Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was ...Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.展开更多
This study examines whether and how cues focusing enhances Chinese-speaking English learners’engagement in comparison,thereby facilitating their acquisition of English articles within xu-based comparative continuatio...This study examines whether and how cues focusing enhances Chinese-speaking English learners’engagement in comparison,thereby facilitating their acquisition of English articles within xu-based comparative continuation writing tasks.Fifty English majors from a Chinese university were randomly assigned to three groups and each group was required to complete a comparative continuation task with one of three conditions:paired cues(cues presented in pairs),randomized cues(cues presented in random order),or implicit cues(no explicit cues provided).All participants undertook pretests,posttests,and delayed tests on English article knowledge,and ten of them volunteered to take follow-up interviews.The results indicate that:1)paired cues were more effective than randomized or implicit cues in promoting the acquisition of English articles;and 2)learners in the paired cues condition produced more target-like article usage in their continuation writings compared to those in the other two conditions.The effectiveness of paired cues is attributed to an enhanced contrast effect,which prompts learners to identify similarities and differences between cues within each pair,relates cue explanations and examples with actual article usage in the reading text,and reflects upon and compares their own article productions against those in the provided reading text.The study concludes that the process of learning through continuation is fundamentally supported by learners’capacity for comparison,reinforcing its role as a core element of xu-competence.展开更多
With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative...With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.展开更多
Objective:To explore the application effect of evidence-based nursing in the postoperative care of patients with ureteral calculi undergoing holmium laser lithotripsy,analyze its impact on the incidence of postoperati...Objective:To explore the application effect of evidence-based nursing in the postoperative care of patients with ureteral calculi undergoing holmium laser lithotripsy,analyze its impact on the incidence of postoperative complications,the degree of stress response,and nursing satisfaction,and provide evidence-based support for optimizing clinical nursing practices.Methods:A total of 100 patients with ureteral calculi who underwent holmium laser lithotripsy in our hospital from January 2023 to June 2025 were selected and divided into an observation group(50 cases)and a control group(50 cases)using a random number table method.The control group received routine nursing interventions,while the observation group adopted an evidence-based nursing model.The incidence of postoperative complications(hematuria,urinary tract infection,renal colic,ureteral stricture),stress response indicators(heart rate,systolic blood pressure,diastolic blood pressure,Self-Rating Anxiety Scale(SAS)score,Self-Rating Depression Scale(SDS)score)before surgery and 24 hours after surgery,and nursing satisfaction were compared between the two groups.Results:The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(p<0.05).At 24 hours after surgery,the heart rate,systolic blood pressure,diastolic blood pressure,SAS score,and SDS score in the observation group were significantly lower than those in the control group(all p<0.01).Nursing satisfaction in the observation group was significantly higher than that in the control group(p<0.01).Conclusion:Evidence-based nursing can effectively reduce the incidence of postoperative complications in patients with ureteral calculi undergoing holmium laser lithotripsy,alleviate patients’stress responses,and improve nursing satisfaction,demonstrating significant clinical application value.展开更多
Objective: To develop an evidence-based plan for cleaning operating room and evaluate the impact on high-frequency contact surfaces. Method: The evidence application model of the JBI Evidence-Based Nursing Center was ...Objective: To develop an evidence-based plan for cleaning operating room and evaluate the impact on high-frequency contact surfaces. Method: The evidence application model of the JBI Evidence-Based Nursing Center was utilized to create a strategy, which was implemented in a tertiary-level hospital in Yunnan Province. The adenosine triphosphate (ATP) biological biofluorescence detection method was used to assess the quality of cleaning before and after the intervention. Results: A total of 17 quality review indicators were established in this study. Following the application of evidence, the implementation rate for 16 quality review indicators increased significantly, from a range of 0-65.8% to 81.5-100%. Moreover, the pass rate of ATP bioluminescence detection on high-frequency contact surfaces increased from 14.07% to 47.19%, with significant difference (p < 0.05). Conclusion: The evidence-based environmental cleaning program proved to enhance the overall cleanliness of operating room and reduce the risk of surgical infections. This strategy holds promise for effective cleaning of operating room.展开更多
Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before...Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.展开更多
BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing...BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.展开更多
Based on the educational evaluation reform,this study explores the construction of an evidence-based value-added evaluation system based on data-driven,aiming to solve the limitations of traditional evaluation methods...Based on the educational evaluation reform,this study explores the construction of an evidence-based value-added evaluation system based on data-driven,aiming to solve the limitations of traditional evaluation methods.The research adopts the method of combining theoretical analysis and practical application,and designs the evidence-based value-added evaluation framework,which includes the core elements of a multi-source heterogeneous data acquisition and processing system,a value-added evaluation agent based on a large model,and an evaluation implementation and application mechanism.Through empirical research verification,the evaluation system has remarkable effects in improving learning participation,promoting ability development,and supporting teaching decision-making,and provides a theoretical reference and practical path for educational evaluation reform in the new era.The research shows that the evidence-based value-added evaluation system based on data-driven can reflect students’actual progress more fairly and objectively by accurately measuring the difference in starting point and development range of students,and provide strong support for the realization of high-quality education development.展开更多
BACKGROUND Cardiopulmonary bypass(CPB)is a life-support technology widely used in surgery.Review articles reflect research advances in a certain topic or field within a certain period of time.AIM To perform a bibliome...BACKGROUND Cardiopulmonary bypass(CPB)is a life-support technology widely used in surgery.Review articles reflect research advances in a certain topic or field within a certain period of time.AIM To perform a bibliometric analysis of the review articles that focused on CPB for cardiovascular surgery.METHODS This study was based on a bibliometric analysis.Data were acquired from the Web of Science and basic bibliometric parameters were analyzed and visualized using VOSviewer and Excel.RESULTS We identified 141 review articles on CPB.Generally,the number of publications increased,and most of them were published in the 2010s(n=57,40.4%)and the 2020s(n=45,31.9%).There were 113(80.1%)narrative review articles,21(14.9%)meta-analysis studies and 7(5.0%)systematic review papers.The United States(n=25,17.7%)and China(n=21,14.9%)were the leading countries in terms of publication number.The articles were published in 98 different journals.The Journal of Cardiothoracic and Vascular Anesthesia(n=14,10.0%)and Perfusion-United Kingdom(n=11,7.8%)were preferred by the authors.The high-frequency keywords included inflammatory response,children,acute kidney injury,meta-analysis and off-pump,except for CPB and cardiac surgery.Inflammatory response had the closest relationship with CPB during cardiac surgery.The complications of CPB,including inflammatory response,kidney injury and ischemia,caught lots of concern.CONCLUSION The rapid increase of review papers shows that the research on CPB in cardiac surgery is increasingly being emphasized by scholars and clinical staff worldwide.Meta-analysis has been widely conducted to analyze clinical controversies and further guide clinical practice.Strategies to improving the outcomes of patients undergoing cardiac surgery with CPB are the hot spots in this field.展开更多
Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideli...Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.展开更多
BACKGROUND With an aging society,older patients undergoing cholecystectomy often have multiple chronic diseases and require long-term multi-medication.Medication complexity significantly increases the risk of medicati...BACKGROUND With an aging society,older patients undergoing cholecystectomy often have multiple chronic diseases and require long-term multi-medication.Medication complexity significantly increases the risk of medication errors and adverse reactions,and effective nursing interventions are urgently required to ensure medication safety.AIM To investigate the efficacy of evidence-based nursing practices in mitigating polypharmacy risks among Suzhou Municipal Hospital Road Front Yard Area,thereby providing clinical guidance.METHODS The sixty older patients who underwent cholecystectomy between September 2024 and September 2025 treated with polypharmacy were enrolled.Using random number tables,hey were divided into study and control groups(n=30 each),who received routine medication nursing and evidence-based