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The Effects of Simulation-Based Learning Using Virtual Reality in Nursing Student: A Meta-Analysis
Run-Jie ZHANG, Shu-Jin YUE , Yun-Yue TANG, Zhi-Qi CHEN, Zi-Pan WANG, Jing WANG, Yu LI
Journal of Integrative Nursing    2019, 1 (2): 96-106.   doi: 10.35437/intnur.issn.2663-4481.2019.01.02.06
Abstract343)      PDF(pc) (1165KB)(1040)      

Purpose: To assess the effect of simulation-based learning using virtual reality (VR) on knowledge, affective, and performance domain outcomes of learning in nursing students.

Methods: A literature search was conducted using Cochrane library, PubMed, EMBASE, Web of Science, ProQuest, ScienceDirect, Springer and Ovid eight electronic English databases, independently by 2 of the authors from January 2008 to December 2018. The RevMan 5.3 program of the Cochrane library was used to analyze the data with mean and standard deviation .

Results: A total of 10 studies (5 randomized control trials (RCTs) and 5 non-RCTs) involved 630 nursing students. As a whole, simulation-based learning using VR appeared to have beneficial effects on the knowledge (I2=50%, 95% CI 0.35 [0.09, 0.62], P=0.009), have no significant difference on the performance (I2=97%, 95% CI 1.05 [-0.54, 2.63], P=0.19) and have a negative impact on the affective field (I2=0%, 95% CI -0.43 [-0.71,-0.15], P=0.003).

Conclusion: The existing evidences imply that simulation-based learning using VR might have a positive trend that is beneficial to knowledge and clinical skill acquisition. However, the best way of integration still needs further research to be identified.

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An Analysis of the Application of the Suggestions of Clinical Practice Guideline for Ostomy Care in China: A Cross-Sectional Investigation
Jing WANG, Shu-Jin YUE, Dong-Qun XUE, Zi-Pan WANG, Yu LI, Zhi-Qi CHEN, Dong-Qin KANG, Qi LIU
Journal of Integrative Nursing    2019, 1 (1): 9-20.   doi: 10.35437/intnur.issn.2663-4481.2019.01.01.02
Accepted: 18 April 2019

Abstract347)      PDF(pc) (405KB)(403)      

Background: Clinical practice guidelines refer to the guidance provided by the expert system to help medical staff and patients decide on appropriate treatments for a specific clinical situation, mainly including guidelines based on expert consensus and evidence-based guidelines. Since there is no research and clinical application of a specific stoma guidance in China. It is of great significance to understand the application status of the recommended guidelines and the influencing factors in promoting the development of stoma care.

Purpose: To investigate the application status of recommended clinical practice guidelines for stoma nursing in China, and to analyse the reasons for the knowledge and application of recommendations.

Methods: The Questionnaire on the Application of Recommendations in Clinical Practice Guidelines for Ostomy Nursing was adopted.

Results: We collected 195 questionnaires and 183 valid questionnaires were available. ①The average knowledge rate of a total of 31 recommendations was 73.65%. The main reasons for unknown were insufficient dissemination and lack of training. ②The average application rate of the 31 recommendations was 58.08%. The overall satisfaction rate of people who used them was high. The main reasons for not applying recommendations were complex.

Conclusions: Different levels of recommendations awareness and application are different. There is a lack of evidence-based guidelines for clinical practice in ostomy nursing in the field of stoma care in China, which limits the scientific development of stoma care to a certain extent. However, this study provides reference for the future construction of a guidebook adapted to our country's localization.

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Research Status of Traditional Chinese Medicine Constitution Theory in Insomnia
Chun-Hua ZHANG, Chun-Guang YU, Pei-Yao LI, Ling WANG, Hui-Xin DING, Wen-Wen ZHAO
Journal of Integrative Nursing    2019, 1 (1): 51-58.   doi: 10.35437/intnur.issn.2663-4481.2019.01.01.07
Accepted: 25 April 2019

Abstract323)      PDF(pc) (367KB)(401)      

With the development of modern bio-psycho-social medical model and traditional Chinese medicine (TCM) constitution theory, we gradually realize that the exploration of the constitution characteristics of insomnia is of great significance for the reveal of the origin of insomnia and the innovation of its treatment and nursing methods. This paper focused on the analysis of the investigation of TCM constitution classification of insomnia and the application of TCM constitution theory in the treatment and nursing of insomnia. Moreover, the research prospect of insomnia in TCM constitution was discussed. The purpose is to provide theoretical basis for the treatment and nursing of patients with insomnia based on analysis of constitution differentiation in the future, and to better serve the clinic.

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Investigation on the Clinical Readiness of Nurses' Evidence-based Practice in a 3A-Level General Hospital in Beijing
Luo YANG, Hong GUO, Yan-Ling SHEN, Li LI, You-Hua LIU, Dan ZHAO, Hai-Yan WANG, Shao-Hua GONG, Xiao-Ping YI
Journal of Integrative Nursing    2019, 1 (1): 1-8.   doi: 10.35437/intnur.issn.2663-4481.2019.01.01.01
Accepted: 10 April 2019

Abstract388)      PDF(pc) (405KB)(371)      

Objective: To understand the evidence-based practice readiness of developing evidence application projects in a 3A-level general hospital in Beijing, to identify barriers to evidence-based practice and to promote the successful application of evidence.

Methods: All the clinical nurses who are going to participate in the application units of the evidence-based practice project are selected as the survey objects, and the self-made “Basic Information Questionnaire” and “Clinical Readiness to Evidence-based Nursing Assessment (CREBNA)” are used to conduct the survey. The total amounts and subscales are calculated. The factors that influence the score of the total scale were scored and analyzed.

Results: The CREBNA total score was (119.87±19.18), the evidence subscale score was (47.94±8.54), the organizational environmental subscale score was (36.09±6.11), and the facilitator subscale score was (35.83±7.56). Univariate analysis showed that the total score of the scale was related to years of work, scientific research experience, knowledge of evidence-based care, and participation in evidence-based practice.

Conclusion: The current evidence-based practice preparation situation is good. It is feasible to carry out evidence-based practice activities in the hospital. The follow-up development plan should be made based on the corresponding obstacle factors.

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Risk and Cumulative Risk of Acute Ischemic Stroke Recurrence in China: A Systematic Review and Meta-Analysis
You-Hua LIU, Hong GUO, Gui-Ying LIU, Luo YANG, Hai-Yan WANG, Dan ZHAO, Hui JU, Shao-Hua GONG, Xiao-Ping YI
Journal of Integrative Nursing    2019, 1 (1): 59-66.   doi: 10.35437/intnur.issn.2663-4481.2019.01.01.08
Accepted: 20 April 2019

Abstract224)      PDF(pc) (693KB)(365)      

Objective: To comprehensively evaluate the risk of recurrence after initial ischemic stroke, and to provide a relatively comprehensive reference for the prevention and control of stroke recurrence.

Methods: CNKI, VIP, Wanfang, PubMed, Web of Science, Embase and other databases were collected to investigate the status of recurrence after initial ischemic stroke, the search period of which was from the establishment of databases to March 2019. And then quality evaluation and data extraction were carried out. The overall cumulative risks of stroke recurrence at 3 months, 6 months, 1 year, 2 years and 5 years after initial ischemic stroke were calculated, and heterogeneity analysis was performed.

Results: A total of 29 studies from 19 provinces (cities, autonomous regions) in China were included. The cumulative total sample size was 22 484 cases, the cumulative recurrent sample size was 3 309 cases. The pooled cumulative risk was 4.5% (95% CI: 3.1-5.8) at 3 months, 7.8% (95% CI: 5.6-10.0) at 6 months, 13.6% (95% CI: 11.0-16.2) at 1 year, 17.5% (95% CI: 12.4-22.6) at 2 years and 30.9% (95% CI: 20.2-41.7) at 5 years after initial ischemic stroke.

Conclusions: The recurrence rate of acute ischemic stroke in China is high. It is recommended that all levels of medical and health departments strengthen the prevention and treatment of ischemic stroke recurrence to reduce the recurrence of ischemic stroke and improve the prognosis of patients.

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Efficacy of Acupoint Massage Versus Normal Treatments for Acute Mastitis: A Systematic Review
Hui JU, Xue-Ling MA, Hong GUO, Hai-Yan WANG, You-Hua LIU, Luo YANG, Ling TANG
Journal of Integrative Nursing    2019, 1 (1): 41-50.   doi: 10.35437/intnur.issn.2663-4481.2019.01.01.06
Accepted: 20 April 2019

Abstract407)      PDF(pc) (731KB)(334)      

Objective  To systematically review the effectiveness of acupoint massage versus normal treatments for acute mastitis. Methods  Databases including CNKI, Wanfang database, VIP, Pubmed, Web of science and Cochrane were searched to collect randomized controlled trials (RCTs) about acupoint massage versus normal treatments for acute mastitis from inception to October 2018. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3.3 software. 

