Objective: To explore the experience and demands of patients after resection for lung cancer undergoing analgesia with virtual reality (VR) technology, and to provide reference for the development of relevant nursing protocols. Methods: A purposive sampling method was used to select 26 patients after resection for lung cancer who participated in VR-based analgesia. From June to September 2023, face-to-face semi-structured interviews were conducted, and Colaizzi′s phenomenological analysis was used to analyze the interview data. Results: The experience and demands of patients after resection for lung cancer using VR analgesia were summarized into 3 themes, including VR analgesia positive experience (recognition of VR analgesia effect and promotion of mood improvement), VR negative experience of analgesia (fear of experiencing new technology and discomfort during use), postoperative needs for VR analgesia (desire for enriched VR content and enhanced VR technology, the demand for VR operation guidance, the demand for a quiet environment and safety concerns, communication needs). Conclusion: VR analgesia presents positive analgesia effect and experience for patients after lung cancer resection. However, there are still some unmet service needs. Healthcare providers should explore coping strategies according to patients′ demands and perfect the nursing of VR analgesia for patients after resection for lung cancer.

Objective: To explore the research hotspots and research trends related to occupational protection in the nursing field in China, and master the literature research status and frontier in this field. Methods: This paper mainly uses the visualization software CiteSpace to draw a mapping knowledge domain from the number of papers, research authors, research institutions, research fields and research hotspots of the occupational protection related research literature in the nursing field collected by CNKI from January 1, 2013 to December 31, 2022, and carry out visual analysis. Results: A total of 1 775 articles were included, and the number of articles issued showed a stepwise downward trend. The research teams lacked cooperation and presented a decentralized development model. Research hotspots included protection education, protection strategies, occupational exposure, novel coronavirus, professional skills, influencing factors, safety management, and risk management. The research frontiers were occupational protection, nursing management, influencing factors, the application of new technologies in protection education, and the application of new theories and models in protection intervention during the epidemic situation. Conclusion: Occupational protection is taken as a basic nursing skill and incorporated into the construction of the core skill system during the school period, so as to synchronize skill teaching with clinical practice. We should improve the early warning mechanism of occupational protection risks. It is suggested to develop risk assessment tools in combination with multiple centers and disciplines, and strengthen the identification, intervention and tracking of occupational exposure risks for high-risk groups. Establishing the core competence index of nursing professional protection is useful to practically improve the occupational health level of nurses.

Objective: To develop an instrument for measuring the discharge preparation for patients with varicose veins of lower extremity after radiofrequency ablation surgery and test its reliability and validity. Methods: Under the guidance of transition theory, the dimensions and entry pool of the scale were initially set through comprehensive literature search, screening, reading and group discussion. Items were modified through expert letter inquiry methods, pre-surveys, project analysis and exploration sub-analyses, and then formal scales were formed. Using the convenient sampling method, 176 patients who underwent varicose veins of lower extremity radiofrequency ablation surgery in the vascular ward of general surgery in a Class A tertiary hospital in Tianjin from July 2022 to April 2023 were included and the reliability and validity test were conducted to construct the discharge readiness scale for patients with varicose veins after surgery. Results: The discharge preparation scale for patients with varicose veins of lower extremity after radiofrequency ablation surgery included 22 items in 4 dimensions. They were disease knowledge, personal status, coping ability and social support. The cumulative variance contribution rate was 75.853%. The recovery rate of the two rounds of expert letters was 100%, the expert authority coefficients were 0.83 and 0.86, and Kendall coordination coefficients were 0.433 and 0.351 ( P<0.05). The total Cronbach′s α coefficient of the questionnaire was 0.954 and the Cronbach′s α coefficients of each dimension were 0.850, 0.958, 0.602 and 0.709. The content validity index (S-CVI) of the scale level was 0.962, and the content validity index (I-CVI) of the items level were 0.813 to 1.000. Conclusion: The discharge preparation scale for patients with varicose veins of lower extremity after radiofrequency ablation surgery constructed in this study is scientific and practical, and can be used to evaluate the discharge preparation of patients with varicose veins of lower extremity after radiofrequency ablation surgery.

