Resistiveness to care in dementia patients is a psycho-behavioral reaction closely related to caregiving activities. Understanding this behavior and developing corresponding intervention measures is of great practical significance for dementia care. This paper systematically introduces the concept and behaviors of resistiveness to care, its causes and consequences, commonly used assessment tools and intervention strategies, to provide reference for long-term care of dementia patients.

Objective: To develop an expressive art therapy for elderly patients with mild to moderate dementia, in order to reduce their mental and behavioral symptoms and alleviate cognitive decline. Methods: Based on the preliminary study of the research group, the expressive art therapy for elderly patients with mild to moderate dementia was developed by focus group interview and literature review, the final intervention plan was revised through experts meeting. Results: Totally 10 experts were included, the expert authority coefficient was 0.89. The final expressive art therapy for elderly patients with mild to moderate dementia included plan content, process, and intervention elements. Conclusion: The expressive art therapy scheme is scientific, rigorous and targeted, suitable for elderly patients with mild to moderate dementia, which can provide a reference for non-pharmacological intervention for elderly patients with mild to moderate dementia.

Objective: To analyze the effect of brain health education combined with motivational interviewing on dementia knowledge, belief and lifestyle of community residents at risk of dementia, and to provide practical basis for the primary prevention of dementia in community. Methods: From March 2021 to February 2022, a total of 83 residents at risk of dementia who participated in free physical examination and established health management records in a community health service center in Chongqing were selected as research objects by convenient sampling method. They were divided into intervention group (n=42) and control group (n=41) by random number table method. The control group received community routine services, and the intervention group received brain health education combined with motivational interviewing intervention on the basis of the control group, the intervention time was 3 months. Knowledge, belief and lifestyle level of dementia prevention, body mass index and waist-to-hip ratio were measured at T0 (before the intervention group received the intervention), T1 (within one week after the intervention) and T2 (3 months after the intervention), respectively. Results: After intervention, the levels of knowledge, belief and lifestyle of dementia prevention at T1 and T2 in the intervention group were significantly higher than those in the control group, with statistical significance (all P<0.05), while there were no significant differences in body mass index and waist-to-hip ratio between the two groups at T1 and T2 (all P>0.05). Conclusion: The brain health education combined with motivational interviewing intervention developed in this study can effectively improve the knowledge, belief and lifestyle of community residents at risk of dementia.

Objective: To develope the care technology program for patients with moderate to severe dementia, and to offer practical guidance for dementia care. Methods: A total of 35 experts were involved in two rounds of expert consultation using the Delphi method. The first draft of the care technology program which was developed based on literature review and service practice, was assessed for importance, and experts provided specific modifications and supplementary suggestions. Results: The response rates for the two rounds of expert consultation were both 91.43%, authoritative coefficients were 0.906 and 0.942, coordination coefficients were 0.096 and 0.065, respectively. Following the two rounds of expert consultation, five care elements, including personalized psychosocial support, drug management, education, age-related physical disease management, and living environment arrangement, were determined as primary indicators. These elements received a mean importance assignment of 4.41-4.75, with a coefficient of variation of 0.093-0.181. Additionally, there were 89 subordinating technical content with a mean importance assignment of 3.84-4.88 and a coefficient of variation of 0.070-0.259. Specifically, there were 37 care technologies for patients with moderate dementia and 39 care technologies for their caregivers. For severe dementia patients, there were 4 additive items, and 9 additive items for their caregivers. Conclusion: The care technology program covers five core care elements, can provide scientific guidance for high-quality care practice for patients with moderate to severe dementia. The expert opinions are coordinated and centralized, and each item of the program has been evaluated to have a good level of importance.

Objective: To investigate the current status and influencing factors of palliative care needs among the elderly with chronic diseases in community settings. Methods: This cross-sectional study enrolled a total of 302 elderly patients with chronic diseases by convenience sampling from February 2022 to March 2022 in Changsha. The general data questionnaire and the Chinese version of palliative care screening tool were used for investigation. Logistic regression were used to analyze the influencing factors. Results: The results showed that 17.9% of the participants were in need of palliative care. According to logistic regression analysis, longer illness duration (OR=1.461, 95%CI: 1.017-2.099), lower self-care ability (OR=3.265, 95%CI: 1.189-8.964), and poorer self-rated health (OR=3.622, 95%CI: 1.871-7.009) were independent risk factors for palliative care needs. Conclusion: The palliative care needs of the elderly with chronic diseases is lower than the middle level, and the main influencing factors are their illness duration, self-care ability and self-rated health. Primary health workers can screen the unmet palliative care needs for the elderly with chronic diseases in the community, and provide timely palliative care services to improve their life quality.