Results  A total of 16 RCTs involving 2056 patients were included. The results of meta-analysis showed that, compared with normal treatments, acupoint massage could improve the efficiency of clinical treatment [RR = 1.18, 95% CI (1.13, 1.22), P< 0.00001], shorten onset time[MD=-1.69, 95% CI (-1.89, -1.41), P<0.00001], decrease the lump size [MD=-2.64, 95% CI (-4.46, -0.82), P=0.005], and decrease the score of symptoms and signs[MD=-3.88, 95% CI (-7.50, -0.27), P=0.04]. However, there was no significant difference in recurrence rate[RR=0.41, 95% CI (0.11, 1.57), P=0.19] and cure rate[RR=11.82, 95% CI (0.50, 282.04), P=0.13]. 

Conclusion  The current evidence shows that, compared with normal treatments, acupoint massage can improve the efficiency of clinical treatment, shorten the onset time, and decrease the lump size. Due to the limited quality of included studies, more high quality studies are needed to verify the above conclusion.

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Nursing Based on Syndrome Differentiation Combined with Auricular Plaster Therapy in Alleviating Insomnia
Ning WANG, Shu-Li MA, Xi LI, Li-Xia YANG
Journal of Integrative Nursing    2019, 1 (1): 27-34.   doi: 10.35437/intnur.issn.2663-4481.2019.01.01.04
Abstract255)      PDF(pc) (442KB)(332)      

Objective: To observe the effect of auricular point pressing combined with nursing bsed on syndrome differentiation in the treatment of insomnia patients.

Methods: Totally 92 patients with insomnia were randomly divided into the observation group given auricular point pressing combined with nursing care based on syndrome differentiation and the control group treated with auricular point pressing alone. The improvement of Pittsburgh Sleep Quality Index (PSQI), TCM Syndrome Score and nursing satisfaction were compared between the 2 groups.

Results The time effect of PSQI total score and six factors in both groups were statistically significant (P<0.05). The time effect, interaction effect and inter-group effect of subjective sleep quality, PSQI total score were statistically significant (P<0.05); the four inter-group factors of sleep quality, sleep latency, sleep duration and daytime function were statistically significant (P<0.05). The total score of TCM syndromes in the observation group was lower than that in the control group (P<0.05), and the satisfaction rate in the observation group higher than that in the control group (80.43% vs. 60.86%, P<0.05).

Conclusion  Auricular point pressing combined with nursing based on syndrome differentiation can effectively improve the sleep quality of insomnia patients, and has significant advantages in improving TCM syndromes, as well as gained higher nursing satisfaction from patients.

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The Application of the Complementary and Alternative Therapies in Relieving Insomnia for Cancer Patients
Juan LIAO, Bu-Xin HAN, Ling TANG, Dong CAO, Nan ZHAO
Journal of Integrative Nursing    2019, 1 (1): 21-26.   doi: 10.35437/intnur.issn.2663-4481.2019.01.01.03
Accepted: 20 April 2019

Abstract330)      PDF(pc) (391KB)(294)      

Objective: To observe the curative effect of mini-needle therapy combined with traditional Chinese Medicine (TCM) five elements music in relieving insomnia caused by qi stagnation of liver in patients with advanced cancer.

Method: According to the principle of randomization, with meeting the inclusion criteria, the 60 patients who were diagnosed as insomnia caused by liver qi stagnation were randomly divided into the control group and the intervention group. The intervention group (30 individuals treated with mini-needle therapy combined with TCM five elements music), the control group (30 individuals who were treated with single mini-needle therapy), the body buried needle 24 hours/time, 5 times for a course of treatment, interval of 2 days between 2 courses, a total of 8 needles embedded.  Pittsburgh sleep quality index (PSQI) scores of 2 groups were analyzed using SPSS 19.0 statistical software.

Results: The total effective rate was 86.1% in the intervention group, and 75.9% in the control group, the difference was statistically significant between 2 groups (P<0.05). The comparison of the PSQI score between the 2 groups pro-post treatment showed that there were statistically significant differences (P<0.05). The reduction rate of PSQI in the intervention group was 31.7%, indicating that 31.7% was effective, while 23.1% in the control group was ineffective. 

Conclusion: The mini-needle therapy combined with TCM five elements music could relieve insomnia caused by qi stagnation of liver in patients with advanced cancer. 

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Application of Out-of-Hospital Extended Nursing in Brace Treatment of Patients with Idiopathic Scoliosis
Feng-Xiang ZHU, Hai-Yan SHAO, Hong-Ying ZHU, Xiao-Ling HUANG Ling TANG
Journal of Integrative Nursing    2019, 1 (2): 92-95.   doi: 10.35437/intnur.issn.2663-4481.2019.01.02.05
Abstract201)      PDF(pc) (378KB)(275)      

Objective: To investigate the effect of out-of-hospital extended nursing on the compliance behaviors and therapeutic effect of brace treatment of patients with idiopathic scoliosis. 

Methods: 54 patients with idiopathic scoliosis between February 2015 and December 2017 were randomly divided into control group and observation group. Patients in the control group received pelvic suspension traction, gymnastic exercises, and brace wear at discharge, on the basis of which patients in the observation group were added with extended care outside the hospital. The compliance behaviors and the changes of scoliosis angle (Cobb angle) of patients in the 2 groups were evaluated. 

Results: Compared with the control group, patients in the observation group had better compliance behaviors in completion status of functional exercise (χ2= 5.594, P= 0.018), brace wear (χ2= 6.171, P= 0.013), subsequent visit on time (χ2= 9.247, P= 0.002). Cobb angle was improved significantly in both groups at the last follow-up compared with that on admission, and the improvement was more significantly in the observation group (P<0.001).  

Conclusion: Through the implementation of out-of-hospital extended nursing, the compliance behaviors and clinical effect of brace treatment for idiopathic scoliosis patients are obviously improved, and this active nursing model is worth popularizing in clinic.

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Correlation of Treatment Compliance, Treatment Attitude and Belief, and Quality of Life in Community Hypertensive Patients
Xiao-Jiao LIU, Hong-Fang CHEN, Jia-Mei LI, Yuan LYU, Sheng-Rui ZHU, Huan-Ze LI
Journal of Integrative Nursing    2019, 1 (3): 143-150.   doi: 10.35437/intnur.issn.2663-4481.2019.01.03.04
Abstract222)      PDF(pc) (385KB)(265)      

Objective: To explore the relationship between treatment compliance, treatment attitude and belief, and quality of life in patients with hypertension in the community, and to provide evidence for improving their quality of life.

Methods: A convenient sampling method was used to survey 250 patients with hypertension who met the inclusion criteria using the General Questionnaire, Treatment compliance, Treatment Attitudes and Beliefs, and Quality of Life Scale.

Results: The total score of treatment compliance of hypertension patients in the community was (91.678±11.431), treatment attitude and belief score (70.407±9.008), quality of life score (113.599±13.511), Pearson correlation analysis showed that the treatment compliance of hypertension patients was positively correlated with quality of life (r=0.433, P<0.01), and treatment attitude and belief were positively correlated with quality of life (r=0.463, P<0.01).

Conclusion: The quality of life of patients with hypertension in the community is related to treatment compliance and treatment attitudes and beliefs.

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Qualitative Study on Health Self-Help Behavior of the Elderly in a Community
Wei LUAN, Yang LIU, An-Li JIANG, Ye CHEN
Journal of Integrative Nursing    2019, 1 (1): 35-40.   doi: 10.35437/intnur.issn.2663-4481.2019.01.01.05
Accepted: 23 April 2019

Abstract203)      PDF(pc) (356KB)(256)      

Objective: To investigate the current status quo of health self-help behavior of elderly in a community and its influencing factors using a semi-structured interview in a qualitative study.

Methods: A phenomenological method is employed for purposive sampling and snowball sampling methods. The elderly (>60 years old), who had lived in the Minhang District of Shanghai for >5 years, with an annual residence duration ≥10 months, were selected. Data were collected in person by a semi-structured and an in-depth interview; the topics were identified according to data arrangement, analysis, and coding.

Results: A total of 10 subjects were enrolled, from Pujiang Town, Minhang District of Shanghai. The cohort constituted of 7 males and 3 females, aged 60-68 years, with an average of (63.40±9.19) years. After data arrangement and analysis, the following topics were obtained: (1) various forms of health self-help behaviors existed among elderly in the community; (2) some factors influenced the health self-help behavior among the elderly in the community; (3) a deviation was observed in the health self-help behavior among the elderly in the community.

Conclusion: The health self-help behaviors of the elderly in the community should be rectified to carry out self and the environmental establishment of the health self-help behaviors of the elderly in the community, as well as, to guide and develop the personalized health self-help behavior program.

