurses should pay attention to patients' symptom distress and provide patients with full and dynamic nursing intervention, in order to reduce symptom troubles and improve the quality of life.

Objective: To investigate the influence of the different placement of the newborn and the delayed umbilical cord on the outcome of the mother and newborn. Methods: A total of 200 pairs of primiparas and their full-term neonates who were given regular births in a tertiary A hospital in Beijing from June to December 2019 were selected, and they were randomly divided into groups a and b. In group a, after the fetus was delivered, the midwife directly placed the newborn on the delivery bed about 20 cm below the vaginal opening of the mother; in group b, the midwife directly placed the newborn on the mother‘s abdomen (about 15 cm above the level of the vaginal opening) after the fetus was delivered, both group cut off the umbilical cord 60 to 90 seconds after the fetus was delivered. Compare the indicators of two groups. Results: For the parturients, the duration of the third stage and blood loss in the 2 hours after delivery were significantly decreased in group b than group a (P<0.05), and the hemoglobin value on the 1st postpartum was higher in group b than group a (P<0.05). For the two groups of newborns, there was no statistically significant difference in the hemoglobin value, blood pH, transcutaneous bilirubin value on the first and second days after birth, and the incidence of postnatal hyperbilirubinemia in the two groups of newborns (P>0.05). Conclusions: The research method of group b can shorten the time of the third stage of labor of the parturient, reduce the bleeding volume of the parturient 2 hours after delivery, and will not increase the risk of neonatal jaundice. Therefore, it is recommended to place the full-term newborn on the abdomen of the mother and delay cutting the umbilical cord.

Objective: To investigate the preventive measures of Venous Thromboembolism (VTE) taken by nurses in hospitals in Tibet, and to provide reference for the development of VTE prevention measures. Methods: A total of 1 117 nurses from 59 hospitals in 7 cities (regions) in Tibet were included in this study by convenient sampling from November to December in 2019, self-designed questionnaires were used to collect active nurses. Results: Among the 1117 nurses in this survey, 35.0% of them had not received the education of VTE prevention. Except for surgery department, the utilization rate of VTE risk assessment scale in other departments was less than 50%. Conclusion: At present, there is a lack of standardized education of VTE prevention and risk assessment of VTE for nurses in Tibet. Clinical nurses have insufficient understanding of the harm of VTE in inpatients and the importance of thrombotic prevention. It is urgent to improve the standardized education program of prevention and control of VTE, standardize nursing behavior, and establish the risk assessment and preventive measures of VTE for inpatients.

Objective: To explore whether the intervention strategy of Promoting Resilience in Stress Management can effectively improve the level of psychosocial adaptation in children with malignant tumors. Methods: From July 2020 to December 2020, 100 children with malignant tumors were selected and randomly divided into the experimental group and control group with 50 cases in each group. The experimental group was given intervention of Promoting Resilience in Stress Management, while the control group was given the routine psychological care. The psychological resilience and psychosocial adaptation of the two groups were evaluated with the 10-item Connor-Davidson Resilience Scale, 21-item Depression-Anxiety-Stress Scale and Conners' Questionnaire for Children's Behavioral Problems before the intervention, the fourth week of intervention and the eighth week of intervention. Results: At the eighth week of intervention, the scores of psychological resilience, negative emotion and behavior problems between the control group and the experimental group were significantly different (P<0.05). Conclusion: The intervention of Promoting Resilience in Stress Management can effectively improve the level of psychological resilience and psychosocial adaptation in children with malignant tumors.

Objective: To explore the effects of multidisciplinary collaboration combined with the critical value management mode on the prevention and control of Multi-Drug Resistant Organisms (MDROs) infection in the liver transplantation ward. Methods: Patients in the liver transplantation ward of a hospital from July 2017 to July 2020 were selected as the research subjects. MDT combined with the critical value management mode was applied to the prevention and control of MDROs infection from July 2018, and continuous quality improvement was carried out one year later. Indicators including the infection rate of MDROs, the implementation rate of isolation measures and the omission rate of report of inpatients were compared before and after the implementation, and after the application of continuous quality improvement. Results: The infection rate of MDROs before the implementation, after the implementation and after continuous quality improvement was 2.88%, 1.84% and 1.39%, respectively, showing a decreasing trend with statistically significant differences (P<0.05). The overall implementation rate of MDROs prevention and control measures increased (P<0.001), and indicators like the compliance and accuracy rate of hand hygiene, the compliance of wearing isolation clothes, the compliance of reporting outside examination information and so on were significantly improved, with statistical significance (P<0.001). The omission rate of MDROs infection was 28.57%, 16.00% and 4.76% before the implementation, after the implementation and after continuous quality improvement, respectively, with statistically significant differences (P<0.05). Conclusion: The establishment of a multidisciplinary infection management team, the inclusion of the critical value management mode, and the strengthening of the two-level supervision between hospital and department can significantly improve the implementation rate of multi-drug resistant bacteria isolation measures in the liver transplantation ward to effectively reduce the infection rate and the omission rate of MDROs cases.