nursing,respectively.Pre-intervention and post-intervention comparisons were made between groups for medication knowledge,competence,and adherence scores.The incidences of duplicate medications,missed doses,self-discontinuation,unauthorized alterations,schedule changes,and adverse reaction rates assessed potential medication risks.RESULTS Both the study and control groups showed significant increases in medication knowledge,management competence,and adherence scores after intervention(all P<0.05).The study group had higher post-intervention scores(medication knowledge:87.29±5.09 vs 70.62±5.38;medication management competence:63.22±3.11 vs 56.19±4.08;medication adherence:7.13±1.04 vs 6.05±1.03,all P<0.05).The incidence of duplicate medication,missed doses,self-discontinuation,unauthorized dose alterations,and schedule modifications decreased in both groups post-intervention(all P<0.05),with lower rates in the study group(duplicate medication:13.33%vs 30.0%;missed doses:10.0%vs 26.67%;all P<0.05).The study group had a lower adverse reaction rate(3.33%vs 26.67%,P<0.05)and more patients with potential medication hazard level 0(83.33%vs 53.33%),while fewer patients had level 2 and 3 hazards(3.33%vs 16.67%and 0%vs 10.00%,respectively;all P<0.05).CONCLUSION Evidence-based nursing for polypharmacy risks in older adults undergoing cholecystectomy can enhance medication awareness,improve management and adherence,reduce adverse behaviors,and lower adverse reactions and hazard levels.展开更多
Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for...Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.展开更多
Objective:To explore the effect of evidence-based care on lower-limb thrombosis and negative emotions following hip arthroplasty.Methods:A total of 108 patients undergoing hip arthroplasty at our hospital were randoml...Objective:To explore the effect of evidence-based care on lower-limb thrombosis and negative emotions following hip arthroplasty.Methods:A total of 108 patients undergoing hip arthroplasty at our hospital were randomly assigned to the observation group(n=54,evidence-based care)and the control group(n=54,conventional care).Postoperative complications,negative emotions,quality of life,activities of daily living,and patient satisfaction were compared between the two groups.Results:The observation group had a lower incidence of lower-limb thrombosis and overall complications,as well as higher patient satisfaction than the control group(all P<0.05).One month after discharge,patients in the observation group showed significantly lower scores on the Hamilton Anxiety Scale,the Hamilton Depression Scale,and activities of daily living scale,but with increased Generic Quality of Life Inventory-74 scores,compared with before intervention(all P<0.05).Conclusion:Evidence-based care significantly relieves anxiety and depression,reduces the incidence of lower-limb thrombosis,and improves quality of life in patients after hip arthroplasty.展开更多
Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted t...Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.展开更多
With the aging of China’s population,tumors have become a major disease affecting people’s normal life.In particular,“cancer pain”caused by tumors has a severe impact on tumor patients,not only reducing their qual...With the aging of China’s population,tumors have become a major disease affecting people’s normal life.In particular,“cancer pain”caused by tumors has a severe impact on tumor patients,not only reducing their quality of life but also exerting negative effects on their physical and mental health and emotions.Therefore,in the clinical care of tumor patients,helping them relieve“cancer pain”and improving the quality and efficiency of medical care services have become important research topics.This paper takes evidence-based nursing as the starting point,analyzes the basic concepts and practical characteristics of evidence-based nursing,and then proposes the application process and effects of evidence-based nursing in cancer pain care for tumor patients.展开更多
Objective: In the Healthy Child Action Enhancement Program (2021-2025), it is proposed to ensure the safety and health of newborns and to promote high-quality development of health. Our department established risk ass...Objective: In the Healthy Child Action Enhancement Program (2021-2025), it is proposed to ensure the safety and health of newborns and to promote high-quality development of health. Our department established risk assessment criteria for medical adhesives in neonates by applying the best evidence in the management program for the reduction of medical adhesive-associated skin injuries in neonates, in terms of the use and removal of adhesives. Methods: A systematic search and quality assessment of topics related to medical adhesive-related skin injury in neonates was conducted to summarize the best evidence and to conduct a quality review in the neonatal unit. Results: After 2 rounds of review, medical and nursing staff in the neonatal unit had a 98% compliance rate for the knowledge of neonatal medical adhesive-related skin injury and a satisfactory compliance rate for the other 9 indicators;after the application of the evidence, the incidence of neonatal medical adhesive-related skin injury was significantly lower than that before the application of the evidence, and the differences were statistically significant (P Conclusion: The application of the best evidence-based management program in neonatal medical adhesive-associated skin injury can reduce the incidence of neonatal medical adhesive-associated skin injury, reduce neonatal infections, and improve the integrity of the protective skin barrier in neonates.展开更多
