Objective: To explore the realistic dilemmas of implementing humanistic caring among nursing students in higher vocational colleges during the clinical clerkship phase, and to provide a reference for the development of a humanistic caring capability cultivation system. Methods: Using the phenomenological research method in qualitative research, purposive sampling was used and 14 nursing students with over 5 months of clinical clerkship experience were included for semi-structured interviews. Colaizzi′s seven-step analysis method was utilized to organize and analyze the data. Results: Barriers to the implementation of humanistic caring were categorized into three main themes involving educational system factors (including insufficient humanistic caring training, inappropriate teaching methods, and educators′ deficiency in humanistic care), occupational environment factors (including heavy workload, lack of caring atmosphere, negative patient feedback, and incomplete evaluation system), and personal quality factors (including insufficient individual abilities and differences in personality characteristics). Conclusion: Nursing education should undergo a reform geared towards caring and nursing focusing on humanistic caring ability training. Hospitals and schools should collaborate to establish a feasible training system which could integrate humanistic quality education with professional content. Additionally, improvements in the occupational environment should be explored, and targeted educational strategies should be developed basing on the characteristics of nursing students to enhance their humanistic caring abilities.

Objective: To investigate the status of family resilience and spiritual well -being in young patients with postoperative breast cancer and explore the correlation between the two. Methods: A survey was conducted using a general information questionnaire, the Family Resilience Assessment (FRA) scale, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being(FACIT-Sp-12) scale among 186 young patients with postoperative breast cancer who were treated in the breast oncology department of a Class A tertiary hospital in Tianjin from March 2022 to December 2022. Results: The scores of family resistance and spiritual well-being of young patients with postoperative breast cancer were 104.07±15.94 and 30.41±6.84. There was a positive correlation between family resilience and spiritual well-being ( r=0.717, P<0.01). Conclusion: There is still room for improvement in the family resilience and spiritual well-being of young patients with postoperative breast cancer. The higher the level of family resilience, the better the spiritual well-being of the patients. Healthcare professionals should implement targeted nursing interventions to enhance patients′ family resilience, thereby improving their spiritual well-being.

Objective: To explore the needs and real experience of home rehabilitation in breast cancer patients with wound drainage tube after surgery，and to provide reference for effective development of continuous nursing. Methods: Purposeful sampling was used and a semi-structured interview was conducted in 14 breast cancer patients with indwelling drainage tube after surgery. Data were coded, classified and extracted by Colaizzi seven-step analysis method. Results: The home rehabilitation needs in breast cancer patients with wound drainage tube after surgery can be summarized into four themes, they were the need to improve home self -management skills, multi -dimensional support requirements, psychological needs and emotional needs and rehabilitation environmental needs. Conclusion: As the length of stay decreases，the number of patients discharged from the hospital with drainage tubes after breast cancer surgery will continue to increase. According to the needs and real experience of patients with wound drainage after breast cancer surgery, medical staffs should provide targeted and continuous nursing，so as to provide quality care for patients，and promote their recovery to health.

Objective: To systematically summarize the experience of weight management in patients with breast cancer and comprehensively understand the needs of patients in the process of weight management, so as to provide evidence for better weight management suggestions. Methods: Pubmed、Scopus、Embase、Web of Science、CINAHL、PsycINFO、CBM、CNKI、 VIP、Wanfang were retrieved from inception to October 2021.The qualitative researches on weight management in patients with breast cancer were extracted. The quality of included studies was evaluated according to JBI critical appraisal tool for qualitative studies in Australia. The results were integrated by integrating methods. Results: A total of nine studies were included. Thirty-four complete findings were grouped according to similarities and nine new categories were formed. These categories resulted in three synthesized findings. They were effects of illness on weight management，the journey of the weight management process，factors affecting weight management. Conclusion: As a common side effect of breast cancer treatment, weight gain has a negative impact on physical and mental health of patients with breast cancer. Healthcare workers should help patients to make effective decisions according to their own conditions.