Objective: To explore the current situation of cardiac rehabilitation recommendation intention and information literacy of cardiovascular nurses and the correlation between them, so as to provide reference basis for increasing the cardiac rehabilitation recommendation intention of nurses and the implementation of cardiac rehabilitation. Methods: A questionnaire survey was conducted among 229 cardiovascular nurses in Shandong Province from September to October 2022 using the convenient sampling method. The Recommending Cardiac Rehabilitation Scale and Information Literacy Self-rating Scale for Clinical Nurses were used to collect data and analyze the correlation between them. Results: The total score of the recommending cardiac rehabilitation scale for nurses was 64.10±7.81, and information literacy self-rating scale for clinical nursing staff was 138.51 ±17.60. The intention of cardiac rehabilitation for nurses was positively correlated with the information literacy( r=0.536， P＜0.01). Conclusion: The nurses with higher level of information literacy have the stronger intention of cardiac rehabilitation recommendation. It is suggested that managers should take effective measures to promote the improvement of nurses′ information literacy, popularize the relevant knowledge of cardiac rehabilitation, improve the nurses′ intention of cardiac rehabilitation recommendation, and promote the clinical implementation of cardiac rehabilitation.

Objective: To understand the real experience of collaborative venous thromboprophylaxis in caregivers of patients undergoing major orthopedic surgery, and to provide a new idea for clinical venous thromboprophylaxis management. Methods: Fifteen main caregivers of patients undergoing major orthopedic surgery were recruited from a Class A tertiary hospital in Henan province from March to July 2023. Semi-structured interviews were performed to collect data and Colaizzi′s 7-steps analysis was conducted to analyze the data. Results: Five themes regarding collaborative venous thromboprophylaxis were extracted including awareness of the risk of venous thromboembolism(perceiving the risk of venous thromboembolism, increased awareness of prolonged thrombosis prevention), caregivers′ positive emotional experience (strong belief in collaborative prevention, acceptance of life refocusing, desire for diversified knowledge acquisition channels), enhanced preventive behavior(actively seeking care support and taking on collaborative responsibilities), lack of care capacity(unable to cope effectively with pain, lack of effect assessment support) and perceived benefits of collaborative prevention (meeting personal value needs and adopting proactive disease prevention behaviors). Conclusion: Clinical providers should focus on the positive behavior experiences of primary caregivers, integrate VTE prevention with the collaborative care model. In the process of prevention and management of VTE, the primary caregivers should be encouraged to assume the role of educators to improve their ability of collaborative care and perceived benefits.

Objective: To explore the experiences of spouses whose husband or wife was diagnosed with hepatocellular carcinoma combined with HBV positive. Methods: A qualitative descriptive design was adopted. A total of 15 spouses were purposefully recruited and interviewed using a semi-structured interview guide in a Class A tertiary cancer hospital in Tianjin, China. The Colaizzi seven-step analysis method was used to analyze the data. Results: Two themes and seven sub-themes were extracted from the data, including manifestations of social isolation (loneliness and powerless, social avoidance); reasons for social isolation(little support, caring role needs, public discrimination, self-discrimination and altruism). Conclusion: Spouses of young and middle-aged cancer patients who were diagnosed with hepatocellular carcinoma combined with HBV positive experience social isolation in the process of providing care to the patients. Clinical nursesare strongly advised to pay attention to this population and take actions to relieve their social isolation, guiding them to hold positive attitudes towards HBV and hepatocellular carcinoma, reducing self-iscrimination, public discrimination and social avoidance. At the same time, close family members are expected to continuously support the spouses of cancer patients who were diagnosed with hepatocellular carcinoma combined with HBV positive.

