Objective: To explore the relationship between sleep quality, psychological status, and symptom severity in patients with atrial fibrillation, and to provide evidence for symptom management in these patients. Methods: A total of 208 hospitalized patients with atrial fibrillation were selected from the cardiology department. Data were collected using a general information questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Mental Health Inventory-5 (MHI-5), and the Atrial Fibrillation Severity Scale (AFSS). Mediation effects were analyzed using AMOS 23.0, with hypothesis models estimated by maximum likelihood and tested for significance through Bootstrap. Results: The mean PSQI score was 8.76± 3.98, the mean MHI-5 score was 73.29±16.24, and the mean symptom severity score was 9.06±4.81. Sleep quality scores were positively correlated with symptom severity ( r=0.223, P<0.01), while negatively correlated with psychological status ( r=-0.221, P<0.01). Psychological status was negatively correlated with symptom severity ( r=-0.272, P<0.01). The direct effect of sleep quality on psychological status was-0.22 (-0.38,-0.05), the direct effect of psychological status on symptom severity was-0.28 (-0.45,-0.12), and the indirect effect of sleep quality on symptom severity was 0.06 (0.02, 0.14). Conclusion: Psychological status fully mediates the relationship between sleep quality and symptom severity in patients with atrial fibrillation. Symptom management strategies for atrial fibrillation should incorporate sleep management and psychological care to reduce the impact of symptoms and enhance quality of life.

 Objective: To investigate the current status of perceived stress in patients with atrial fibrillation and analyze its influencing factors. Methods: A cross -sectional study of 297 patients with atrial fibrillation was conducted using a convenience sampling method. General information questionnaire, the Pittsburgh Sleep Quality Index, the Social Support Rating Scale, and the Chinese version of the Perceived Stress Scale were used in the investigation. Factors influencing perceptual stress in patients with atrial fibrillation were analyzed using univariate and multiple linear regression. Results: The score of the perceived stress in patients with atrial fibrillation was 23.56±6.85, and 26.2% of patients with atrial fibrillation had perceived stress scores greater than 28 points. Multiple linear regression analysis showed that age, average monthly income, atrial fibrillation symptom grade, and sleep quality were influencing factors of perceived stress in patients with atrial fibrillation ( P<0.05). Conclusion: Perceived stress in patients with atrial fibrillation is higher in patients with age >60 years, low average monthly income, severe atrial fibrillation symptoms and poor sleep quality. Reducing symptom burden and improving sleep quality can help to improve perception and evaluation of stressful events and improve stress management skills, so as to reduce stress levels.

Objective: To investigate the current status of health-related quality of life (HRQoL) in patients with atrial fibrillation (AF) and analyze its influencing factors. Methods: A total of 283 patients with atrial fibrillation were included by convenience sampling and investigated with the general information questionnaire, European quality of life 5 dimensions (EQ-5D) scale, FRAIL scale, generalized anxiety disorder self-rating scale, social network scale short form, International Physical Activity questionnaire short form. Univariate analysis and multivariate Tobit regression model were used to analyze the influencing factors of patients′ quality of life. Results: Patients with atrial fibrillation had the most prominent problems in the dimensions of pain/discomfort and anxiety/depression, and the health utility value was 0.869 (0.783, 1.000). The type of atrial fibrillation, cardiac function classification, frailty and anxiety were the influencing factors of HRQoL ( P<0.05). Conclusion: The quality of life of patients with atrial fibrillation needs to be further improved, and there are many influencing factors which can be intervened. It is suggested that medical staff should formulate targeted intervention plans to improve the existing problems and improve the quality of life of patients.

Objective: To explore the relationship and internal mechanism of self-efficacy, readiness for hospital discharge and Internet medical treatment willingness. Methods: A total of 307 patients were selected from a third-class hospital in Tianjin on the day before discharge. Self-efficacy level, readiness for hospital discharge and willingness to adopt“Internet + nursing service” of the patients were investigated by general information questionnaire, readiness for hospital discharge scale, general self-efficacy scale and willingness to adopt “Internet + nursing service” questionnaire. Data were statistically analyzed using SPSS 21.0 and AMOS 21.0. Results: There was a positive correlation between patients’ discharge readiness, self-efficacy and willingness to adopt “Internet + nursing service”( P<0.001). Discharge readiness could not only directly affect patients’ willingness to adopt “Internet + nursing services”, but also indirectly affect the willingness to adopt“Internet + nursing services” through self-efficacy. Conclusion: Self-efficacy plays an intermediary role between middle-aged and elderly patients’ readiness for hospital discharge and willingness to“Internet + nursing service”. Managers should pay full attention to improve the self-efficacy level of such people and enhance their willingness to seek medical treatment on the Internet.