Objective: To develop a Chinese version of the Communication-Burden Scale (COM-B) for family caregivers of aphasia patients after stroke, and to test its reliability and validity. Methods: According to FACIT translation model, the COM-B for family caregivers of aphasia patients after stroke was modified for cultural adaptation. Totally 434 family caregivers of aphasia patients were investigated with the convenient sampling method. Two weeks later, 32 caregivers were randomly selected for test-retest reliability of the scale. Results: The Chinese version of the COM-B included 6 dimensions, 29 items. Exploratory factor analysis extracted a total of six common factors with a cumulative variance contribution of 57.206%. The confirmatory factor analysis showed that the chi square degree of freedom ratio was 1.776, the root mean square error of approximation was 0.061, the goodness of fit index was 0.820, and the adjusted goodness of fit index was 0.783. The model fitted well. Cronbach's α coefficient was 0.906. Cronbach's α coefficient of retest reliability was 0.910. Conclusion: The Chinese version of COM-B has good reliability and validity, and it can be used as an effective tool to assess the communication burden of family caregivers of aphasia patients after stroke.

Objective: To develop and verify an intelligent early warning model of pressure injury risk in inpatients, and provide reference for the risk management of pressure injury in inpatients. Methods: The pressure injury cases and non-pressure injury cases were selected in a tertiary hospital in Changsha city by convenient sampling method. The intelligent feature extraction of early warning indicators was performed by structured query statements, and the consistency test was carried out. Random forest Gini index combined with the good parsimonious prediction model was used to rank the importance of features. The machine learning algorithms were applied to develop prediction model and evaluate the model performance. Results: The Kappa consistency coefficient between intelligent feature extraction and manual extraction of the indicators were 0.639-1.000. The feature importance of random forest Gini index ranged from 0.005 to 0.220. The good parsimonious prediction model with prediction accuracy screened 12 early warning indicators, including physical restraint, mechanical ventilation, use of vasoactive drugs, disturbance of consciousness, edema, and old age and so on. After comparing the model performance of each prediction model, the one established by random forest was the best. Conclusion: This study developed an intelligent prediction model for pressure injury in inpatients based on healthcare information systems with good model performance. This prediction model is suitable for clinical application.

Objective: To carry out evidence-based nursing practice of limb management in Percutaneous Coronary Intervention (PCI) via the radial artery, and to formulate nursing quality review indicators, analyze barriers to explore action strategies. Methods: According to the evidence clinical transformation model proposed by the Evidence-based Nursing Center of Fudan University, an evidence-based team as established to carry out evidence summary through scenario analysis and formulate review indicators and have baseline reviews to analyze the obstacles and stimuli and figure out change strategies. Results: This study finally included 14 best evidences and developed 19 review indicators. In addition, this article also analyzed the obstacles and stimuli, and based on this, formulated reform strategies. Conclusion: At present, there is a certain gap between the evidence-based practice and clinical situations of limb management in PCI via the radial artery, so we should overcome obstacles, implement reform strategies to promote the effective application of the best evidences.

Objective: To develop a hierarchical training system for care of patients with Continuous Renal Replacement Therapy, so as to provide basis for standardizing the authorized management of nursing operations and ensuring nursing quality and safety. Methods: Based on the model of post competency, the hierarchical training program was developed through literature review, qualitative interview, and Delphi expert consultation. Results: A two-level training program was constructed. The primary training program included 3 first-level indicators, 10 second-level indicators, and 45 third-level indicators, with a total of 54 to 66 class hours. The advanced training program included 3 first-level indicators, 14 second-level indicators, and 40 third-level indicators, with a total of 60 to 68 class hours. Conclusion: This study established a hierarchical training system for care of patients with Continuous Renal Replacement Therapy. The system has good scientific and clinical application value, and can provide guidance for the authorization management and safe application of the Continuous Renal Replacement Therapy practice.