Objective: To explore the basic prevention measures of Venous Thromboembolism (VTE) for surgical patients. Methods: Totally 595 surgical inpatients were observed within 24 hours of admission, 2 days before operation, 1 day before operation, the day of operation, 1 day after operation and 2 days after operation. Results: The implementation rate of VTE basic prevention measures was various at each time during hospitalization, and showed an increasing trend after admission. The implementation rates of "health education for prevention of thrombosis" "health lifestyle suggestion" and "exercise guidance" on the operation day were 96.64%, 79.83% and 96.81% respectively, which were higher than those at the first day before operation (P<0.001). The rate of basic prevention measures of VTE was low in patients before operation, and some nurses' cognition of VTE risk was not accurate. Conclusion: The overall implementation rate of basic prevention measures of VTE led by nurses is relatively high, but it still needs to be improved. It is necessary to formulate basic prevention strategies suitable for surgical patients, and establish long-term mechanism to prevent the VTE in patients. The implementation time, contents and evaluation way of basic prevention of VTE should be standardized to guide clinical work.

Objective: To summarize the relevant evidence of eye care for ICU patients, aiming to improve the eye care management and preventive intervention measures for ICU patients, and to provide reference for clinical medical staff. Methods: We searched clinical decision-making, guideline websites, professional association websites, and evidence-based resources for guidelines, clinical decision-making, evidence summary, and systematic reviews on ICU patient eye care. After methodological quality evaluation, the evidence was extracted and summarized based on the themes. Results: A total of 13 articles were included, and 15 items of evidence were finally formed through reading, extraction, and classification, including five themes, eye care standards and management, assessment, specific problem nursing plans, consultation, and education. Conclusion: Medical staff should pay attention to eye care for ICU patients. They are supposed to reduce the incidence of ocular complication in ICU patients according to evidence-based nursing standards and selecting evidence based on actual situation. In order to improve the patients' quality of life and promote the transformation of evidence-based knowledge into practice.

Objective: To systematically evaluate the impact of spouse's cognitive intervention on the mental state and quality of life of breast cancer patients. Methods: We searched Cochrane Library, Embase, PubMed, OVID, PQDT, CNKI, CBM, VIP and Wanfang Data to collect Randomized Controlled Trials (RCTs) on the impact of spouse's cognitive intervention on mental state and quality of life of breast cancer patients from the establishment of these databases to February 20, 2021. Two researchers screened the literature independently according to the inclusion and exclusion criteria, extracted the data and evaluated the methodological quality. Meta-analysis was conducted using RevMan 5.3. Results: Sixteen RCTs involving 1 716 patients were included. The results of the Meta-analysis indicated that the spouse's cognitive intervention could improve the anxiety [SMD=-1.01, 95%CI (-1.55, -0.47), P<0.001], depression [SMD=-0.99, 95%CI (-1.48, -0.51), P<0.001], and the quality of life [SMD=1.91, 95%CI (1.09, 2.73), P<0.001] of breast cancer patients. Conclusion: Spouse's cognitive intervention can improve the anxiety, depression and the quality of life of breast cancer patients. More attention should be paid to the positive effect of spouse's cognitive intervention on patients, structured and operable intervention programs should be developed, and more high-quality studies should be carried out.

Objective: To carry out a systematic evaluation and integration of the experience of the medical staff who offered support and service to the fight against COVID-19 outside of their own hometowns. Methods: The Cochrane Library, Web of Science, CNKI, Wanfang Data and other domestic and foreign databases were searched for Meta-synthesis of literatures published from January 1, 2020 to December 5, 2020 on the real experience of the front-line medical personnel to combat COVID-19 in another place. Results: A total of 16 literatures were included, and 31 findings were extracted, which were divided into 7 new categories and summarized into 3 integrated results: ①Medical staff generating positive feelings through receiving external support from the society, family members and colleagues;②Medical staff having negative experience relating to external pressure, work disturbance and a bad physical and mental state; ③Various suggestions and reflections on the work of medical staff against COVID-19. Conclusion: Although the medical staff engaging in the fight against COVID-19 in other places have acquired some positive feelings during the process, more attention should be attached to advice and reflections on coping with their negative experience in the future to ensure the physical and mental health of medical staff and the quality of patient care, and to improve the decision-making system in responsing to public health emergencies by establishing a scientific and efficient emergency management system.

