Objective: To discuss the correlation between the psychological resilience of interns and their professional identity, and provide a reference for the development of the nursing talent team. Methods: A survey was conducted on 340 interns of nursing students from two medical colleges in Tianjin using general information questionnaire, resilience scale and occupational identity scale, and the correlation between resilience and professional identity was analyzed. Results: A total of 330 valid questionnaires were recovered, with an effective recovery rate of 97.9%. The total score of psychological resilience of the nursing students was 66.35±15.57, which was at the general level; the total score of professional identity was 65.61±11.37, which was at the general level. Univariate analysis showed that there were statistically significant differences in the scores of nursing students’ professional identity scale whether they were only children, whether they were student cadres, volunteering to fill in the nursing major, and whether they choose nursing work( P<0.05). Spearman correlation showed that the total score of resilience scale and the scores of each dimension were positively correlated with the total score of professional identity scale ( P<0.01). Conclusion: The psychological resilience and professional identity of nursing students are at the general level. In order to cultivate a team of nurses with high quality and a high degree of professional identity, manager should pay attention to the training of intern nurses’ resilience and psychological intervention guidance in the professional education stage and clinical teaching stage, and carry out nurses’ professional emotional education to help them better. Cope with psychological pressure and improve professional identity.

Objective：To explore the relationship between areas of worklife and job burnout in nurses. Methods： A total of 310 nurses from a tertiary Class A hospital in Tianjin were included by convenience sampling method. Data were collected by Six Areas of Worklife Scale(AWS) and Maslach Burnout Inventory(MBI). Results：The score of each dimension of areas of worklife was workload (2.82±0.59), autonomy (3.30±0.85), work recognition (3.14±0.50), team atmosphere (3.54±0.58), fairness (3.16±0.62) and value (3.50±0.62)，respectively. The overall score of job burnout was 2.37±0.88. Areas of worklife was negatively correlated with job burnout( r=-0.082~-0.381, P<0.05). Multiple linear regression analysis showed that workload, autonomy and job approval were influencing factors of job burnout( F=9.937， P<0.001)， and could explain 24.0% of the variance rate of job burnout. Conclusion：The areas of worklife and job burnout are negatively correlated. Nursing managers should pay attention to the level of areas of worklife in nurses, and adopt effective measures to improve the degree of areas of worklife , so as to reduce job burnout of nurses.

Objective: To analyze the current situation of professional identity and learning motivation of secondary vocational nursing students, and to explore the correlation between them, so as to enhance the learning motivation and professional identity of secondary vocational nursing students. Methods: A total of 420 secondary vocational nursing students were surveyed by general data questionnaire, nursing students’ occupational identity and learning motivation questionnaire. Results: A total of 405 valid questionnaires were recovered. The total score of professional identity was 61.13±11.02, the score of learning motivation was 86.42±9.49. Among the factors of professional identity, the score of social persuasion was 3.79±0.80, which was highest; the score of retention benefit and resignation risk was the lowest(3.35±0.80). In learning motivation, the score of enthusiasm dimension was the highest(3.06±0.42); the score of relying on others’ evaluation was the lowest(2.68±0.37). The scores of endogenous learning motivation subscale were higher than that of exogenous learning motivation. There were statistically significant differences in the professional identity scores of secondary vocational nursing students in terms of whether students participated in clubs, reasons for choosing nursing majors, and whether COVID-19 pandemic had influence on the selection of nursing specialty( P<0.05). There was a positive correlation between professional identity and learning motivation( r=0.508, P<0.01). Conclusion: In order to enhance secondary vocational nursing students’ professional identity, and thus increase their employment rate, we need to encourage them to participate in activities of school club and encourage their parents to play an educational role, increase interest in nursing, help them to understand the COVID-19 pandemic correctly and improve learning motivation.

Objective: To explore the obstacle factors for ICU nurses to perform physical restraint minimization action, and to provide reference for formulating standardized physical restraint management plan. Methods: The interview outline was developed based on the theoretical domains framework(TDF). Totally 12 ICU nurses from a tertiary hospital in Tianjin were selected for semi-structured interviews by purposive sampling, the transcribed texts were categorized according to the relevant domains of TDF, and the interview data were analyzed by content analysis. Results: In the current clinical work, ICU nurses had bias in understanding of physical restraint minimization action and unfamiliarity with the content of alternative restraint measures, which was one of the obstacles to their implementation of physical restraint minimization action. The decision process of evaluation tool of physical restraint minimization plan was not uniform and standardized, which has caused some obstacles to the development of restraint minimization action. The limitation of environmental factors and the concern about the outcome of reduction constraints made ICU nurses not confident enough to perform; The lack of organizational atmosphere supporting reduction constraints in the department made it difficult for nurses to pay attention to the implementation of reduction actions, and thus reduce the motivation of implementation. Combined with TDF, the above obstacles were classified into 5 domains: knowledge, beliefs about capabilities, environmental context and resources, social influences, behavioural regulation. Conclusion: On the basis of clarifying the obstacle factors, the department needs to strengthen the leadership’s attention and support to the implementation of physical restraint minimization, and develop the standardized decision-making process of restraint reduction assessment and training programs to advocate team cooperation, create an organizational atmosphere supporting physical restraint minimization action, encourage ICU nurses to firmly implement the confidence of restraint minimization, and promote the continuous implementation of physical restraint minimization action.