Objective: We systematically evaluate the risk prediction models for Chemotherapy-Induced Oral Mucositis in order to provide reference for clinical staff to select appropriate prediction model or develop a new one. Methods: The studies about risk prediction models for Chemotherapy-Induced Oral Mucositis were searched. Two researchers independently screened the literature, extracted the data, and evaluated the bias risk as well as applicability of the included study. Results: A total of 8 studies including 12 models were identified. Among them, 11 models reported the area under the ROC curve which was 0.61-0.97, and 5 models reported the calibration. Only one model was externally validated. Predictors reported repeatedly of the models were age, chemo-therapy regimens, times of chemotherapy, body mass index, radiation dose, oral hygiene and smoking history. All included studies showed good applicability, but had high risk of bias. Conclusion: The risk prediction models for Chemotherapy-Induced Oral Mucositis have good discrimination and applicability, but the risk of bias is high. And the predictive factors of each model are different. In the future, it is necessary to adjust the existing models or develop more targeted, low bias risk prediction models according to different tumor types under the guidance of methodological statements, and conduct internal and external validation.

Objective: To search and summarize the evidence for smoke prevention measures for medical staff during operation, and to provide references for clinical practice. Methods: Based on the evidence-based "6S" model, relevant databases and official websites were searched from January 1, 2012, to September 30, 2022. Three researchers conducted the quality evaluation and evidence extraction for all the data. The 2016 version of the JBI evidence classification and recommendation level system was used to classify the included evidence. Results: A total of 14 studies were included, including 5 guidelines, 3 systematic reviews, 1 randomized controlled trial, 3 quasi-experiments, and 2 cross-sectional studies, which were summarized into 26 items of evidence on 5 topics: creating a smoke-free environment, smoke extraction and filtration, personal protection, personnel education, the development of appropriate policies. Conclusion: The summarized evidence can be used to improve the scientific understanding of intra-operative surgical smoke for medical personnel, improve the management of occupational protection, and provide evidence-based basis for the prevention of surgical smoke.

Objective: To apply the best evidence of prevention and management of perioperative Venous Thromboembolism to clinical practice and to evaluate its effect. Methods: According to the evidence-based clinical transformation model of Fudan University Evidence-based Nursing Center, and to formulate strategies based on the current clinical situation. From August 2021 to May 2022, 215 patients and 323 nurses working in 13 surgical wards of a tertiary grade A hospital in Beijing were selected as subjects using convenience sampling method. The cognitive level of knowledge about Venous Thromboembolism and the implementation rate of review criteria were compared between nurses and patients before and after intervention. Results: The scores of nurses' knowledge about Venous Thromboembolism before and after intervention were 79.13±13.97 and 87.37±12.91, and the difference was statistically significant (t=7.571, P<0.05). Before and after intervention, the scores of patients' knowledge related to Venous Thromboembolism were 4.55±2.11 and 6.52±1.75, and the difference was statistically significant (t=-7.456, P<0.05). The implementation rate of all the indicators after intervention was higher than that before intervention, and the difference was statistically significant (P<0.05). Conclusion: The formulation and application of best practices can improve patients' awareness and self-management to prevent perioperative Venous Thromboembolism, enhance nurses' compliance with the implementation of the best evidences, and promote the continuous improvement of nursing quality.

Objective: To systematically review the experience of women with pregnancy-related low back pain, and to provide reference for perinatal management. Methods: A computer search was conducted in English and Chinese databases for qualitative research on experience of pregnancy-related low back pain during pregnancy. The search time was from the database establishment to November 2022. The quality evaluation was carried out by the quality evaluation standard of qualitative research of Joanna Briggs Institute (JBI), Australia (2016 edition), and the research results were summarized and integrated by the convergent integration method. Results: Totally 7 articles were included, 31 topics were extracted, and 9 categories were summarized. Three integrated findings were formed as follows: pain leads to increased pregnancy burden and negative emotional reaction, loss of control of life and social role, and seeking coping strategies and external environmental support actively. Conclusion: Medical staff should pay attention to the prevention and management of pregnancy related low back pain during pregnancy, formulate effective intervention measures, pay attention to the mental health of pregnant women, and encourage pregnant women to actively seek professional medical help and social support to relieve pregnancy-related low back pain and improve the quality of life during pregnancy.