Objective: To systematically analyze the effects of preoperative oral carbohydrates in children before selective surgery. Methods: Articles on the topic of preoperative oral carbohydrates in children before selective surgery with RCT design were searched from PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP and WanFang Database. All the data were Meta-analyzed. Results: Seven RCTs were included, with 700 participants, and 420 participants in the experiment group and 280 in the control group. The Meta-analysis showed the carbohydrate drinking before selective surgery for children did not affect the preoperative residual gastric volume and the postoperative blood glucose, and it also did not decrease the pH of gastric fluid, while it could improve the intraoperative sedation level, reduce the incidence of postoperative nausea and vomiting, and improve the insulin level. Conclusion: Preoperative oral carbohydrate preoperative diet for children was relatively safety and feasibility, but the evidence is insufficient. There were differences in sample size, intervention methods, time and frequency of each study, and more evidence is needed for its popularize in pediatrics clinical practice.

Sir Run Run Shaw Hospital is one of the first hospitals in mainland China that set up Advanced Practice Nurses (APN). Over the past 20 years, the hospital has experienced the introduction, implementation and evaluation of advanced nurse roles. Through reviewing this process, this article sorted out the Advanced Practice Nurses primary criteria, core competencies, job responsibilities and professional development direction based on China's national conditions, and summarized management experience of Advanced Practice Nurses. The APN had provided direct nursing practice, taken care of specialist consultation and discussion of MDT cases, performed education training and supervision, participated multi-disciplinary team of diagnosis and treatment work, promoted nursing scientific research and technology innovation and participated in quality control and discipline development practice. It is concluded that the advanced practice nurses play positive roles on patients, nurses, organization and medical system. With the vigorous development of higher nursing education, the number of nursing graduate students in China is increasing day by day. In the future, we can try to combine professional degree graduate students with APN. It is expected to develop the effectiveness of nursing talents, and promote the healthy development of China's health care system.

Objective: To investigate and analyze the status of nurse practice environment in tertiary general hospitals in Tibet Autonomous Region, and provide references for improving the practice environment of nurses. Methods: A questionnaire survey was conducted among 953 nurses in seven tertiary general hospitals of seven prefectures and cities in Tibet Autonomous Region. The general data and nurse practice environment were collected using a self-developed questionnaire and nurse practice environment assessment scale. Results: The total mean score of the nurses' practice environment was 73.04±23.38, presented higher score in "doctors and nurses cooperation", and lower scores in "nurses' participation in hospital practice". Multiple linear regression analysis showed that educational background and professional title were the influencing factors of nurses' practice environment evaluation (P<0.05). Conclusion: The practice environment of nurses in the tertiary general hospitals of the Tibet Autonomous Region is at a relatively low level. For improving the practice environment of nurses, the focus lies on the nurses' involvement in hospital affairs, and the improvement of remuneration.

Objective: To identify the status quo of young nurses' professional growth and the influencing factors in tertiary Grade A hospitals in China, so as to provide references for young nurses' professional development. Methods: Three-stage randomized cluster sample of 11420 young nurses from 10 tertiary grade A hospitals in 10 provinces were recruited. They were surveyed by using the Professional Growth Scale, General Self-Efficacy Scale, Work-family Support Scale, and Organizational Commitment Questionnaire. Results: The average career growth score of young nurses was 3.41±0.87. The highest score was the development of professional competence (4.02±0.87), and the lowest one was the growth of organizational returns (2.93±1.05). Work-family support, organizational commitment, self-efficacy, the extent to which nurses were interested in nursing, years of work experience, average monthly income, whether had an administrative job title, whether the only-child in the family, form of employment, and whether a specialized nurse were the main factors that affected the professional growth of young nurses. Conclusion: The professional growth of young nurses is still unsatisfactory. Medical institutions could apply strategies such as creating a good organizational atmosphere, implementing family-supporting supervisory behaviors, and helping nurses form strategies to cope with adversity, to improve nurses' professional interests, self-efficacy, family-work support, organizational commitment, and to promote better professional growth for young nurses.