Objective: To investigate status and its influential factors of family adaptability among spouses of young and middle-aged cancer survivors, so as to provide evidence for improving family adaptability. Methods: A total of 282 spouses of young and middle -aged cancer survivors were included. A social -demographic questionnaire, Family Cohesion and Adaptability Scale, Family Resilience Scale, and ZBI Caregiver Burden Scale were used in investigation. Results: Young and middle-aged cancer survivors’ spouses had a median score of 54 （49 ，58) for family adaptability. The mean score of family resilience was 199.05±21.26, and the score of caregiver burden was 27 （17，41）. The family adaptability of spouses was significantly positively correlated with family resilience （ r =0.584, P ＜0.001）. Family adaptability was significantly negtively associated with caregiver burden ( r=-0.284, P<0.001). The multiple linear regression analysis showed that the two second-dimensions of family resilience including family belief and family strength, cancer survivors’ job (no work), disease type (lung cancer and head -neck cancer) and the family’s monthly income were the influencing factors of family adaptability for these spouses, accounting 57.2% of the variable. Conclusion: The family resilience among spouses of young and middle-aged survivors affects their family adaptability. It is suggested that healthcare professionals should improve their family resilience, help them seek solutions to problems, strengthen their communicating ability and cooperation with family members, and maintain the routines of family life and the intimacy between family members, which probably, in turn, increases these people’s family adaptability.

Objective：To conduct a systematic review of the qualitative researches on the care experience in spouses of patients with breast cancer, so as to provide references for further development of nursing programs for spouses of patients with breast cancer. Methods: Qualitative researches on care experiences in spouses of patients with breast cancer were retrieved from The Cochrane Library, Web of Science, PubMed, China Knowledge Network, Wanfang and Weipu databases. The retrieval time was from inception to November 2019. The literature quality was evaluated according to the quality evaluation criteria of JBI evidence-based health care centers in Australia and Meta-integration was carried out for the included studies. Results: A total of 12 studies were included, 48 research results were extracted, summarized into 11 categories, and 4 integrated results were combined finally.Conclusion: During the diagnosis and treatment of breast cancer, the spouse suffers from physical and mental problems, spousal relationship breaks, and lack of support and coping, etc. While paying attention to patients with breast cancer, Medical staff should also pay attention to their spouse’s psychological changes and information needs in time, and provide necessary support and help, so as to promote the quality of caring.

Objective: To investigate the status of disease uncertainty and its association with hope and anxiety among spouses of liver cancer patients who were diagnosed as family aggregation of liver cancer, so as to provide theoretical basis for nursing staffs to help spouses reduce disease uncertainty. Methods: Convenient sampling method was used to recruit 200 spouses of liver cancer patients who had family aggregation of primary liver cancer. Measurement tools included a self-designed general data questionnaire, Mishel Uncertainty in Illness Scale-Family Member Form, Herth Hope Scale and Zung Self-Anxiety Scale. Results: The mean score of disease uncertainty of spouses was 64.17±11.61, which was at a medium level, and the mean score of hope was 38.39±4.59, and the mean score of anxiety was 37.09±8.76. The results of single-factor analysis showed that spouses with different age, and education qualifications had different scores of disease uncertainty ( P<0.05). Correlation analysis showed that disease uncertainty was negatively associated with hope ( r=-0.447, P<0.001), and was positively associated with anxiety( r=0.252, P<0.001). Conclusion: The disease uncertainty of the spouses was at a medium level, and the hope was at a high level. Parts of spouses were anxious about the patients’ disease. It is highly recommended that nurses should provide personalized and targeted information and education to the spouses of liver cancer patients who were diagnosed as family aggregation of liver cancer, so as to assist with reducing their sense of disease uncertainty and improving their sense of hope.

Objective: To explore the demands for death education of nursing students in oncology departments. Methods: A purposive sampling method was adopted in this study. A total of 17 nursing students were included and in-depth interview was conducted in nursing students one by one. Thematic analysis method was adopted to analyze the data, then themes and subthemes were organized. Results: Three themes were refined including "demand for death educational knowledge", "diversified demand for death educational skills" and "demand for improving self-care capacity". Nursing students stated that they received inadequate theoretical knowledge and skills from previous death education, then they could not meet the needs of clinic practice, which contributed to their ineffectiveness of coping patient’s death and relatively poor self-care capacity after experiencing patient’ death. Conclusion: Medial schools are advised to incorporate death education into nursing students’ education as a compulsory course and clinical nursing teachers are advised to provide more opportunities to nursing students for taking care of dying patients and dealing with patient’ death. These strategies would assist nursing students strengthening their knowledge of death, building scientific perspective of death, and ultimately meet their needs of death education.