Objective: To understand the current status of nurses' knowledge hiding, analyze the influencing factors of nurses' knowledge hiding behavior, and provide management enlightenment for reducing their knowledge hiding behavior, promoting knowledge circulation and improving nurses' knowledge sharing ability. Methods: From June 24 to July 1, 2021, 548 nurses from six hospitals in Guangzhou were investigated by general data questionnaire, knowledge-hidden behavior questionnaire, organizational trust questionnaire and organizational fairness scale. Results: The knowledge hiding score was 25.24±7.88. The results of multiple gradual regression analysis showed that 10 variables including gender, age, marital status, education, nursing age, specialized nurse, professional title, organizational fairness, system trust and organizational trust were influencing factors for the knowledge hiding behavior of nursing staff (P<0.05). Conclusion: Hospital managers should promote the organizational fairness of the unit, improve the organizational trust of nurses, reduce their knowledge hiding behavior, and promote their knowledge sharing ability and scientific research and innovation ability.

This paper reviews the application status of situational-based teaching method in disaster nursing teaching, and analyzes their development methods in combination with specific situation teaching techniques from the perspective of simulation situation, reasoning situation and imagination situation with the situation fidelity ranging from high to low to figure out how to combine situational-based teaching method with various disaster stages and how to improve the students' core competence of disaster nursing, aiming to provide references for the effective application of situational-based teaching method in disaster nursing teaching.

Nursing certification determines practical qualifications, ensures clinical quality, and provides reference for advanced nursing education. This article mainly focuses on the development of Nurse Practitioner certification in the United States, and summarizes the history of Nurse Practitioner certification, certification institutions, certification process and the development direction of research related to certification to provide a reference for Nurse Practitioner certification in China.

Objective: To explore the effect of head nurses' authentic leadership on nurses' intention to report negative events, and to examine the moderating roles of nurses' self-efficacy and job satisfaction. Methods: In September 2020, a questionnaire survey was conducted in 655 nurses from two tertiary grade A hospitals in Shenzhen. The authentic leadership scale, the self-efficacy scale, the job satisfaction scale and the intention to report negative event scale were used as measures. Descriptive analysis and multiple hierarchical regression analysis were employed for data analysis. The moderating effect diagram through simple slope method was drawn. Results: The Authentic leadership (β=0.349, P<0.001) had a positive effect on nurses' intention to report negative events. Self-efficacy (β=-0.146, P<0.001), job satisfaction (β=0.067, P<0.01) and their interaction (β=0.071, P<0.01) had moderating roles between authentic leadership and nurses' intention to report negative events. Conclusion: Authentic leadership had a positive effect on nurses' intention to report negative events. Self-efficacy and job satisfaction independently and jointly enhanced the above positive relationships.

Objective: To construct a medication safety management scheme for patients with chronic diseases in community based on middle-range theory, so as to provide reference for community medical staff. Methods: The prototype of the management scheme is constructed based on concept-theory-empirical framework of middle-range theory, and the core concepts and implementation paths were organized by expert meetings. Results: The expert authority coefficient was 0.858. The management scheme consisted of theoretical framework, empirical framework, and implementation table. The theoretical framework included four concepts: stimulus, response process, adaptation, and output. The empirical framework presented a chain-like visualization of the medication safety management map from the perspective of "traveler's map". A specific and operable implementation table was constructed under the guidance of the above framework, and the intervention was implemented by a combination of online and face-to-face way. Conclusion: This scheme can scientifically recognize, explain, and elaborate the relations between various concepts, and is a standard practice model with strong guidance and operability to manage medication safety for community medical staff.

Objective: To investigate the status and risk factors of the adverse airway events in pediatric patients in Post-Anesthesia Care Unit (PACU), and to improve the safety and quality of post anesthesia care. Methods: A retrospective analysis was conducted on the incidence and clinical manifestations of respiratory adverse events in 16 012 children transferred to PACU after general anesthesia from September 1st, 2021 to August 31st, 2022. Chi-Square analysis and multivariate logistic regression analysis were used to find the risk factors of adverse airway events in this population. Results: The overall incidence of airway adverse events was 0.6%, and atelectasis was the most common cause. After treatment, 93.3% of the children could recover without the need to improve the postoperative care level, while 6.7% of the children couldn't wean from ventilation and were unexpectedly transferred to the Intensive Care Unit. The incidence of adverse airway events in children with American Association of Anesthesiologists grade ≥Ⅲ, age ≤28 days, and thoracic surgery was significantly higher. Multivariate logistic regression revealed that the latter two were risk factors. Conclusion: The incidence of adverse airway events in pediatric patients in PACU is relatively high. Special attention should be given to the children with high risks.

