Objective: To construct the health management need assessment scale for elderly patients with chronic diseases and test its reliability and validity. Methods: Based on the Omaha system, the first draft of the health management need scale for elderly patients with chronic diseases was formed through literature analysis, expert correspondence and preinvestigation. A questionnaire survey was conducted in elderly patients with chronic diseases in a Class A tertiary hospital in Tianjin from March to September 2022 to test the reliability and validity of the scale. Results: A total of 330 questionnaires were distributed and 320 valid questionnaires were recovered. The final scale consisted of 27 items in 4 dimensions including physical health need, psychosocial health need, environmental health need and health behavior related needs. Exploratory factor analysis showed that the four common factors explained 58.646% of the total variance. Cronbach′s α were 0.803 ～0.886 for subscales, and Cronbach’s α for the total scale was 0.917. Split -half reliability coefficients were 0.801～0.914 for subscales, and 0.815 for the total scale. Test-retest reliability coefficients were 0.498～ 0.647 for subscales, and 0.911 for the total scale. Conclusion: The health management need assessment scale for elderly patients with chronic diseases is scientific, reasonable, reliable and valid, which can be used to evaluate the health management needs of elderly patients with chronic diseases.

Objective: To investigate the clinical effects of aromatherapy and auricular plaster therapy on inpatients with post-stroke insomnia(PSI). Methods: Using a convenience sampling method, 120 inpatients with post-stroke insomnia from a Class A tertiary neurological hospital in Tianjin were selected as study subjects. The research subjects were randomly divided into control group, aromatherapy group, auricular plaster group, and combination group, with 30 cases in each group. The changes in sleep quality(Pittsburgh Sleep Quality Index,PSQI) and depressive symptoms(Hamilton Depression Scale, HAMD) were compared among the four groups at admission, after 7 days of intervention, and after 1 month of intervention. Additionally, differences in hospital stay duration and overall satisfaction with nursing services among the groups were compared. Results: After 7 days of intervention, the PSQI scores in the aromatherapy group and the combined group were lower than those in the control group( P<0.05), while there was no significant difference in PSQI scores between the auricular plaster group and the other three groups( P>0.05). There was no statistically significant difference in HAMD scores among the four groups ( F=2.462, P>0.05). After 1 month of intervention, the PSQI scores in the aromatherapy group, auricular plaster group, and combined group were all lower than those in the control group( P<0.05). And the HAMD scores in the aromatherapy group and combined group were lower than those in the control group( P<0.05), but there was no significant difference between the auricular plaster group and the control group( P>0.05). In terms of hospital stay duration, the combined group had a shorter hospital stay than the other three groups ( F=3.213, P<0.05). There was no statistically significant difference in inpatient satisfaction among the groups( H=6.629, P>0.05). Conclusion: Aromatherapy can improve sleep quality in PSI patients with short-term use (7 days) and can also alleviate depressive symptoms with continued use. Auricular plaster requires long-term treatment(over 1 month) to improve sleep in PSI patients. The combination of aromatherapy and auricular plaster therapy helps shorten hospital stay and supports maintaining a positive nurse-patient relationship.

Objective: To explore the impact of active cycle breathing techniques training based on IKAP theory on dyspnea belief, peak expiratory flow rate, and exercise self-efficacy in patients with undergoing high-flow nasal oxygen therapy during ICU transition period. Methods: Patients with high-flow nasal oxygen therapy during ICU transition period were selected from a Class A tertiary hospital in Tianjin. The control group comprised 46 patients admitted from October 2021 to February 2022, who received active cycle breathing techniques training under conventional health education guidance. The observation group included 46 patients admitted from March to September 2022, who received active cycle breathing techniques training guided by the IKAP theory. The scores for dyspnea belief, peak expiratory flow rate, and exercise self-efficacy were compared between the two groups before and after the intervention. Results: The observation group had significantly lower scores for dyspnea belief, and higher scores for peak expiratory flow rate and exercise self-efficacy compared to the control group ( P<0.05). Conclusion: Active cycle breathing techniques training based on the IKAP theory can reduce patients′ exercise-related fear of dyspnea, enhance their ability to cough and expectorate, and improve their confidence in physical activity.

Objective: To analyze the current status, hot spots and cutting-edge trends in researches on the care of patients with cardiovascular comorbidities. Methods: The Web of Science database was used as a source to collect literatures on the care of patients with cardiovascular comorbidities from the inception of database to January 1, 2023, and CiteSpace software was used to map the country, institution, author collaboration network and keyword co-occurrence to analyze thecurrent status, hot spots and frontiers of researches on cardiovascular comorbidities patient care. Results: A total of 1 044 literatures were included and the number of publications showed a continuous increasing trend. The country with the highest number of publications was the United States. The issuing institutions were dominated by Karolinska Institute and the University of Toronto. The number of authors engaged in researches on the care of patients with cardiovascular comorbidities was high, but the distribution was scattered and collaboration was weak. Hot spots in cardiovascular comorbidities patient care researches were comorbidities management, cardiovascular metabolic comorbidities, and psycho-cardiology. Future research trends are evidence-based care studies on patients with cardiovascular comorbidities. Conclusion: The research field of cardiovascular comorbidities patient care has entered a stable development stage, research teams and institutions should continue to strengthen communication and cooperation to promote the continued development of cardiovascular comorbidities patient care research.