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Quantitative and Qualitative Investigation of Traditional Chinese Medicine Nursing Protocols for Type 2 Diabetes Mellitus
Di SANG, Yan-Ping HUANG, Xiao-Qin CHENG
Journal of Integrative Nursing    2019, 1 (2): 80-85.   doi: 10.35437/intnur.issn.2663-4481.2019.01.02.03
Abstract197)      PDF(pc) (398KB)(250)      

Objective: To analyze the implementation status of traditional Chinese medicine (TCM) nursing protocols for type 2 diabetes mellitus. 

Methods: Totally 420 hospitalized patients with type 2 diabetes mellitus were given TCM nursing protocols by syndrome differentiation. A quantitative and qualitative investigation was conducted to patients who received TCM nursing and nurses who performed TCM nursing techniques.

Results: According to the self-evaluation outcomes of patients, TCM nursing protocols were effective to relieve polydipsia, polyuria, fatigue and other symptoms. Patients exhibited a high level of compliance with nursing techniques such as auricular point pressing, acupoint massage, Chinese herbal foot-bath and moxibustion. The interview showed that patients could benefit from the TCM nursing protocols, and nurses considered that application of TCM nursing protocols could enhance their awareness of TCM knowledge and practice skills. 

Conclusion: The application of TCM nursing protocols is effective to relieve clinical symptoms of type 2 diabetes mellitus. It can also improve the knowledge level and practice skills of nurses in TCM hospitals.

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Five-Tone Therapy Plus Head and Face Massage Relieves Insomnia of Patients with Heart and Spleen Deficiency
Ming-Hui MA, Hai-Yun GAI, Ya-E NIE, Cai-Yun CUI, Zhen WANG
Journal of Integrative Nursing    2019, 1 (3): 151-156.   doi: 10.35437/intnur.issn.2663-4481.2019.01.03.05
Abstract235)      PDF(pc) (511KB)(244)      

Objective: To explore the therapeutic effect of five-element music therapy based on syndrome differentiation plus head and face massage in relieving insomnia of patients with heart and spleen deficiency.  

Methods: Sixty patients with heart and spleen deficiency were divided into control group and test group, 30 cases each. The control group received routine treatment and nursing. The experimental group was given five-element music therapy plus head and face massage on the basis of the control group, once a day, 15 minutes/time, 5 times/week, and continuous observation for 4 weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality before and after intervention.

Results: After 30 days, the total effective rate of the experimental group was 86.67%, which was higher than the total effective rate of 76.67% in control group (P<0.05). There were significant differences in the time of sleep, sleep quality, sleep efficiency and PSQI score between the two groups (P<0.05).

Conclusion: Five-tone therapy based on syndrome differentiation combined with head and face massage can effectively improve the sleep quality of patients with heart and spleen deficiency, prolong sleep time, with no adverse reactions, so it is worthy of clinical application.

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Effect of Acupoint Massage on Cognitive Dysfunction: A Systematic Review and Meta-Analysis
You-Hua LIU, Luo YANG, Shao-Hua GONG, Xiao-Ping YI, Hong GUO
Journal of Integrative Nursing    2019, 1 (2): 107-114.   doi: 10.35437/intnur.issn.2663-4481.2019.01.02.07
Abstract286)      PDF(pc) (886KB)(241)      

Objective: To evaluate the clinical effect of acupoint massage in improving cognitive function, in order to provide a relatively comprehensive reference for dementia prevention and control.

Methods: Clinical trial studies on the improvement of cognitive function by acupoint massage were systematically collected from multiple Chinese and foreign databases, consisting of CNKI, VIP, Wanfang, PubMed, Web of Science, Embase, the Cochrane Library, and CINAHL. According to the inclusion and exclusion criteria, the two researchers independently screened the literature, extracted the data, evaluated the quality of the included articles and cross-checked, and then carried out a meta-analysis with the RevMan 5 software.

Results: A total of 10 studies were included, and the cumulative total sample size was 818. The results of meta-analysis showed that the improvement of cognitive function in acupoint massage group was significantly better than that in control group. Compared with the control group, acupoint massage significantly increased the total score of mini-mental state examination (MMSE) scale for the elderly [SMD=0.80, 95% CI (0.53, 1.07), P<0.0001]), and significantly improved the picture memory ability [SMD=-3.69, 95% CI (-5.08, 2.30), P<0.0001], associative memory ability [SMD=0.24, 95% CI (-0.73, 1.20), P<0.0001]), understanding and memory ability [SMD=1.33, 95% CI (0.58, 2.09), P<0.0001]), instantaneous memory ability [SMD=1.70, 95% CI (0.77, 2.62), P<0.01]) of the elderly.

Conclusion: Acupoint massage can improve the cognitive function of the elderly and reduce the risk of Alzheimer disease (AD) in the elderly. More large samples, multicenter and high quality randomized controlled trials are needed to verify the intervention effect of acupoint massage on cognitive impairment.

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Application of Comprehensive Health Education in Nursing of Patients with Metrorrhagia and Metrostaxis Treated by Hysteroscopic Electrotomy
Fei YANG, Qing-Wen GENG, Jing WANG, Yan-Min LI, Ya-Li WANG
Journal of Integrative Nursing    2019, 1 (2): 67-72.   doi: 10.35437/intnur.issn.2663-4481.2019.01.02.01
Abstract265)      PDF(pc) (381KB)(238)      

Objective: To explore the application of health education in the nursing care of patients with metrorrhagia and metrostaxis after hysteroscopic electrotomy and the effect on the occurrence of disease complications.

Methods: Totally 70 patients admitted from March 2018 to March 2019 were randomly divided into two groups. The control group was given routine nursing, while the observation group was given comprehensive health education combined with routine nursing. The unhealthy emotions (anxiety and depression) of patients were assessed using Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). The incidence of complications, and surgical related matters were recorded and compared between two groups after nursing interventions.

Results: A lower HAMD score, A lower HAMA score, a shorter hospitalization time, a shorter operation time and a less intraoperative bleeding volume, a lower incidence rate of complications (massive bleeding and uterine perforation), and a higher degree of patients’ cooperation in surgery were shown in observation group compared with control group after nursing intervention (P all <0.05).

Conclusion: The application of health education in the nursing of metrorrhagia and metrostaxis patients can relieve the patients’ anxiety and depression, improve their understanding and mastery of relevant disease knowledge and their ability to cope with bleeding and their self-health care, as well as reduce the incidence of complications and the length of hospital stay and promote the rehabilitation of patients. Therefore, it is worthy of clinical application.

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Analysis of Adaptation Process of Evidence-Based Interventions by Taking Post-Stroke Dysphagia Screening As an Example--Based on a Series of Empirical Studies
Xiao-Yan ZHANG, Jun-Qiang ZHAO, Shang-Qian GAO, Li-Jiao YAN, Xue-Jing LI, Jing-Ya MA, Yu-Fang HAO
Journal of Integrative Nursing    2019, 1 (3): 123-131.   doi: 10.35437/intnur.issn.2663-4481.2019.01.03.01
Accepted: 10 September 2019
Online available: 15 November 2019

Abstract193)      PDF(pc) (384KB)(238)      

Background: Evidence-based interventions (EBIs) are frequently adapted or modified during the implementation process to meet the needs of the target context, public health professionals, or health practitioners. However, little is known about how the EBIs of the same clinical problem at a different time (sustainability) and a different setting (scalability) should be adapted to facilitate implementation. To address this gap, this research aims to analyze the adaptations process of EBIs by taking post-stroke dysphagia screening as an example based on a series of empirical studies.

Methods: We reviewed three best practice implementation projects of post-stroke dysphagia identification and management in mainland China, and conducted a comparative analysis of three projects of dysphagia screening practical decision-making according to core elements of evidence-based nursing (EBN).

Results: We identified the core elements of EBN that influence decision-making in each best practice implementation project. The decision-making of screening time and tool for dysphagia in the three projects varied. Project 1: Post-stroke dysphagia was screened using Water Swallow Test (WST) before the first intake of liquid or food. Project 2: A sustainability study based on project 1, post-stroke dysphagia was screened using Standardized Swallowing Assessment (SSA) before the first intake of liquid or food, within 24 hours of admission. Project 3: A community scalability study based on project 2, post-stroke dysphagia was screened using Water Swallow Test (WST) before the first intake of liquid or food, within 24 hours after referral.

Conclusions: Adaption of EBIs needs to fully consider the best available external evidence from systematic research, clinical expertise, patient preferences, as well as context.

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Investigation and Analysis on the Physical and Mental Health Status of Intern Nurses in a Hospital, Gansu Province
Dong-Mei YAN, Dan-Lin LI, Hui-Hui ZHAO, Meng-Yao SHI
Journal of Integrative Nursing    2019, 1 (3): 138-142.   doi: 10.35437/intnur.issn.2663-4481.2019.01.03.03
Online available: 15 November 2019

Abstract228)      PDF(pc) (379KB)(236)      

Objective: To analyze the investigation results of mental health Symptom Checklist-90 (SCL-90) of nursing interns (hereinafter referred to as nursing students) in a hospital in Gansu Province, to comprehensively and objectively understand the mental health status of nursing students, in order to provide the basis of maintaining and improving the mental health level of nursing students.