Objective: To study the experience of self-image change in patients with inflammatory bowel disease, so as to provide a reference for developing reasonable and effective intervention strategies to improve patients’ self-image. Methods: A total of 11 patients with inflammatory bowel disease admitted to a tertiary Class A hospital in Tianjin were included by the phenomenological research method. The patients received semi-structured in-depth interviews,and the data were analyzed by Colaizzi 7-step analysis method. Results: Four themes were summarized including multiple negative emotions, difficult to pursue, lack of understanding and acceptance, and gain from disease. Conclusion: Patients with inflammatory bowel disease have positive self-image and more serious negative self-image. Medical staff should pay attention to provide psychological counseling for patients with serious negative self-image, strengthen health education, and assist social forces to improve patients’ self-image, so as to promote disease recovery.

Objective: From the perspective breast specialized medical staff, to explore the promoting and hindrance factors of home care for wound catheter in patients with breast cancer after surgery, so as to provide more humanized home care services for patients with wound catheters. Methods: A total of 19 breast specialized medical staffs were included and in-depth interviews were conducted with semi-structured interview outlines. Field recordings and transcripts were made, and the interview data were sorted and analyzed by Nvivo 12.0 and Colaizzi method of phenomena observation in qualitative study. Results: The promoting factors of home care in patients with wound catheter were including obtaining good family and social support, diversified and personalized health education forms.The hindrance factors were including patient factors such as insufficient voluntary learning ability and cognition, poor compliance, and caregiver factors such as elderly family caregivers, changing family supervision and care, and other factors such as patients living alone and geographical factors. Conclusion: Clinical medical staffs should actively provide targeted professional guidance and information support for patients, so as to solve their actual problems, help patients safely pass the period of wound catheterization at home, reduce the occurrence of complications, promote rehabilitation, and then improve their quality of life.

Objective: To explore the mediating role of social support in coping style and health-related hardiness in unmarried women after breast cancer surgery. Methods: The research objects were selected by target sampling, including 115 unmarried women after radical mastectomy for breast cancer from a tertiary A hospital in Tianjin. The simplified coping style questionnaire(SCSQ), social support rating scale(SSRS), revised health-related hardiness inventor(RHHI-24) questionnaire and self-designed general information questionnaire were used. Results: The total score of social support in 115 unmarried women after breast cancer surgery was 36.65±7.38; the score of positive coping was 24.36±6.68; the score of negative coping was 11.39±4.15； the score of health-related hardiness was 76.83±21.46. The score of health-related hardiness was significantly correlated with total score of social support and score of positive coping style( P<0.05), while was negatively correlated with the score of negative coping style( P<0.05). Structural equation model analysis showed that social support significantly positively predicted health-related hardiness（ β=0.65， P<0.001）, Negative coping significantly negatively predicted health-related hardiness( β=-0.28, P<0.001), and social support was a complete mediator between positive coping and health-related hardiness. Conclusion: Unmarried women had a moderately low level of health toughness after breast cancer surgery. In clinical work, we should pay attention to patients’ coping styles and social support status, encourage them to adopt more positive coping styles, provide all-round social support for patients to the greatest extent, in order to alleviate negative emotions, and improve the quality of life.

Objective: To investigate the current status of knowledge, attitude and practice of clinical nurses in preventing PICC catheter-related infections, and to analyze the influencing factors. Methods: In October 2019, 215 clinical nurses from 5 hospitals in Tianjin were selected by convenience sampling method. The self-designed questionnaire for knowledge, attitude and practice was used to conduct the survey. The multiple linear stepwise regression was used to analyze the influencing factors. Results: The total scores of knowledge, attitude and practice on prevention of PICC catheter-related infections were 90.86 ± 5.23, among which the score of knowledge was 17.36 ± 3.00, the score of attitude was 24.13 ± 1.83, and the score of practice was 49.37 ± 2.36. The results of multiple linear stepwise regression analysis showed that education background, PICC specialist nurses, and knowledge training were the main influencing factors of knowledge scores( P<0.05); PICC specialist nurses, PICC dressing change assessment were the main factor affecting attitude( P<0.05). Conclusion: The nurses’ knowledge, attitude and practice level on the prevention of PICC catheter-related infections were generally good. The scores of nurses’ attitudes and practice were high, but the scores of knowledge was low. It is recommended to strengthen the learning and training of relevant theoretical knowledge to improve infection prevention.