Objective: To explore the working experience of nurses collecting specimens for COVID-19 nucleic acid testing.Methods: Fourteen nurses who collected specimens for COVID-19 nucleic acid testing were interviewed by semi-structured in-depth interview. The data was analyzed by Colaizzi analysis. Results: Two themes and seven sub-themes were refined finally. Theme 1 was positive experiences including enhancing professional responsibility, strengthening professional achievement and value, bringing security by social support, improvement of working ability and self-confidence and improvement of empathy; Theme 2 was negative experiences including high work pressure and uncertainty about the future. Conclusion: During the prevention and control of COVID-19, nursing management should allocate human resources reasonably, value nurses’ psychological counseling and actively mobilize nurses’ social support system to eliminate nurses’ negative emotions in time, so as to improve nurses’ coping ability with novel coronavirus epidemic.

Objective: To evaluate the application effect of quality management standards for intravenous access care clinics in Secondary and above medical institutions in Tianjin. Methods: A total of 280 patients who visited intravenous access care clinics from October to December 2018 were selected as the control group and 280 patients who visited intravenous access care clinics from October to December 2019 were selected as the intervention group. The intervention group adopted standardized training program to implement the quality management standards of intravenous access care clinics. The control group implemented daily management requirements according to the routine care. The self-management ability of catheters in the two groups was investigated with the PICC self-management scale for tumor patients, meanwhile, the incidence of PICC complications in the two groups was calculated. Results: The incidence of PICC catheter-related bloodstream infection in the intervention group was 1.07%, significantly lower than the control group(1.79%). The total score of self-management ability of catheters and the scores of three dimensions including maintenance compliance, confidence in catheter management and abnormal treatment in the intervention group were significantly higher than those in the control group(P<0.05). Conclusion: The application of quality management standards for intravenous access care clinics is helpful to standardize the behaviors of nurses to implement standardized maintenance services for patients with catheters which can improve the self-management ability of patients and reduce the occurrence of complications, so as to reduce the medical cost of patients.

Objective: To investigate the status quo of health information seeking behavior and health behavior ability of PICC outpatients, and to explore and analyze their relationship, so as to provide support for the management of PICC outpatients.Methods: A total of 138 PICC patients in outpatients of a grade A hospital in Tianjin from February to December 2020 were selected as the study subjects by convenience sampling method. The general data questionnaire, health information search behavior scale and health behavior scale were used for cross-sectional investigation. Pearson correlation analysis was used to explore the relationship between health information search and health behavior ability. Results: The total score of health information searching behavior was 158.46±15.70, and the scores of each dimension from high to low were health information demand, information searching attitude, access to information barrier, information source. The total score of healthy behavior ability was 99.24±9.77, it was at a high level, including 87 cases (63.1%) good, 46 cases (33.3%) normal, and 5 cases(3.6%) poor, the each dimension were nutrition (24.91±3.46) , sports (25.17±3.35) , psychological well-being (24.15±3.14), health responsibility (25.01±2.72). Pearson results showed that health information searching attitude, information demand and information source were positively correlated with the total score of health behavior ability and the scores of each dimension (r= 0.263~0.462, P<0.05).There was a negative correlation between access to information and the total score of decision-making ability and the scores of each dimension(r=-0.168~-0.251, P<0.05). Conclusion: PICC outpatients’ health information searching behavior attitude is at a medium level, the information demand level is high, but the searching way is more limited, there is a certain degree of information acquisition obstacles; The more positive the patient’s attitude of information searching, the higher the healthy behavior ability. It is suggested that based on patients’ health information demand orientation and information searching behavior characteristics, medical staff should provide personalized guidance and various forms of health education for patients， lack of information, so as to improve patients’ health behavior ability and improve health outcomes.