Methods: Totally 121 nursing interns were surveyed using SCL-90, and statistical analysis was performed using SPSS19.0.

Results: The mental health status of nursing students in a hospital in Gansu Province is higher than that of normal adults in China. The scores of the six factors (somatization, obsessive-compulsive symptoms, depression, anxiety, horror, and psychosis) are higher (P<0.01). Compared with the group norm, the four factors of somatization, obsessive-compulsive symptoms, terror, and anxiety are higher (P<0.01), but they are better than the mental health status of college students in China (except for somatic symptoms) (P<0.01).

Conclusion: The mental health status of nursing students is poor and needs attention. Interventions can be taken to alleviate psychological problems of nursing students, thoroughly improve their anxiety and depression, and thus improve their health.

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Application of Stone Needle Therapy Based on Blood Stasis Theory in the Treatment of 36 Cases of Knee Osteoarthritis in Early and Middle Stage
Yu-Feng MA, Xue-Jian ZHANG, Ling TANG, Xu-Yue PAN, Yue TANG, Li-Li DING, Ya-Li XIAO
Journal of Integrative Nursing    2019, 1 (2): 73-79.   doi: 10.35437/intnur.issn.2663-4481.2019.01.02.02
Abstract182)      PDF(pc) (457KB)(229)      

Objective: To evaluate the clinical efficacy of stone needle therapy based on blood stasis theory for different traditional Chinese medicine (TCM) syndrome types of patients with knee osteoarthritis in early and middle stage.

Methods: Totally 36 patients with knee osteoarthritis were enrolled in the orthopaedic ward between March 2016 and December 2017, and diagnosed as qi stagnation and blood stasis syndrome, cold dampness and stasis syndrome, or phlegm and stasis syndrome according to TCM syndrome differentiation. After treatment, stone needle was used for ironing on the different meridian acupoints according to different syndromes. The efficacy of patients with the above three syndromes was respectively evaluated, and the visual analogue scale (VAS) score and western ontario and mcMaster universities arthritis Index (WOMAC) score of the three groups were calculated before treatment, 2 weeks, and 4 weeks after treatment.

Results: The effective rates of the three groups were 86.67%, 81.82%, and 80.00%, respectively. After 2 weeks and 4 weeks of treatment, the VAS and WOMAC scores of the three groups decreased significantly compared to treatment before (P<0.05).

Conclusion: Stone needle therapy for ironing on the acupoints around the knee joint has a good therapeutic effect on knee osteoarthritis of different syndrome types, which is worthy of further application.

 

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Research Progress of Traditional Chinese Medicine Constitution Theory in Patients with Cervical Spondylosis
Hui-Xin DING, Chun-Guang YU, Ling WANG, Chun-Hua ZHANG, Pei-Yao LI
Journal of Integrative Nursing    2019, 1 (2): 115-122.   doi: 10.35437/intnur.issn.2663-4481.2019.01.02.08
Abstract239)      PDF(pc) (403KB)(226)      

This paper expounds the theory of traditional Chinese medicine (TCM) constitution applied to patients with cervical spondylosis, in order to clarify the distribution characteristics of TCM constitution of patients with cervical spondylosis. And to analyze the correlation between TCM constitution theory and cervical spondylosis is helpful to provide ideas for integrated nursing care of TCM and modern medicine in patients with cervical spondylosis, and provide the basis for the construction of health management program and the evaluation of health promotion effect. 

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Surrounding Needling with Fire Needle and Filiform Needle Plus Moxibustion in the Treatment of Lower Limb Herpes Zoster: One Case Report
Chen YANG, Li-Na QIN, Su-Hua SHI, Hui JU
Journal of Integrative Nursing    2019, 1 (3): 170-172.   doi: 10.35437/intnur.issn.2663-4481.2019.01.03.08
Abstract120)      PDF(pc) (322KB)(212)      
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Effect of Auricular Piont Pressing Combined with Thunder-Fire Moxibustion on Abdominal Distension and Constipation After Thoracic Compression Fracture
Xue-Jian ZHANG, Ling TANG, Jing ZHANG, Li-Li DING, Si-Ting LIU, Ya-Li XIAO, Yue TANG
Journal of Integrative Nursing    2019, 1 (2): 86-91.   doi: 10.35437/intnur.issn.2663-4481.2019.01.02.04
Abstract197)      PDF(pc) (421KB)(208)      

Objective: To explore the effect of auricular point pressing combined with thunder-fire moxibustion in the treatment of abdominal distension and constipation after thoracic compression fracture.

Methods: Totally 100 patients were randomly divided into 4 groups, the observation group 1 (n = 25) which were treated with conventional nursing combined with auricular piont pressing, observation group 2 (n = 25) treated with conventional nursing combined with thunder-fire moxibustion, observation group 3 (n = 25) treated with conventional nursing combined with auricular point pressing and thunder-fire moxibustion, and the control group (n = 25) which adopted conventional nursing. First exhaust and defecation time after fracture in 4 groups were observed and compared.

Results: The effect of observation group 3 was better than that of observation group 2, observation group 1 and control group (P<0.05).

Conclusion: It is obvious that auricular point pressing combined with thunder-fire moxibustion has better result in treating abdominal distension and constipation after thoracic compression fracture.

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Home-based treatment and nursing plan of a patient diagnosed with mild-to-common coronavirus disease 2019
Bing-Rui WEI, Dian Francis SAVELLANO, Cui-Huan HU
Journal of Integrative Nursing    2020, 2 (1): 27-31.   doi: 10.4103/jin.jin_8_20
Abstract194)      PDF(pc) (767KB)(201)      

To date, there are no known specific antiviral medicines recommended for coronavirus disease 2019 (COVID-19). The treatment mainly focuses on the improvement of the immunity of the individual and the application of palliative treatment. A case of a patient diagnosed with mild COVID-19 and then later developed common COVID-19 which was treated and closely monitored at home will be presented. The patient was advised for self-quarantine with several prescribed medications. Nursing home and self-care advice were given to the patient, including a change of lifestyle for the duration of the isolation, medication advice, symptomatic care, change of diet, how to monitor the progress of the disease, psychological care, and follow-up instructions. During the course of the nursing plan, the patient showed significant improvements, and normal life functions were restored. On February 05, 2020, novel coronavirus nucleic acid test showed negative after re-examination; the patient was cured. Therefore, providing adequate nursing plan for home-based self-care treatment can effectively cure mild and common cases of COVID-19.

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The effects of enteral nutrition in the bowel preparation in patients with diabetes mellitus
Xiu-Li OU, Yu-Zhen CHEN, Min ZHANG, Li-Zhen LYU
Journal of Integrative Nursing    2020, 2 (1): 18-21.   doi: 10.4103/jin.jin_2_20
Abstract105)      PDF(pc) (582KB)(195)      

Objective: The objective of the study was to investigate the effect of enteral nutrients in diabetic patients with fibrocolonoscopy.

Materials and Methods: A total of 58 diabetic patients undergoing fibrocolonoscopy from January 2017 to December 2017 were included as the traditional bowel preparation group. The patients took traditional semi-flow diet and catharsis as intestinal preparation and were given health education. Sixty patients treated with fibrocolonoscopy from July to December in 2018 were included as the enteral nutrition group and received enteral nutrients and catharsis as intestinal preparation and were given modified health education. The incidence of hypoglycemia during intestinal preparation was compared between the two groups.

Results: A total of 20 (34.48%) patients in the traditional bowel preparation group had hypoglycemia (including asymptomatic hypoglycemia) during bowel preparation, with the total frequency of 40. The blood glucose level fluctuated between 1.7 and 3.9 mmol/L. Only five patients in the enteral nutrition group had hypoglycemia (including asymptomatic hypoglycemia) during bowel preparation. The incidence of hypoglycemia was lower in the enteral nutrition group than that in the traditional bowel preparation group (χ2 = 4.937, P = 0.026).

Conclusion: The enteral nutrients as diet for fibrocolonoscopy bowel preparation and strengthening health education could reduce the incidence of hypoglycemia in patients with diabetes during bowel preparation and ensure patient safety.

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Analysis of the Influence of Probiotics on Intestinal Micro-ecology and Related Diseases
Luo YANG, Hong GUO, Yan-Ling SHEN, Li LI, You-Hua LIU, Dan ZHAO, Hai-Yan WANG, Shao-Hua GONG, Xiao-Ping YI
Journal of Integrative Nursing    2019, 1 (3): 163-169.   doi: 10.35437/intnur.issn.2663-4481.2019.01.03.07
Online available: 15 November 2019

Abstract257)      PDF(pc) (369KB)(187)      

Probiotics are a kind of living microorganisms added into food or drug,which are beneficial to our health. Probiotics can regulate the balance of microecosystem in intestine. Recently, people have paid more attention to the effect on the intestinal microecology. This article mainly made a review on the mechanism and application of probiotics.