Comprehensive and effective occupational protection can reduce the occupational exposure risk of medical staff during mechanical ventilation treatment for patients with respiratory infectious diseases. Based on the review of relevant domestic and foreign literature and the work experience of hospital infection prevention and control, this study summarized three occupational exposure protection suggestions in terms of scientific management of the ward environment, strict protection of the entire process of mechanical ventilation treatment for critically ill patients, and optimization of human resource management, with a view to standardizing the medical behaviors of medical staff when providing mechanical ventilation treatment services for severely ill patients with respiratory infectious diseases, strengthening the protection awareness of medical staff, and improving the level of medical protection.

Objective: To explore the relationship between feedback seeking behavior and transition shocks of new nurses. Methods: Totally 99 standardized training nurses were investigated using Feedback Seeking Behavior Questionnaire, Transition Shocks of New Nurses Questionnaire and Perceived Social Support Questionnaire. Hierarchical regression analysis was used to analyze the moderating effect of perceived social support between feedback seeking behavior and transition shocks of new nurses. Results: The score of transition shocks of new nurses was 72.01±20.28, with the highest dimension was physical health. The score of feedback seeking behavior was 51.92±12.93, and perceived social support was 67.45±11.11. The results of Pearson correlation analysis showed that feedback seeking behavior (r=-0.308, P=0.002) and perceived social support (r=-0.594, P<0.001) were significantly related to transition shocks of new nurses. Hierarchical regression analysis showed the association between feedback seeking behavior and Transition shocks of new nurses was moderated by perceived social support (β=-0.060, P<0.01). Conclusion: The association between feedback seeking behavior and transition shocks of new nurses is moderated by perceived social support. The perceived social support can enhance the link between feedback seeking behavior and transition shocks of new nurses.

Objective: To establish and practice the pattern of cardiovascular nursing and technology and training management in order to improve the professional skills of clinical nurses and technicians, and build up the foundation for promoting the development of cardiovascular specialty nurses. Methods: By analyzing the data of training regarding 1106 nurses who studied in the Cardiovascular Nursing and Technology Training Center of China Cardiovascular Association from November 2018 to November 2019, experiences concering the setting of online and offline courses based on the competency-oriented training management pattern, including the normative training contents, the organizational processes, the examination and assessment methods of the courses, and the improvement programs were summarized. Results: Through the implementation of the management pattern of cardiovascular disease nursing and technical training to improve their post competency, nurses had done quite well in the theory and skills assessment, and their satisfaction of training standards, training methods, training expected objectives and professional skills training in each base reached a high score of more than 90%. Conclusion: The competency-oriented training management pattern is valid and feasible in clinical practice.

Objective: To construct and preliminarily implement an information system for the whole-process cancer pain management. Methods: Based on the contents of guidelines, consensus and needs of hospital cancer pain management, we developed an information system which was dedicated to the whole-process management of patients with cancer pain. Data on the whole-process cancer pain management based on the information system from June to November 2020 was reviewed and analyzed. Results: Ninety-three patients received a 4-week follow-up intervention by using the information system. The basic pain intensity indicated by the score of Numerical Rating Scale (NRS) decreased from 4(2, 5) in first week to 2(0, 3) in the fifth week (P<0.05); the score of the pain management satisfactory increased from 7.08±2.31 in the first week to 8.60±1.87 in the fifth week (P<0.05). Conclusion: The information system for cancer pain management provides an information path for the implementation of inpatient-outpatient-home whole-process management model for patients with cancer pain. It helps to understand the current situation and changes of pain management outcomes of patients with cancer pain in real time. It also provides scientific basis for the evaluation and improvement of cancer pain management quality in hospitals.

Objective: To explore the application effects of 8S management mode in the whole flow management of ventilator pipeline in Central Sterile Supply Department. Methods: Totally 36,894 sets of ventilator pipes and fittings used from January 2019 to June 2020 were set as the 8S management experimental group. A total of 21,672 sets of ventilator pipes that were routinely managed from January 2018 to December 2018 were set as the control group. The breakage rate, error rate, qualified rate of cleaning quality and clinical satisfaction rate were compared between the experimental group and the control group. Results: The breakage rates of the experimental group and the control group were 1.90% and 5.40%, respectively. The difference between the two groups was statistically significant (P<0.05). The error rates of the experimental group and the control group were 0.80% and 4.00%, respectively. The difference between the two groups was statistically significant (P<0.05). The quality qualified rates of cleaning of experimental group and control group were 99.82% and 94.59%, respectively. The difference between the two groups was statistically significant (P<0.05). The clinical satisfaction of experimental group and control group was 99.17% and 97.20%, respectively. The difference between the two groups was statistically significant (P<0.05). Conclusion: In the whole process of the ventilator pipeline treatment, the 8S management mode can significantly improve the cleaning quality, reduce the error and damage rates of items, improve the clinical satisfaction.