Objective: To explore the effect of health management based on cloud platform with self-management as the core in the continuous nursing of patients with chronic kidney disease(CKD), and so as to expand the model of continuous nursing for them. Methods: A total of 160 nephrology outpatients from October 2020 to March 2021 were randomly divided into control group( n=80) and observation group( n=80). The control group was given traditional health management, while the observation group was given health management based on cloud platform with self-management as the core for 3 months. The self-management ability, self-efficacy and medication compliance were investigated by scales before and after the intervention, and the changes of clinical laboratory indicators and dietary compliance were also observed. Results: Before the intervention, there was no significant difference in self-management ability, self-efficacy, diet and medication compliance, and laboratory parameters between the two groups( P>0.05). After intervention, self-management ability, self-efficacy, diet and medication compliance in the two groups were higher than those before intervention, and the observation group was superior to the control group, and the difference had statistical significance( P<0.05). Systolic blood pressure, diastolic blood pressure, blood uric acid and serum phosphorus in observation group decreased compared with those before intervention, while serum albumin increased, systolic blood pressure and albumin in observation group were superior to those in control group( P<0.05). Conclusion: Relying on the development of Internet hospitals, the health management based on cloud platform with self-management theory as the core can timely detect and solve the potential problems in the process of home treatment for patients, improve the nursing work efficiency, effectively improve the self-efficacy, self-management ability and treatment compliance of patients, and improve the clinical indicators.

Objective: To test the reliability, validity and predictive ability of the risk assessment tool for surgical patients with pressure injury in multicenter clinical application, and to compare the clinical application effect with the Waterlow scale. Methods: Quota sampling method was used to select 530 surgical patients undergoing general anesthesia from 4 Grade A hospitals in Tianjin from July to December 2020 as the research objects. The reliability and validity of the risk assessment tool for pressure injury in patients was tested, and the predictive ability was compared with Waterlow scale. Results: The Cronbach’s α coefficients of the risk assessment tool before and after surgery were 0.809 and 0.804, and S-CVI/Ave were 0.905; The contribution rate of cumulative variance of rotation transformation shows that the 12 entries were about 8%, which had strong stability, the contribution rate of cumulative variance of entries with eigenvalue >1 was 75.5%； The area under ROC curve before and after surgery was 0.722 and 0.732, respectively; and the area under ROC of Waterlow scale was 0.574. Conclusion: The risk assessment tool for surgical patients with stress injury has good reliability, validity and prediction ability, which can effectively judge the risk degree of surgical patients with stress injury. It has the characteristics of universality for surgical patients, and lays a foundation for the homogenous prevention and management of pressure injury in the operating room.

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 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 explore the effect of multidisciplinary team collaboration in inter-hospital transport of patients with acute and critical cardiovascular diseases. Methods: A total of 180 patients with acute and critical cardiovascular diseases were selected and 90 patients who received routine inter-hospital transport model from July 2018 to June 2019 were selected as the control group, while another 90 patients who received the multidisciplinary team collaboration in inter-hospital transport from July 2019 to June 2020 were selected as the observation group. The average transport time, incidence of adverse events, transport success rate and transport satisfaction were compared between the two groups. Results: The transport reaction time of the observation group was significantly lower than that of the control group, while the evaluation and treatment time on-site was significantly higher than that of the control group(P<0.05).  The time to destination and the time to return were not statistically different between the two groups (P>0.05). The incidence of adverse events, success rate of transport and patient/family transport satisfaction were significantly different between the two groups( P<0.01). Conclusion:The multidisciplinary team collaboration can effectively shorten the transport reaction time in inter-hospital transport of patients with acute and critical cardiovascular diseases, win more time for the assessment and treatment and reduce the incidence of adverse events during transportation, meanwhile, improve the success rate of transport and the degree of satisfaction. It provides reference for implementing the new inter-hospital transport model in patients with acute and critical cardiovascular diseases.

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.