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Efficacy of compound Bai Yu San in treating diabetic skin ulcer
Yun-Xia GE, Xiao-Rong LIU, Bei WANG, Yong ZHANG, Jia-Jia TONG, Dou-Dou LI
Journal of Integrative Nursing    2020, 2 (1): 7-10.   doi: 10.4103/jin.jin_7_20
Abstract78)      PDF(pc) (586KB)(176)      

Objective: To assess the efficacy of compound Bai Yu San (CBYS) as a new treatment option, in healing diabetic skin ulcer.

Materials and Methods: A total of 64 diabetic patients with skin ulcer were enrolled and randomly assigned to experimental group (n = 33) and control group (n = 31). In the control group, normal saline (NS) was used to cleanse the wound. After debridement, the wound was dressed with modern materials. In the experimental group, the NS-cleansed wound was dressed with CBYS. The infection rate, healing rate, treatment cost, and patient satisfaction between the two groups were compared. Results: On the 35th day after treatment, the infection rate and healing rate showed no between-group difference (P > 0.05); the experimental group showed lower treatment cost and higher satisfaction than the control group (P < 0.05).

Conclusion: As a new treatment option for diabetes-induced skin ulcer, CBYS can effectively control the infection, promote the healing, reduce treatment cost, and increase patient satisfaction. Dressing with CBYS can be clinically replicated in the treatment of diabetic skin ulcer.

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The psychological experience of Chinese nurses in support of COVID-19 frontline: A qualitative study
Ju‑Hong PEI, Hai‑Xia CHEN, Xing‑Lei WANG, Rui‑Ling NAN, Xin‑Man DOU, Xian PENG
Journal of Integrative Nursing    2020, 2 (2): 55-60.   doi: 10.4103/jin.jin_24_20
Abstract183)      PDF(pc) (522KB)(173)      
Objective: The objective of the study is to explore the real psychological experience of the frontline support nurses in fight against COVID-19, so as to provide a reference basis for targeted intervention and ensure the mental health of the frontline support nurses.
Methods: The objective sampling method was used to conduct semi-structured interviews with 9 frontline support nurses fighting COVID-19, and the interview contents were analyzed using Colaizzi's 7-step method.
Results: The psychological experience of frontline support nurses in fight against COVID-19 can be summarized into four themes: The coexistence of negative psychological experience and positive psychological experience (tension, anxiety, fear, and depression); psychological pressure; many factors that affect the negative psychological experience (the stimulation of the external environment, the care of family members, the guidance of network public opinion); and solid support system (good family support and rich social support).
Conclusion: Although frontline support nurses have negative emotions and bear great psychological pressure, they all have a high sense of professional responsibility. Therefore, managers should pay attention to their psychological experience and provide targeted assistance to them.

 

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"Jianpi Tongwei Prescription" Acupoint Application Combined with Moxibustion for Gastric Retention in Elderly Patients with Nasal Feeding
Jing ZHAO, Ling TANG, Pei-Yao LI
Journal of Integrative Nursing    2019, 1 (3): 157-162.   doi: 10.35437/intnur.issn.2663-4481.2019.01.03.06
Abstract101)      PDF(pc) (354KB)(173)      

Objective: To explore the effect of "Jianpi Tongwei Prescription" acupoint application combined with moxibustion in the treatment of gastric retention in elderly patients with nasal feeding. 

Method: 60 cases elderly patients with nasogastric gastric retention in our hospital were selected as the research object from March 1, 2019 to on October 31, 2019, and were randomly divided into treatment group and control group. Patients in the control group received the nasal feeding of domperidone, 10 mg/time, 3 times/d, for 21 days or until gastric retention <100 mL. On the basis of the control group, patients in the treatment group was treated with traditional Chinese medicine (TCM) characteristic nursing "Jianpi Tongwei Prescription" acupoint application combined with moxibustion on Zusanli.

Results: The effective rate of Jianpi Tongwei Prescription combined with moxibustion in the treatment of gastric retention in elderly patients with nasal feeding was higher than that of conventional treatment (51.2% vs. 23.3%, P<0.05), and the rate of gastrointestinal reaction in the treatment group was significantly lower than that in the control group (P < 0.05), moderate and severe gastrointestinal reactions were significantly lower than the control group (P < 0.05).

Conclusion: "Jianpi Tongwei Prescription" acupoint application combined with moxibustion is effective in the treatment of early clinical symptoms of gastric retention in elderly patients with nasal feeding, no adverse reactions, worthy of clinical promotion and application.

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Evaluation and analysis of the effect of continuing education on nurses’ physical restraint knowledge, attitude, and behavior
Luo YANG, Ling TANG, Hong GUO, Yan-Ling SHEN, Li LI, Qing-Xia LIU, Hai-Yan WANG, Yan-Juan LIU
Journal of Integrative Nursing    2020, 2 (1): 11-17.   doi: 10.4103/jin.jin_4_20
Abstract167)      PDF(pc) (630KB)(173)      

Objective: The objective of the study is to construct a training course for physical restraint (PR) evidence-based practice project and apply it to verify its effect.

Methods: A total of 162 nurses from five departments of a general hospital in Beijing were trained to compare the PR knowledge, attitudes, and behaviors of nurses before and after training.

Results: The nurses were satisfied with the overall curriculum; the total scores of PR’ knowledge, attitude and behavior of nurses after training were higher than before, and the difference was statistically significant (P < 0.05); the total scores of nurses who received evidence-related training before this training were higher than those of nurses who did not receive relevant training, and the difference was statistically significant (P < 0.05).

Conclusion: Continuing education can effectively improve nurses’ knowledge, attitude, and behavior level of PR, ensure patient safety, and promote physical and psychological rehabilitation of patients.

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Effect of moxibustion combined with five-element music therapy on postoperative pain relief after mixed hemorrhoid operation
Li-Yuan WANG, Hai-Yun GAI, Yu WEN, Ming-Hui MA
Journal of Integrative Nursing    2020, 2 (1): 22-26.   doi: 10.4103/jin.jin_5_20
Abstract121)      PDF(pc) (602KB)(171)      

Objective: To investigate the effect of moxibustion combined with five-element music therapy on the postoperative pain relief of patients undergoing surgical operation for mixed hemorrhoid with damp-heat syndrome.

Methods: Totally, 159 patients meeting the inclusion criteria were assigned to the control group, study group 1, and study group 2, with 53 cases in each group. All patients received routine care after surgical treatment, including acupoint application and Chinese herbal fumigation. In addition, patients in the study group 1 received moxibustion, and those in the study group 2 were given moxibustion combined with five-element music therapy. The degree of postoperative pain was evaluated using visual analog scale (VAS).

Results: There was no significant difference in VAS score on pain during dressing changes among three groups (P > 0.05). After 3, 5, and 7 days of intervention, there was a significant difference in VAS score on pain at rest among three groups (P < 0.001), and VAS score in the study group 2 was lower than that in the study group 1 and the control group after 3 and 5 days of intervention, respectively (P < 0.05).

Conclusion: Moxibustion combined with five-element music therapy is effective to relieve the postoperative pain of patients undergoing a surgical operation for mixed hemorrhoids with damp-heat syndrome.

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Construction of a Talent Cultivation Mode for Traditional Chinese Medicine Nursing Inheritance
Ye LI, Jing LIU, Ling TANG, Chun-Mei ZHANG, Mi ZHANG
Journal of Integrative Nursing    2019, 1 (3): 132-137.   doi: 10.35437/intnur.issn.2663-4481.2019.01.03.02
Online available: 15 November 2019

Abstract186)      PDF(pc) (387KB)(162)      

Objective: To explore and build traditional Chinese medicine (TCM) nursing inheritance on the talent training scheme, the foundation for cultivating outstanding talents of TCM nursing inheritance. 

Methods: The modified Delphi method was used for conducting two rounds of consultation with 15 TCM nursing experts to formulate training plan.

Results: The questionnaire recovery rates of two rounds of expert enquiry were 100.00%, with high experts enthusiasm, experts coefficients were 0.83 and 0.81, respectively. Kendall coordination coefficient were 0.26 and 0.30, respectively (P<0.01). After two rounds of expert consultation, the TCM nursing inheritance talent training scheme was finally formed, including 3 first-level indicators, 7 second-level indicators and 24 third-level indicators.

Conclusion: Construction of talent cultivating program of TCM nursing inheritance is scientific and feasible, with a certain reference value.