Objective: To explore the relationship among self-image, coping style and social support of unmarried young women after radical mastectomy. Methods: A cross-sectional survey was conducted to select 155 young unmarried women after radical mastectomy from three grade-A hospitals in Tianjin. The simplified coping style questionnaire(SCSQ), social support rating scale(SSRS), body image after breast cancer questionnaire (BIBCQ) and self-designed general information questionnaire were used. Results: The self-image score of 155 unmarried young women after radical mastectomy was 150.58±25.22. Self-image was positively correlated with positive coping and social support( P<0.05), and negatively correlated with negative coping（ P<0.05）. Structural equation model analysis showed that social support significantly positively predicted self-image（ β=-0.28, P<0.001）; social support and positive coping（ β=0.40, P<0.001）; positive coping significantly positively predicted self-image( β=-0.14, P=0.019); active coping is a partial mediator between social support and self-image. Conclusion: The self-image level of unmarried young women after radical mastectomy was lower. In order to improve the self-image level and living quality of the patients, we should encourage them to take more positive coping strategies and provide full range of social support in clinical work.

Objective: To evaluate the research topic and popular themes of domestic and foreign literature on medical adhesive-related skin injuries(MARSI) by using bibliometric methods. Methods: The MARSI related literatures were retrieved from Cochrane Library, PubMed, EMbase, Web of science, sinoMed, CNKI, Wanfang, VIP and other databases. The search time was from construction of the library to May 2019. SPSS 22.0 software was used for bibliometric analysis, and gCLUTO statistical software was used for cluster analysis of high frequency keywords for domestic and foreign literature. Results: A total of 103 papers were included, of which foreign literature accounted for 27.18% of the total literature, and Chinese literature accounted for 72.82%. In the cluster analysis, high-frequency keywords were clustered into 4 categories, which were skin damage and injury types, related risk factors, risk assessment and management, nursing interventions. Conclusion: The research of MARSI is still a hotspot at home and abroad, its pathogenesis and prevention are being explored. In the future, the research of MARSI prevention should be strengthened and multidisciplinary cooperation should be emphasized.

Objective: To explore the effect of the whole course of the multi-subject liaison nurse in improving the nursing quality of the critical patient.  Methods: Head nurses of medical departments and multi-subject liaison nurse composed of the quality tracking steering group of critical patients. In each quarter, a critical patient was selected to evaluate nursing quality every 1-3days from admission to discharge. And the effect of quality supervision was assessed by head nurses of internal medicine before and during the follow-up. Results: The five nursing quality index including pipeline nursing, bedsore nursing , intravenous therapy nursing, emergency medicine and specialist nursing skills of were increased than that before the follow-up (P<0.001), the difference was statistically significant.  Conclusion: Multi-disciplinary liaison nurse not only to ensure the accuracy of nursing measures and safety of critical patients, but also can promote the homogenization of the care of critically patients.

Objective: To explore the effect of network-model intervention on self-image of young breast cancer patients after breast-conserving surgery.  Methods: Young breast cancer patients after breast-conserving surgery were chosen from Tianjin Medical University Cancer Institute and Hospital from August 2014 to June 2015. These patients were randomly divided into intervention group (50 cases) and control group (50cases). Patients of the intervention group were given a supportive nursing intervention for 6 months, while patients of the control group received routine nursing care. These two groups were assessed by the body image after breast cancer questionnaire (BIBCQ) before discharge，2 and 6 months after discharge separately to evaluate the effect of the nursing intervention.  Results: There were significant differences (P<0.01) in body stigma and body concerns. There were differences (P<0.05) in body concerns, transparency, arm concerns and the total scores of IBCCQ. There were statistically differences in vulnerability, body stigma, limitations, transparency, arm concerns and interaction between time and intervention methods of total scores of IBCCQ (P<0.05). Conclusion: The network-model intervention is scientific and personalized, it may improve both the physical and psychological health and social adaptability of breast cancer patients, thus elevating their self-imaging level.