Objective: To implement the goal-based management plan of multidisciplinary cooperation, and to provide reference for nurses to reduce the incidence of postoperative aspiration in patients with brain tumors. Methods: A goal-based management plan was applied in patients received brain tumor resection in a tertiary grade A specialist hospital from April to September 2022, including formulating improvement goals, plans, implementation and quality evaluation, and adjusting actions based on evaluation results with a duration of 6 months. Completion rate of measures and aspiration rate were collected. Results: The target was achieved at the end of the project, the incidence of aspiration was significantly reduced compared with the baseline (P<0.05), and the completion rate of 3 measures in the process was ≥95%, and the completion rate of 1 measure was≥90%. Conclusion: The implementation of multidisciplinary goal-based management plan can effectively reduce the incidence of aspiration in patients with brain tumors and promote the nursing quality.

Objective: We conducted this scoping review aiming to explore the acceptability of monitoring vital signs using smart wearable devices within hospital setting, providing clues for future practice. Methods: According to the Joanna Briggs Institute scoping review methodology framework, we searched domestic and foreign databases for technical acceptance studies on wearable vital signs monitoring, and summarized and analyzed related literature. Results: A total of 14 articles were included in this study. Our results showed that the acceptability level of monitoring vital signs using smart wearable technologies in hospital settings was medium and beyond. Several terminology and definitions were associated with technological acceptance, including 'acceptability', 'experience', 'usability' and 'satisfaction'. The research variables and tools were not uniform due to different theoretical frameworks in various studies. We found that influencing factors of technological acceptance included technology, personnel and environment. Conclusion: The definition and usage of intelligent wearable vital sign monitoring technology in hospital settings are inconsistent. Technical acceptance should be considered as a phased process in the future. It is also suggested to construct a unified definition and evaluation framework, to promote the comparison of research in this field and provide clues for clinical application.

Objective: To systematically evaluate the qualitative research on the experience of patients with Pelvic Floor Dysfunction participating in telemedicine, and provide evidence-based basis for the application and development of mobile health care in patients with Pelvic Floor Dysfunction. Methods: We searched for national and international qualitative studies on the experiences of patients with pelvic floor dysfunction using telemedicine. We used the JBI qualitative research quality evaluation tool to evaluate the quality of the literature, and the aggregated meta-integration method was used to integrate the literature. Results: A total of 7 studies were included, and 41 research results were summarized into 10 categories and 3 synthesized findings according to their similarities. The 3 findings are good experience, poor experience and the expectation of telemedicine in patients with Pelvic Floor Dysfunction. Conclusion: The experience of patients with Pelvic Floor Dysfunction participating in telemedicine is diversified. In future studies, it is necessary to increase the support of professionals to improve the trust of patients with Pelvic Floor Dysfunction in mobile medical treatment, enrich the forms of mobile medical treatment to ensure the adherence of using mobile medical care, and explore the effective mode of mobile medical care for patients with Pelvic Floor Dysfunction.

Objective: To systematically evaluate the nurses' experience with Automated Medication Dispensing System (AMDS), and to provide evidence for rational use of clinical drugs dispensing system. Methods: Qualitative studies on nurses' experience with the AMDS were retrieved from the establishment of the database to November 1, 2022. The quality of literature was evaluated by the Quality Evaluation Criteria of Evidence-Based Health Care Center (2016) of Joanna Briggs Institute in Australia, and the findings were summarized and integrated by the aggregation integration method. Results: A total of 11 studies were included, and 41 results were extracted, which were summarized into 9 categories on 3 integrated results: medication can be administered more quickly and safely with AMDS, more restrictions and challenges at work, and not enough training and learning in the use of AMDS. Conclusion: AMDS can improve nurses' management of medication, but the technology still needs to be improved, the training and management of nursing staff should be strengthened, and the communication between medical staff and system developers should be promoted to further play the advantages of AMDS.