Objective: To explore the effect of cosmetic interventions on patients with gynecologic tumors undergoing chemotherapy. Methods: A total of 114 patients with gynecologic tumors undergoing chemotherapy were included by convenient sampling and were divided into the control group and the observation group according to the order of hospitalization time. The control group received routine nursing and knowledge education, and the observation group was given cosmetic intervention on the basis of routine nursing. Repeated measures analysis of variance was used to compare the scores of anxiety, self-esteem levels and body image between the two groups at multiple time points. Results:There was no significant difference in the anxiety scores between the two groups during the first chemotherapy( P>0.05); after the third chemotherapy and all chemotherapy, the anxiety scores in the observation group were lower than those in the control group, and the difference was statistically significant( P<0.05). The anxiety score of the patients changed with the intervention time( P<0.05). There was no significant difference in the scores of self-esteem between the two groups after the first chemotherapy and the third chemotherapy( P>0.05); after all chemotherapy, the self-esteem score of the observation group was lower than that of the control group, and the difference was statistically significant( P<0.05).The self-esteem level scores of the two groups changed with the intervention time( P<0.05), and there was an interaction effect between the intervention method and the intervention time( P<0.05). There was no significant difference in the body image score between the two groups during the first chemotherapy( P>0.05); after the third chemotherapy and all chemotherapy, the body image score of the observation group was lower than that of the control group, and the difference was statistically significant( P<0.05), and there was an interaction effect between the intervention method and the intervention time of the body image score in the two groups( P<0.05). Conclusion: Through the implementation of cosmetic interventions, it can effectively relieve the patients’ anxiety, and improve the patients’ self-esteem and body image level.

Objective: To explore the mechanism of each factor and construct a structural equation model of caring activities and supportive behaviors of family caregivers of diabetic kidney disease patients. Methods: A convenience sampling method was used to select 280 family caregivers for patients with diabetic kidney disease admitted to two Grade A hospitals in Tianjin. Data was collected using structured questionnaires which included Barthel Index Scale, Social Support Rating Scale, General Self-efficacy Scale, Zarit Caregiver Burden Interview Scale, and Diabetes Caregiver Activity and Support Scale. Amos 21.0 software was used to construct the structural equation model, and the hypothesis model was tested and evaluated. Results: Self-care ability, family caregivers of social support and self-efficacy had a direct effect on caring activities and supportive behaviors, while care burden had a direct effect on caring activities and supportive behaviors, and self-care ability and social support had an indirect effect on caring activities and supportive behaviors through the mediating effect of care burden. Conclusion: The burden of care cannot be ignored in the mechanism of caring activities and supportive behaviors, and it plays an intermediary role in the process of the influence of self-care ability and social support factors on caring activities and supportive behaviors.

 Objective:To understand the job satisfaction of junior nursing staff and construct its structural model. Methods: A total of 296 junior nursing staff with a working life of less than or equal to 3 years were selected. General information questionnaire, nurse occupation identification scale, nurse occupational values scale, nurse job engagement scale and job satisfaction scale were used to conduct surveys, and then constructed the structural equation model of job satisfaction. Results: The total score of job satisfaction of the 296 nursing staff was 21.54±4.57, and the scores of each dimension were ranking from high to low: satisfaction with colleagues, satisfaction with the work itself, satisfaction with the leader, overall satisfaction, satisfaction with promotion, satisfaction with salary. The results showed that in terms of the overall effect, professional identity had the strongest effect on job satisfaction and the path coefficient was 0.741. In terms of direct effect, professional values had the strongest effect on job satisfaction and the path coefficient was 0.376. Conclusion: The job satisfaction of junior nursing staff was at a relatively high level, and professional identity had the strongest overall effect on job satisfaction. It is recommended to formulate a standardized training system, pay attention to the vocational education of junior nurses, guide them to establish correct professional values, enhance their professional identity and professional investment, then improve job satisfaction.

Objective: To explore the influence of nurses’ authorization ability and job satisfaction on turnover intention in grade A hospitals, and to clarify the mechanism among them. Methods: From October 16, 2018 to October 29, 2018, a cross-sectional questionnaire was conducted among 508 registered nurses in a grade A hospital in Tianjin by questionnaire stars. Results: Psychological empowerment and job satisfaction were negatively correlated with turnover intention( P<0.05), but there was no significant correlation between structural authorization and turnover intention( P>0.05). At the same time, the structural equation model was constructed, which nurses’ psychological empowerment and structural authorization were taken as independent variables, job satisfaction as intermediary variables, and turnover intention as dependent variables. The results showed that the fitting indexes were CMIN/DF=2.182 < 3, GFI = 0.929 > 0.90, AGFI= 0.905 > 0.90, RMSEA = 0.048 < 0.05.The total effects of structural authorization and psychological empowerment on turnover intention were 0.293 and-0.344 respectively, and the total effect of job satisfaction on turnover intention was-0.320. Conclusion: The turnover intention of nurses in grade A hospitals is still on the high level, the psychological empowerment is the main negative predictor, and structural authorization has the strongest indirect effect on nurses’ turnover intention.