Objective: To explore the application effect of nurse-led group management model in CT examination. Methods: 92 patients who underwent CT examination were randomly divided into control group and observation group, with 46 cases in each group. The control group adopted the nurse and patient one-to-one management model of the conventional CT examination, and the observation group adopted the nurse-led group management model on the basis of the control group. The examination time, one-time success rate and patient compliance of CT examination were compared between the two groups. Results: The time of CT examination in the observation group was shorter than that in the control group, and the one-time success rate and compliance of examination were better than those in the control group( P<0.05). Conclusion:The nurse-led group management model can effectively improve the quality of CT examination and improve the utilization of medical.

Objective:To explore the mechanism of mediating role of social support between fertility anxiety and quality of life, so as to provide a theoretical basis for reducing the level of fertility anxiety of breast cancer patients. Methods:A questionnaire survey was conducted among 120 breast cancer patients in a tertiary Class A hospital in Tianjin with the Post-Cancer Fertility Anxiety Scale, the Comprehension Social Support Scale, and the Quality of Life FACT-B Scale.   Results:The total score of fertility anxiety, social support and quality of life were 52.36±13.66, 69.19±11.71, 100.48±19.04, respectively. Fertility anxiety was negatively correlated with quality of life and social support（P<0.05）. Social support was negatively correlated with quality of life(P<0.05). The analysis of mediating effects showed that social support played a partial mediating role in the relationship between fertility anxiety and quality of life in breast cancer patients. Conclusions:Fertility anxiety was influencing the quality of life in breast cancer patients. Social support played an important role in relieving fertility anxiety and improving the quality of life of breast cancer patients. It is necessary to provide a complete social support system to breast cancer patients.

Objective: To analyze the influencing factors of the success rate of blind insertion of naso-intestinal tube in critically ill patients. Methods: The critically ill patients who underwent blind insertion of naso-intestinal tube were selected. The patients’ acute physiology and chronic health evaluationⅡ(APACHEⅡ),sequential organ failure assessment(SOFA), Glasgow coma score(GCS), Ricker sedation and restlessness score(SAS), blood sugar, potassium, hospitalization time, bowel sounds, artificial airway, sedative and vasoactive drugs, operation, gastric motility drugs, mild hypothermia therapy, mechanical ventilation, and other general datum were collected. Logistic regression was used to analyze its influencing factors. Results: 156 critically ill patients with blind insertion of naso-intestinal tube were collected.132 were successfully inserted(84.6%),the average intubation time was 15.1±9.4. APACHEⅡ≥20,mechanical ventilation were risk factors for successful intubation.Bowel sounds was the protective factor for successful intubation. Conclusion: In addition to their own disease factors, drugs and therapeutic interventions may affect the intubation. Medical staff should evaluate as soon as possible and place the appropriate feeding tubes early.

Objective: To explore the effect of home care on the self-management of patients with chronic heart failure (CHF) based on the theory of timing. Methods: 23 patients with first onset heart failure in cardiology from January to June 2018 in the observation group were given home care based on timing theory; 25 patients from January to December 2017 in control group were received routine care and follow-up. The level of self-management, quality of life and re-admission rate were recorded at 6 months after discharge. Results: The patients in observation group had higher level of self-management, lower scores of living quality, and lower re-admission rate than those of in the control group( P<0.05). Conclusion: Home care based on timing theory can effectively improve the self-management ability and quality of life, and reduce the rate of re-admission of CHF patients.

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 explore the real thoughts and feelings of nurses assisting in Hubei province, during outbreak of COVID-19, so as to provide references for nursing managers to make decisions. Methods: A total of 12 nurses of a tertiary and first-class hospital in Ningxia were selected by purposive sampling methods. Colaizzi’s seven-step analysis method was used to collate and analyze the data. Results: 4 themes were extracted, including high sense of responsibility and mission, psychological state differences, discomfort of wearing medical protective equipment, and gratitude to social support. Conclusion: The overall experience of nurses assisting Hubei is positive, with a high sense of professional identity. However, nursing managers should also pay attention to gender of nurses, severity of the patient’s illness, changes of nurses’ mental state in different periods, and discomfort coming from protective equipment, so as to have a better respond to public health emergencies.