The current status of diabetes foot risk pre-control management in foreign countries was analyzed from the perspectives of risk classification, three-level pre-control network, professional and cooperative care team, and health education of patients and caregivers. It is suggested that the integrated management of "risk screening-risk grading-risk pre-control and follow-up recommendation", multidisciplinary care under the linkage of hospital-community, continuous improvement of patients' self-management ability and personalized pre-control measures of diabetic foot risk should be strengthened in diabetic foot risk pre-control management in China.

This paper introduces the related concepts, theoretical models, assessment tools and the current status of the quality of death for terminal cancer patients, and summarizes its influencing factors from four dimensions including age, the number of days in hospital, bereavement experience, etc. It hopes to provide references for future researchs and improve the quality of death for terminal cancer patients in China.

Objective: To describe the characteristics of marital adjustment among infertile couples, and analyze the relationship between sexual pressure and marital adjustment, therefore provide references for developing interventional strategies to improve psychological outcomes in infertile couples. Methods: Between December 2019 and June 2020, following convenient sampling, 312 infertile couples admitted to the reproductive center were selected for a cross-sectional survey using the simplified Chinese version of Locke-Wollance Marital Adjustment Test (LWMAT) and the Sexual Concern Scales (SCS). The relationship of the mutual influence of marital adjustment and sexual concerns of infertile couples was analyzed based on the Actor-Partner Interdependence Model. Results: Scores of sexual concerns in both wives and husbands were significantly related to their own marital adjustment (β=-0.51, -0.43, all P<0.001), with the main effect being significant. In terms of object effect, sexual concerns from wives had a significant effect on men's marital adjustment (β=-0.15, P=0.006), while husband's sexual concerns had no statistical significance on their wives' marital adjustment (P>0.05). Conclusions: Infertile couples experienced low level of marital adjustment. Our results suggests that marital adjustment of infertile couples is significantly influenced by individual and object sexual concerns. Therefore, in order to improve the psychological adjustment outcomes in infertile couples, it is of great importance to evaluate both partners from a systematic approach and focus on the actor-partner effect of these couples.

With the development of positive psychology, scholars pay more and more attention to patients' family resilience, which contributes to understanding family adversities and family adjustment from the priority perspective. Family, which exists in a complex ecosystem, could be influenced by multilevel factors. Studies showed that some factors affected family resilience, which were disease severity, posttraumatic growth, individual resilience, caregiver burden, social support and so on. Attaching importance to culture, identifying adjustment variables, and paying more attention to dynamic do good to find out influencing factors, which provide references for clinical practice.

We aim to introduce the Respecting Choices model of Advance Care Planning in the United States including the key roles, education and certification of roles, implementation forms and contents, the status quo of application and popularization in details. This paper could provide references for the development of community Advance Care Planning model under the cultural background in China, so as to ensure that individuals can obtain the care in line with their own preferences and improve their quality of life.

Learning from Australia's palliative care policy and its successful experience in its implementation, with a view to promoting the development of China's hospice care, and meeting the public's expectations for death. The study analyzes the characteristics of Australia's palliative care policy based on the "six elements of the health system": unify palliative care service standards; adopt multiple funding methods; build a palliative care service framework; ensure the balance of service supply and demand in various regions; reduce the proportion of self-financed drugs and rich information acquisition ways. Combining with China's actual situation, the following suggestions are made: formulate a national hospice care service plan, unify service standards; clarify the positioning of hospice care services, and promote capital investment; implement graded hospice care services to achieve fairness and accessibility of services; establish an independent discipline of hospice care; base on the three-level hospice care service system to solve the difficulty of special medication at the grassroots level; build a hospice care information sharing platform and formulate a pre-established care plan.

This review summarized the concepts, currently available assessment tools, existing evidence, influencing factors and interventional strategies related to moral courage among nurses. The purpose of this review was aimed to emphasize the importance of study on moral courage among nurses, therefore to provide references for future research and inform clinical practice.