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The effects of health Qigong Baduanjin on the prevention, treatment, and recovery of COVID‑19
Yi‑Zhen HAN, Meng‑Wei FU, Zi‑Jie CHEN, Fei‑Hong REN, Dan‑Dan XIE, Jing‑Lei LI, Si‑Yu ZHAO, Qian SHEN
Journal of Integrative Nursing    2020, 2 (2): 33-39.   doi: 10.4103/jin.jin_27_20
Abstract157)      PDF(pc) (494KB)(159)      
To summarize the application and modern studies on health Qigong Baduanjin by domestic and foreign scholars, combined them with clinical practice of mobile hospital in Wuhan, we explore the prevention, treatment, and recovery of Baduanjin in the war against COVID 19. On the basis of studying ancient classics, such as Huangdi’s Internal Classic, and the concrete exercise methods of Baduanjin, we propose three ideas: prevention before disease onset, promoting healing during illness, and strengthening the body after recovery. We aimed to give full play to Baduanjin in the battle against COVID 19 to popularize correct prevention and health knowledge for the patients and the healthy as well as to provide a reference for medical workers to use Traditional Chinese Medicine to prevention and treatment.
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Studies of nursing in acute mastitis in China: Bibliometric analysis
Hui JU, Ling TANG, Hong GUO
Journal of Integrative Nursing    2020, 2 (1): 1-6.   doi: 10.4103/jin.jin_1_20
Abstract156)      PDF(pc) (737KB)(158)      

Objective: To analyze the research hotspots of nursing related to lactation acute mastitis in China and provide guidance and reference for nursing researchers.

Methods: Papers from China National Knowledge Infrastructure, Wanfang Data, VIP Data, and SinoMed are collected. All papers were imported into Noteexpress software in the form of bibliography to check again and delete duplicate references. The remaining literature was screened by reading the title and abstract and finally included by reading the full text. The paper’s information was analyzed using SPSS 22.0.

Results: 1275 papers are searched and 531 papers are included at last. Periodical literature accounted for the highest proportion, 96.80%. Moreover, the journal with the largest number of entries is China Health Care and Nutrition. In 2007, the number of literatures related to acute mastitis nursing began to increase rapidly, and the most articles were published in Henan. Among the literature types, the majority are literatures expert experience. Only 18 literature reports were funded.

Conclusions: Papers on acute mastitis nursing are increasing year by year and gradually become a research hotspot. However, the development of this study is uneven in different regions, with little financial support, and randomized controlled trials are still to be carried out.

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Competence investigation on insulation testing on electrosurgical instruments and needs analysis of training for Central Sterile Supply Department staf
Xu WANG, Qing ZHANG, Yi‑Qin ZHOU
Journal of Integrative Nursing    2020, 2 (3): 134-137.   doi: 10.4103/jin.jin_15_20
Abstract90)      PDF(pc) (543KB)(122)      
Objective: The objective of this article is to investigate the competence of Central Sterile Supply Department (CSSD) staff in insulation testing on electrosurgical instruments, to analyze the needs of training for CSSD staff, and also to strengthen the effectiveness of monitoring the insulation testing on electrosurgical instruments for CSSD staff to provide a reference for the nursing safety training.
Materials and Methods: A total of 180 CSSD staff from 36 hospitals were enrolled as the research objects and investigated using “self-assessment questionnaire of the competence in insulation testing on electrosurgical instruments and the needs of training”.
Results: The overall self-assessment score of competence in insulation testing on electrosurgical instruments for CSSD staff is 3.10 ± 0.42, including four dimensions which are attitude, system, cognition, and skills with the scores 3.31 ± 0.55, 2.80 ± 0.63, 2.74 ± 0.68, and 3.03 ± 0.36, respectively. Based on the survey of training needs for CSSD staff, the top three ranked training needs are trace management record of insulation testing on electrosurgical instruments (93.89%), disposal procedures for insulation damage of electrosurgical instruments (92.78%), and adverse events caused by leakage of electrosurgical instruments (80.55%).
Conclusion: The competence of insulation testing for CSSD staff is at a low level by overall. The competence of CSSD staff could be improved by analyzing the needs of training, establishing a systematic training system, and taking effective training action, thus ensuring the safety of patients and medical personnel.
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Impact of the emigration of nurses on health care delivery system in selected hospitals, Benin‑City, Edo State, Nigeria
Olaolorunpo OLORUNFEMI, David Idenyi AGBO, Omotayo Mercy OLORUNFEMI, Esther Odogho OKUPAPAT
Journal of Integrative Nursing    2020, 2 (3): 110-115.   doi: 10.4103/jin.jin_42_20
Abstract97)      PDF(pc) (579KB)(121)      
Background: Globally, there is a high demand for nurses, resulting in migration from low-to high-income countries. The emigration of nurses is the act of leaving one's own country to settle permanently in another country, leading to a shortage in the number of nurses in their home countries. Consequently, this study aims to assess the impact of the emigration of nurses on the health-care delivery system in Nigeria.
Materials and Methods: A descriptive cross-sectional survey was conducted with a stratified sampling technique to select 270 nurses from three selected hospitals in Benin-city Edo state. A self-structured questionnaire with open and Likert scale questions were used as an instrument to assess the Impact of the Emigration of nurses on the Health Care Delivery System. Data collected were analyzed using tables, percentages, means, standard deviation and t-test.
Results: The result showed a mean score of 1.59 ± 0.92 impacts of the emigration of nurses on health-care delivery system and identified how to reduce it. The study also showed that there is no significant difference between gender and reason for emigration among nurses (t = 3.84, P ≤ 0.001).
Conclusion: The emigration of nurses is severely affecting the health care delivery system in the country. Recently, the Nursing and Midwifery Council of Nigeria gave the directive for training schools to increase their training capacity and number of students' intake to cushion the effect, and this study shows that this palliative can only be a short time measure, and however will encourage more nurses traveling abroad on the long run. Therefore, the hospital managers and government should provide a conducive working environment, better remuneration, attractive retirement benefit, and other incentives as a push in factor for nurses to stay back in their home countries.
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Effect of mild moxibustion in improving the quality of life of patients with diabetic peripheral neuropathy
Dou-Dou LI, Yu-Hua ZHU, Ting-Li YOU, Yun-Xia GE, Xiao-Rong LIU, Xiao SUN
Journal of Integrative Nursing    2020, 2 (4): 203-206.   doi: 10.4103/jin.jin_41_20
Abstract54)      PDF(pc) (529KB)(112)      

Objective: The objective of this study is to investigate the effect of mild moxibustion on quality of life of patients with type 2 diabetic peripheral neuropathy (DPN).

Materials and Methods: Fifty-five patients with type 2 DPN from October 2018 to July 2019 were recruited in the present study and randomly divided into two groups: 7 cases in the control group and 28 cases in the intervention group. The control group received routine treatment of hypoglycemic, hypotensive, mecobalamin nutritional nerve, while the intervention group received mild moxibustion on the basis of the control group. The course of treatment for both groups was 10 weeks. The quality of life of the two groups was assessed using short form-36 health survey and compared with t-test at 0.05 significance level.

Results: The total score of the short form-36 in the intervention group was higher than the control group (P < 0.05); the scores of bodily pain, physical functioning (PF), general health (GH), and mental health dimensions in the intervention group increased significantly compared with the control group (P < 0.05); the scores of role physical, social functioning (SF), vitality, and role-emotional (RE) dimensions showed no between-group difference (P > 0.05).

Conclusion: Mild moxibustion can effectively improve the quality of life of patients with type 2 DPN, relieve patient pain symptoms, and improve PF and GH.

 