Objective: To construct a sensitive, scientific, and targeted evaluation system for the quality of nursing care in otolaryngology head and neck surgery, in order to provide a standardized and quantitative basis for evaluating and monitoring the quality of otolaryngology head and neck surgery specialized nursing care. Methods: Based on Donabedian′s "structure process results" theoretical framework, literature analysis, expert groups discussion were performed to access the preliminary screening of indicators, prepared a consultation questionnaire and two rounds of Delphi expert consultation, and then sensitive indicators of nursing quality in otolaryngology head and neck surgery were revised and determined. The weight of each indicators was calculated using analytic hierarchy process. Results: The positivity coefficients of the two rounds of consultation experts were both 100%, the authority coefficients were 0.919 and 0.934 respectively. The Kendall harmony coefficients of the first round of expert consultation were 0.218~0.294, and the second round were 0.269~0.335 (both P<0.05). The constructed otolaryngology head and neck surgery nursing quality sensitive indicator system included 3 first level indicators, 10 second level indicators and 31 third level indicators. The weight results of the first level indicators were 0.112, 0.444, and 0.444 respectively, the weight results of the second level indicators were 0.028~0.207, and the weight results of the third level indicators were 0.005~0.111. Conclusion: The constructed sensitive indicators for the nursing quality of otolaryngology head and neck surgery highlight the characteristics of specialized departments, and are scientific and practical, and can provide reference for the evaluation of nursing quality in otolaryngology head and neck surgery.

Objective: To translate the women′s attitudes towards birth questionnaire (WATBQ) into Chinese, and evaluate its reliability and validity in order to provide our country with a more convenient and effective tool for measuring female childbirth attitudes. Methods: Based on the Brislin translation model, the original questionnaire was forward-translated and back-translated. After expert committee review and pre-test, the Chinese version of WATBQ was formed. The Chinese version of the WATBQ instrument was tested for reliability and validity using a convenience sample of 472 pregnant women during the third trimester of pregnancy in Hangzhou. Results: The Chinese version of WATBQ was consisted of 5 dimensions and 22 entries. Five common factors were extracted from exploratory factor analysis, and the cumulative variance contribution rate was 64.274%. The item-level content validity index of the questionnaire ranged from 0.83 to 1.00, and the content validity index at the questionnaire level was 0.96. The Cronbach′s alpha coefficient for the total scale was 0.890, and the Cronbach′s alpha coefficients for the dimensions ranged from 0.804 to 0.923. The re-test reliability of the total scale was 0.824, and its split-half reliability was 0.798. Conclusion: The Chinese version of WATBQ has good reliability and validity. It can be used as an assessment tool for pregnant women′s childbirth attitudes in our country.

Objective: To explore the effect of stratified case management on maintaining self -management ability and quality of life in patients with chronic kidney disease undergoing maintenance hemodialysis. Methods: A total of 96 cases of patients with chronic kidney disease undergoing maintenance hemodialysis(MHD) were included from January 2021 to December 2021.The patients were divided into observation group ( n=48）and control group ( n=48）by random number table. The control group received routine nursing intervention. The observation group received stratified case management. The improvement of self-management ability and quality of life in two groups before intervention and after 3 months intervention were compared. The occurrence of adverse events of hemodialysis during the 3 -month follow -up of two groups were recorded. Results: The MHD Self-Management Behavior Scale(SMSH) score and Brief Health Status Scale (SF -36) related dimension scores of the observation group were significantly higher than the control group after intervention ( P<0.05). The incidence of hemodialysis adverse events of the observation group were significantly lower than the control group during the follow-up period(P<0.05). Conclusion: Stratified case management can effectively improve the self -management ability of patients with chronic kidney disease undergoing MHD, reduce the occurrence of hemodialysis adverse events, and improve the quality of life of patients.

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.

Abstract Objective: To analyze current status and influencing factors of readiness in family caregivers of elderly patients with first-time stroke and provide reference for future intervention guidance. Methods: A total of 160 elderly patients with first-time stroke and the main caregivers were included in the study. Caregiver readiness scale, first-time stroke related knowledge scale and medical social supports scale were used in the investigation. Results: Score of readiness was 23.53± 6.18. Caregiver′s readiness was positively associated with the level of stroke related knowledge ( r=0.309, P<0.05), and positively associated with social medical support ( r=0.248, P<0.05). Multivariate analysis revealed that care experience, number of caregivers, patient Rankin level, stroke related knowledge level, and medical social support were factors affecting family care readiness of first-time elderly stroke patients ( P<0.05). Conclusion: The readiness of family caregivers of elderly patients with first-time stroke needs to be improved, and medical staff should give timely health education, and help patients and caregivers to develop personalized guidance programs for further rehabilitation. 

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.