Mobile health provides a new approach to disease health management. This paper introduces the concept of mobile health, expounds the application form and effects of mobile health in respiratory rehabilitation of patients with Chronic Respiratory Diseases, summarizes the shortcomings of existing research and prospects for the future, in order to provide reference and basis for the further development of respiratory rehabilitation mobile health services in China in the future.

Functional exercise is an important non drug treatment for improving inflammatory pain, physical disorders, and joint deformities in patients with Rheumatic Immune Diseases (RID). This paper introduces the application progress on Virtual Reality technology in rehabilitation nursing for patients with RID, focusing on the application methods, evaluation, advantages and disadvantages of Virtual Reality technology, so as to provide reference for exploring the Virtual Reality technology for rehabilitation process for patients with RID that matches the current situation in China.

Objective: To introduce the development of multi-site practice of nurses in the United States, the United Kingdom, Australia and Japan, and to provide suggestions based on the present situation in China. Methods: The data were obtained through literature investigation and expert consultation, and comparative method was used to systematically compare the main features, similarities, and differences of multi-site practice of nurses in different countries. Results: There are both differences and commonalities in the concept, development background, legal protection, practice authority, insurance support, safety regulation, and practice mode of multi-site practice of nurses in different countries. Conclusion: It is necessary to improve the legal policies and management system related to multi-site practice of nurses in China on the basis of learning from international experience, so as to promote the further promotion and implementation of multi-site practice of nurses.

Objective: To explore the multiple mediating effects of self-efficacy and social support in the relationships of financial toxicity and quality of life among patients with esophageal cancer. Methods: A total of 452 patients with esophageal cancer from National Cancer Center were selected by convenience sampling. A self-designed sociodemographic questionnaire, the Comprehensive Scores for Financial Toxicity Based on the Patient-Reported Outcome Measures (COST-PORM), the Social Support Rating Scale (SSRS), the Strategies Used by People to Promote Health (SUPPH), and the Functional Assessment of Cancer Therapy-G (FACT-G) were utilized for survey. Results: The patients scored (20.68±7.06) on financial toxicity, (38.20±7.89) on social support, (85.01±14.78) on self-efficacy, and (52.08±11.34) on quality of life. The indirect effect of financial toxicity on quality of life was identified, and the total indirect effect value was 0.112 (χ2/df=1.988, CFI=0.928, IFI=0.914, RMSEA=0.038). Self-efficacy and social support accounted for 43.85% and 14.60% of the total indirect effect, respectively. The chain-mediating effect of self-efficacy and social support on the relationship between financial toxicity and quality of life accounted for 6.0% of the total indirect effect. Conclusion: Financial toxicity not only directly affected patients' quality of life, but also indirectly affected patients' quality of life through self-efficacy, social support, and its chain mediating effect.

Premature infants are unable to adapt to the multiple stimuli of external environment because their cranial nerves and important organs are not yet mature, which leads to subsequent developmental disorders. Studies have shown that the implementation of developmental care theory can promote nervous system development in premature infants. Based on the proposal and content of developmental care theory, this paper reviews previous research to demonstrate the clinical effectiveness of developmental care and developmental supportive care interventions in promoting premature infants' neurodevelopmental outcomes, so as to promote the practice of developmental care theory in premature infants and provide guidance for future research.

Cancer Clinical trials are an essential part of advancing oncology treatments and disciplines, where informed consent is a critical element in protecting the rights of participants and facilitating the smooth conduct of clinical trials. However, the quality of informed consent of domestic clinical trial participants is often neglected at present. In this article, we review the progress of domestic and international research on the concept of informed consent in cancer clinical trials, the tools for assessing the quality of informed consent, the current situation, and the influencing factors, in order to draw the attention of healthcare professionals to the quality of informed consent of subjects in cancer clinical trials and to provide a reference for further improving the quality of cancer clinical trials and conducting related research.

Post-Thrombotic Syndrome is a long-term chronic complication after Deep Vein Thrombosis, which seriously affects the prognosis and quality of life of patients. This paper reviewed the development process, basic information, and predictive performance of the risk prediction models of Post-Thrombotic Syndrome in patients with Deep Vein Thrombosis. Besides, the paper summarized the current research status of Post-Thrombotic Syndrome aiming to provide references for the development and application of prediction model in China.