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Traditional Chinese medicine nursing protocols for COVID-19
Mei‑Zhen LIN, Qiao‑Mei WU, Yu LIU, Zhong‑De ZHANG, Gang‑Yi PENG, Chang‑Xiu WAN, Xiao‑Pan WANG, Ying‑Rui MA, Ping XIONG, Hui‑Chao CHEN, Qiu‑Ying DENG, Li‑Li DENG, Ding‑Rong QIU, Lin WEI, Jiu‑Hong YOU, Yang‑Chen LIU, Guang‑Qing ZHANG, Li‑Xia KOU, Ming‑Ming XU, Yu‑Mei CHEN, Yin‑Qin ZHONG, Xiao‑Qin LU, Han‑Jiao LIU, Jin ZHOU, Hong YE, Xiao‑Zhen GONG, Shi‑Miao LUO, Xi‑Yan HU
Journal of Integrative Nursing    2020, 2 (2): 40-49.   doi: 10.4103/jin.jin_23_20
Abstract68)      PDF(pc) (553KB)(108)      
In order to facilitate nurses to understand the key points of COVID-19's common syndromes, master the key points of nursing with syndrome differentiation, use the advantages of traditional Chinese medicine (TCM) nursing characteristics, standardize TCM nursing behavior, and improve the TCM nursing effect, through the search of relevant information, combined with the clinical practice experience of more than 1 month of front-line anti-epidemic nursing staff, the TCM nursing protocols for COVID-19 (draft) were formed. After four rounds of expert consultation and discussion, and 15 times of collation and revision, the final version of TCM nursing protocols for COVID-19 was formed. The TCM nursing protocols for COVID-19 include the following five parts: key points of common syndromes, nursing for common symptoms/syndromes, TCM special nursing, healthy guidance, and difficulties in nursing; it is scientific and practical, and can provide clinical guidance for nursing of patients with COVID-19.
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The relationship between diabetes‑related distress and self‑management in empty‑nest elderly patients with type 2 diabetes mellitus: The mediating effect of self‑efficacy
Hui‑Wen XU, Yuan YUAN, Lin LIU, En TAKASHI, Kitayama AKIO, Xin LI
Journal of Integrative Nursing    2020, 2 (3): 103-109.   doi: 10.4103/jin.jin_11_20
Abstract67)      PDF(pc) (717KB)(107)      
Objective: The aim of this study is to investigate the mediating effect of self-efficacy between diabetes-related distress and self-management in empty-nest elderly patients with type 2 diabetes mellitus (T2DM).
Methods: A total of 347 empty-nest elderly patients with T2DM from Jiangsu Province Hospital of Chinese Medicine and Affiliated Hospital of Yangzhou University were investigated by a self-designed General Information Questionnaire, the Self-efficacy for diabetes, the Diabetes Distress Scale, and the summary of diabetes self-care activities. Diabetes-related distress and diabetes self-management were tested for correlation analysis with self-efficacy. Meditational analyses were conducted to test the hypothesized mediating effects of diabetes self-efficacy as an intervention variable between diabetes distress and self-management.
Results: About 68.59% of patients suffered from diabetes-related distress. The results of bivariate correlations revealed that self-efficacy was negatively correlated with diabetes-related distress (r =–0.627, P < 0.01) and positively correlated with self-management (r = 0.356, P < 0.01). The relationship effects of diabetes distress on self-management were fully mediated by self-efficacy.
Conclusions: Diabetes-related distress prevails in empty-nest elderly patients with T2DM. Self-efficacy plays a mediate role between diabetes-related distress and self-management. Psychological intervention is contributed to reducing diabetes-related distress.
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Anxiety and perception among nurses toward the outbreak of COVID‑19 in University of Uyo Teaching Hospital, Akwa Ibom State
Emilia James OYIRA, Easter Chukwudi OSUCHUKWU, Margaret Mombel OPIAH, Ndukaku Nwakwe CHINAZAEKPERE, Teresa Achi OSAJI, Augusta Nkechi EMEH, Chinedu Godwin AWO
Journal of Integrative Nursing    2020, 2 (4): 186-189.   doi: 10.4103/jin.jin_43_20
Abstract70)      PDF(pc) (509KB)(105)      

Purpose: This study sought to examine the anxiety and perception of nurses toward the outbreak of COVID-19 in University of Uyo Teaching Hospital (UUTH). Two research questions one hypothesis were used. What is the level of anxiety among nurses toward the outbreak of COVID-19? What is the perception of nurses toward the outbreak of COVID-19? The hypothesis states that there is no significant relationship between anxiety and perception of nurses toward the outbreak of COVID-19. Literature was reviewed based on the research variables.

Methods: The research instrument used in collecting the data for the analysis was a questionnaire administered to 100 nurses in UUTH, Uyo. Their responses were analyzed using frequencies, percentages, and Chi-square analysis, and the following results were obtained.

Results: The results indicated that 36 (36%) of the respondents strongly agreed that most nurses perceive that poor provision of equipment’s in the hospital result into the transmission of COVID-19 to another person, 35 (35%) agreed, 20 (20%) of the respondents strongly agreed, whereas 9 (9%) of the respondents disagreed. Majority of the respondents 56 (56%) strongly agreed that nurses sometimes perceive that patients sometimes harbor COVID-19 without showing the symptoms.

Conclusion:  The above data, therefore, showed that nurses in UUTH, Uyo, had moderate perception toward COVID-19.

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Physical restraint using, autonomy, ethics among psychiatric patients in nursing practice in China
Jun-Fang ZENG, Hong-Tao CAI, Wei-Ming LI, Cai-Mei ZOU
Journal of Integrative Nursing    2020, 2 (3): 97-102.   doi: 10.4103/jin.jin_29_20
Abstract73)      PDF(pc) (501KB)(103)      
The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all (clients and staff) while at the same time curtailing the individual's autonomy. This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy, beneficence, nonmaleficence, and ethical theories. Given that nursing workforce was limited and workload among psychiatric nurses was heavy, physical restraint was one of the coercive interventions managing aggressive behavior. In relation to address ethical dilemmas, it was proposed to acquire informed consent of physical restraint from the individuals and provide person-centered care. Effective communication and negotiation with patients could help to strike a balance between patients' autonomy and nurses' accountability when using physical restraint. In addition, guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint. Finally, a collaboration among nurses, psychiatrists, and families is essential to protect patients' autonomy concerning physical restraint use.
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Medical assistance in fighting against COVID-19 in Wuhan, China: A frontline nurse’s experience and lessons learned
Qian‑Qian LI, Feng‑Li GAO
Journal of Integrative Nursing    2020, 2 (2): 85-88.   doi: 10.4103/jin.jin_35_20
Abstract91)      PDF(pc) (456KB)(99)      

This article shared personal experiences of encountering challenges during the work at the frontline fighting against COVID-19 in Wuhan, China, and found solutions and suggestions to overcome the challenges during the period, including solutions to address challenges encountered during work, suggestions for smooth communication among different parties, and suggestions for optimizing work regulations and workflow and establishing behavior habits and professional knowledge and practices. These experiences would be helpful for health?care workers to fight against the pandemic.

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Establishment and management of neurosurgery emergency observation ward during the COVID‑19 epidemic period
Hui‑Ting NIE, Zong‑Ying ZOU, Hui ZHANG
Journal of Integrative Nursing    2020, 2 (3): 138-143.   doi: 10.4103/jin.jin_13_20
Abstract87)      PDF(pc) (1288KB)(97)      
During the COVID-19 epidemic period, the front-line antiepidemic departments have attracted much attention. However, to meet people's daily needs for the diagnosis and treatment, emergency department and intensive care unit are also the focus of work to control the source of infection, cut off the transmission route, and reduce the risk of novel coronavirus transmission while treating patients. In order to further strengthen the management, our department of neurosurgery took active measures in the emergency treatment for patients and summarized the coping strategies and relevant experience from the aspects of establishment of emergency observation wards, medical staff management, patients and family management, daily environment and object surface disinfection management, material management, and nursing quality management, hoping to provide reference for the nursing management of emergency wards after the outbreak of public health emergencies.
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A bibliometric analysis of nursing research in COVID‑19 in China
Ke PENG, Qiu‑Lu MAI, Mei‑Qi MENG, Dou WANG, Xiao‑Yan ZHANG, Yu‑Fang HAO
Journal of Integrative Nursing    2020, 2 (3): 116-122.   doi: 10.4103/jin.jin_32_20
Abstract81)      PDF(pc) (1228KB)(96)      
Objective: The objective of this study is to analyze the current status of nursing research in COVID-19 through literature metrology and provide ideas and references for further research.
Methods: The search terms such as “novel coronavirus/COVID-19” and “nursing” were used to search the nursing-related papers published in China National Knowledge Infrastructure, Wanfang Data, VIP Data, SinoMed, Web of Science, and PubMed from October 1, 2019, to March 30, 2020. The bibliometric methods and related software were used for analysis.
Results: A total of 234 articles were included from 48 journals, and core journals accounted for 61.1%. There were five nursing literature topics and 14 document types. There is a cooperative relationship between six institutions. Keywords include nursing staff, nursing management, and protection.
Conclusions: The opening of journal green channels and the establishment of database columns will help the spread of anti-epidemic academic results. The topics of nursing literature include clinical nursing, nursing management, prevention and control, nursing education, and social surveys. Nursing literature types focus on cross-sectional research and experience summary; the cooperation between researchers and research institutions has begun to take shape, and it is recommended to strengthen the research on iatrogenic injuries and nurse training in future nursing research.
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Clinical nursing care of a nurse diagnosed with COVID-19 in Wuhan Union Hospital
Bing-Rui WEI, Dian Francis SAVELLANO, Chang-Sheng ZHANG, Cui-Huan HU
Journal of Integrative Nursing    2020, 2 (3): 144-148.   doi: 10.4103/jin.jin_33_20
Abstract96)      PDF(pc) (825KB)(95)      
The coronavirus disease (COVID-19) has claimed thousands of lives. The patients have been quarantined and treated in special shelter hospitals, and mild illness accounts for the majority of the total number of patients. This article reports one case of the first batches of infected medical staff, who got infected with 2019 novel coronavirus and later discharged 2 weeks after receiving treatment and nursing care in Wuhan Union Hospital. Considering all aspects of the patient's hospitalization, the patient was performed ward environment management, medical nursing, symptomatic treatment, nutrition management, vital signs monitoring, observation and nursing, psychological assessment and support, and infection protection and management. As the earliest successful case of cure, the patient's manifestations are classical and common. Moreover, we hope to share it with colleagues to fight against COVID-19 for reference. The treatment and nursing guidelines can be applied to treat a large number of mild cases, thus improving the discharge rate of patients and reducing the pressure of epidemic situation.
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Management experience of care workers during epidemic prevention and control of COVID-19
Na CHENG, Run‑Xi TIAN, Nan TONG, Qing GONG,
Journal of Integrative Nursing    2020, 2 (2): 89-92.   doi: 10.4103/jin.jin_19_20
Abstract111)      PDF(pc) (461KB)(91)      

Since the rapid spread of COVID?19, our hospital has actively implemented the idea of “preventing the coronavirus from entering.” We paid close attention to details, rapidly carried out personnel and material management at all levels, and strived to do a good job in the prevention and control of the epidemic, so as to achieve zero infection. Patients’ carers are an important part of quality care. Lacking of protection knowledge of infectious diseases would increase the risk of nosocomial infection. Therefore, our nursing department set up a team of epidemic prevention and control management. The team made the revision on contingency plans and care management regulations during the outbreak of COVID?19, strengthened epidemic prevention and control knowledge training, carried out the supervision inspection work, and paid attention to humanized management measures to provide an important guarantee for victory over the COVID?19.

