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 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 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 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 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 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 apply the best evidence for continuous quality improvement for nursing care in ICU continuous renal replacement therapy (CRRT) to clinical practice and evaluate its effectiveness, with the aim of providing a reference for improving CRRT nursing quality in clinical settings. Methods: An evidence-based team was established, guided by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. An evidence based practice plan was developed and implemented in the Department of Critical Care Medicine at a grade Ⅲ and first class hospital in Tianjin from May to July 2023. The comparison of the application of the best evidence before and after included the execution rates of review indicators, as well as differences in patient filter usage time, unplanned catheter removal rates, and the incidences of hypotension and hypothermia. Results: A total of 13 pieces of best evidence were incorporated, and 9 review indicators were established. After the application of the evidence, filter usage time increased. the unplanned weaning rate, hypotension, and hypothermia incidence all decreased, with statistically significant differences ( P<0.05). Conclusion: Evidence-based practice for ICU CRRT nursing quality improvement can effectively improve CRRT treatment outcomes and reduce complication rates.

Objective: To explore potential categories of characteristics of family caregivers′ perceived benefit for young and middle-aged stroke patients, and to analyze differences in caregiver characteristics across categories and the factors that influence them. Methods: A convenience sampling method was used to select family caregivers of young and middle-aged stroke patients hospitalized at a grade Ⅲ and first-class neurological hospital in Tianjin from October 2023 to April 2024. The Stroke Caregiver Benefit Scale(CBS) was used for data collection. The potential categories of family caregivers were analyzed, and unordered multinomial logistic regression was used to analyze the relevant influencing factors. Results: The perceived benefit characteristics of family caregivers were categorized into 3 categories, including the "Low benefit-Lack of personal and family growth" (39.4%), "Moderate benefit-High self-transcendence" (32.9%), and "High benefit-Moderate self-transcendence" (27.7%). The results of unordered multinomial logistic regression analyses showed that coping style, social support levels, presence of a co-caregiver, caregiver burden levels, frequency of stroke events, and employment status were the factors influencing the perception of benefit for family caregivers of young and middle aged stroke patients. Conclusion: There are obvious categorical characteristics of family caregivers in young and middle aged stroke patients. It is recommended that medical staff take targeted interventions according to different types of perceived benefit characteristics to enhance the caregivers′ sense of benefit.

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 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.