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The impact of sleep quality on reported anxiety and fatigue among shift nurses: The mediating role of resilience
Xin-Ge WANG, Yan-Yan LUO, Shuan-Rong LI
Journal of Integrative Nursing    2020, 2 (4): 190-195.   doi: 10.4103/jin.jin_39_20
Abstract63)      PDF(pc) (590KB)(91)      

 Aims: The aim of this article is to explore the relation of sleep quality, anxiety status, fatigue level and psychological resilience among rotating?shift nurses, thus, to ropose solutions and promote physical and psychological health of shift nurses.

Methods: The cross?sectional survey was performed on 263 clinical nurses recruited from three tertiary hospitals of Xinxiang City, Henan Province, China from October 2017 to June 2018. The questionnaire survey was conducted using Pittsburgh Sleep Quality Index (PSQI) for measuring nurses’ sleep quality, connor-davidson resilience scale (CD-RISC) for measuring their psychological resilience, self-rating anxiety scale (SAS) for measuring their anxiety status, and Fatigue-14 Scale for measuring their fatigue. The relationship among above indicators were analysed using Pearson correlation analysis. The mediating effect of psychological resilience on the process of sleep quality impacting anxiety and fatigue was analyzed using Wen’s causual steps method and linear regression.

Results: The mean CD?RISC score of shift nurses was 57.76 ± 11.90, which indicated that resilience level was at a medium level. The mean of PSQI, SAS and total fatigue score was (7.53 ± 2.83), (50.56 ± 9.57) and (7.81 ± 9.42), respectively. Resilience could negatively predict the anxiety state (β= 0.366, P < 0.01) and fatigue (β = 0.197, P < 0.01). Sleep quality could positively predict anxiety (β = 0.395, P < 0.01) and fatigue level (β = 0.495, P < 0.01) for shift nurses. The mediating effects of resilience upon sleep quality and anxiety or fatigue was 0.044 and 0.026, respectively.

Conclusion: The resilience could fuel sleep quality and reduce the occurrence of negative emotion and fatigue among shift nurses. 

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Clinical effect of scraping therapy in the treatment of knee osteoarthritis
Jin‑Rong WEI, Hui‑Ping ZHANG, Shu‑Ying XU, Bo MA, Jin‑Hua ZHANG, Jia LIU
Journal of Integrative Nursing    2020, 2 (3): 129-133.   doi: 10.4103/jin.jin_9_20
Abstract67)      PDF(pc) (609KB)(90)      
Objective: The objective of this study is to investigate the effect of scraping therapy in the treatment of knee osteoarthritis.
Materials and Methods: A total of eighty patients with knee osteoarthritis were assigned to the moxibustion group and the scraping therapy group according to the random numerical table method, with forty cases in each group. Patients in both two groups received functional exercise and moxibustion therapy, and those in the scraping therapy group were supplemented with scraping therapy. The serum indexes of interleukin-1 (IL-1), IL-6, tumor necrosis factor-alpha (TNF-α), and superoxide dismutase (SOD) were detected before and after the treatment. The clinical syndrome integral and Visual Analog Scale (VAS) on pain of patients were assessed. The clinical therapeutic efficacy was evaluated and compared between the two groups.
Results: Patients in the scraping therapy group received better outcomes of serum IL-1, IL-6, TNF-α, and SOD compared with those in the moxibustion group at 2 months after treatment (P < 0.05). The scores of clinical syndrome integral and VAS on pain were decreased in two groups at 2 months after the treatment and were lower in the scraping therapy group than those in the moxibustion group (P < 0.05). The overall effective rate in the scraping therapy group was higher than that in the control group (87.50% vs. 67.50%, P < 0.05).
Conclusion: The scraping therapy is potentially effective to ameliorate the clinical symptom and pain degree of patients with knee osteoarthritis.
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Comprehensive evaluation method of epidemic prewarning and treatment for COVID-19 in general hospitals
Wei LUAN, Dong‑Ping ZHU, Wei‑Ren SHI, Jin LI
Journal of Integrative Nursing    2020, 2 (2): 81-84.   doi: 10.4103/jin.jin_12_20
Abstract63)      PDF(pc) (474KB)(90)      

In recent years, due to frequent occurrence of public health emergencies, outbreaks of major infectious diseases represented by COVID-19 have brought great harm to the lives and health of people. General hospitals are indispensable in disease prevention and control. The study analyzed a comprehensive evaluation method of epidemic prewarning and treatment for COVID?19 in general hospitals through literature review and provided a reference for constructing urban public health prewarning and treatment system.

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Rehabilitation nursing for an earthquake survivor with severe polytrauma: A case report and literature review
Chun‑Yi XU, Fang TANG
Journal of Integrative Nursing    2020, 2 (3): 149-152.   doi: 10.4103/jin.jin_38_20
Abstract47)      PDF(pc) (459KB)(90)      
The aim of this article is to summarize the experience of rehabilitation nursing of one case of severe polytrauma caused by earthquake. The key points of the rehabilitation nursing include body posture nursing, orthopedic rehabilitation nursing, pulmonary function rehabilitation nursing, bladder rehabilitation nursing, nutritional support, and psychological rehabilitation nursing. Through the comprehensive rehabilitation nursing interventions, satisfactory outcomes were obtained, and the patient was successfully recovered and discharged after 2 months.
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The psychological status investigation on the nursing staff in a 3A-level hospital during the prevalence of COVID-19 and the analysis of its influencing factors
Hai-Xia CHEN, Ju-Hong PEI, Xing-Lei WANG, Rui-Ling NAN, Xin-Man DOU
Journal of Integrative Nursing    2020, 2 (2): 61-67.   doi: 10.4103/jin.jin_25_20
Abstract110)      PDF(pc) (565KB)(86)      
Objective: The objective of the study is to investigate the psychological status of nursing staff both working on nonfront line and on the front line during the epidemic period of COVID-19 and to analyze the influencing factors related to mental health state, as well as to provide targeted psychological intervening measures for nursing staff in the face of this major public health event.
Methods: We used data from January 28, 2019, to February 08, 2020, on the number of cases who worked in the 3A-level hospital as nonfront-line nurses (n = 29, 54%) and those who worked in Wuhan infectious hospital as the front-line supporters (n = 25, 46%) came from the 3A-level hospital. The participants completed the symptom checklist 90, and the researchers recorded data on demographics, psychological status, and the influencing factors.
Results: In our baseline scenario, we estimated that the total symptom index was 1.676 ± 0.654 for nurses who worked on the front line, 1.260 ± 0.304 for those who worked as the front-line reserve nurses, and was 1.486 ± 0.647 for those who worked as the nonfront-line nurses. The results of correlation analysis show that the factors related to the psychological status of nurses include age, professional title, marital status, and family support; different factors have different effects on psychological status.
Conclusion: In the face of major public health emergencies, both front-line nursing staff and nonfront-line staff are confronted with different degrees of psychological stress, so effective psychological support should be given to improve the working efficiency and enthusiasm of nurses.
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The application of feedforward control in the nursing emergency management of COVID-19
Zhao Jia WANG, Yan Rong SUN, Jing ZHANG, Hui JU, Ling TANG
Journal of Integrative Nursing    2020, 2 (2): 50-54.   doi: 10.4103/jin.jin_17_20
Abstract119)      PDF(pc) (520KB)(86)      
Objective: To explore the application of feedforward control in the nursing emergency management of COVID-19.
Methods: The feedforward control theory was applied to the emergency management of COVID-19 nursing, including grasping the latest epidemic information, preparing for the early stage, formulating nursing workflow, implementing flexible management, standardizing isolation and protection measures, unifying nursing document record format, and implementing humanistic care.
Results: During the period of support to Wuhan, the nursing work in the isolated area was orderly, the nursing staff's job satisfaction was high, no nursing errors and hospital infections occurred.
Conclusion: Efficient feedforward control in the nursing emergency management that could avoid work blindness to a certain extent and play a guiding role in maintaining the normal operation of treatment and nursing work and protecting the safety of patients and medical staff in the ward during the epidemic period of COVID-19.
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