Purpose:With the growth of knowledge and increasing competition,the assessment of scientific articles has become a challenging issue.Previous research suggests that multiple variables influence the number of academic ...Purpose:With the growth of knowledge and increasing competition,the assessment of scientific articles has become a challenging issue.Previous research suggests that multiple variables influence the number of academic articles.In this study,we aimed to evaluate the relationship between the beginning of chancellorship in top-ranked universities and the number of chancellors’articles.Design/methodology/approach:Chancellors of 200 top universities worldwide were randomly selected from the top 1,000 universities listed on the topuniversities.com profile page.Data were collected through the Scopus Database using a checklist that contained variables such as gender,age,being active or nonactive,and continent.The mean number of articles during the period of three years before the beginning of the chancellorship until three years after that was compared using the Friedman test.Findings:Considering the starting point of the chancellorship,the data showed that the mean number of published articles per year decreased significantly after beginning the chancellorship.Among the chancellors,active chancellors(having a minimum of one article each year),male chancellors,and those from North America indicated a decrease in the number of publications.Research limitations:A major limitation was that in some universities,governance falls under vicechancellor(s)rather than chancellor(s).Practical implications:The study underscores the difficulty of balancing administrative responsibilities,such as university chancellorship,with academic pursuits.Originality/value:For the first time,the results revealed that beginning chancellorship negatively impacts publication output.展开更多
In this study,the evidence-based design(EBD)of naturalized decoration in hematopoietic stem cell transplantation(HSCT)wards of Peking University First Hospital was explored to improve patients’psychological state and...In this study,the evidence-based design(EBD)of naturalized decoration in hematopoietic stem cell transplantation(HSCT)wards of Peking University First Hospital was explored to improve patients’psychological state and rehabilitation environment by introducing natural elements.Based on questionnaire surveys and literature research,the EBD method was adopted to propose a naturalized decoration scheme for HSCT wards,and a satisfaction evaluation was conducted after construction and use.The research results show that naturalized decoration can effectively enhance the satisfaction and comfort of patients and medical staff,verifying its positive effects in HSCT wards.展开更多
Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge tran...Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge translation model to guide evidence-based practice in nutrition management, and compare the nutritional status, cardiac function status, quality of life, and quality review indicators of chronic heart failure patients before and after the application of evidence. Results: After the application of evidence, the nutritional status indicators (MNA-SF score, albumin, hemoglobin) of two groups of heart failure patients significantly increased compared to before the application of evidence, with statistically significant differences (p Conclusion: The KTA knowledge translation model provides methodological guidance for the implementation of evidence-based practice for heart failure patients. This evidence-based practice project is beneficial for improving the outcomes of malnutrition in chronic heart failure patients and is conducive to standardizing nursing pathways, thereby promoting the improvement of nursing quality.展开更多
Objective:To construct an evidence-based practice plan for perioperative nutritional optimization in esophageal cancer patients.Methods:By systematically searching relevant guidelines at home and abroad,two experts in...Objective:To construct an evidence-based practice plan for perioperative nutritional optimization in esophageal cancer patients.Methods:By systematically searching relevant guidelines at home and abroad,two experts independently assessed the quality of the guidelines,extracted valuable evidence and recommendations,and initially formed a draft nursing program.Subsequently,an expert panel was organized to conduct a detailed discussion to review the practicality and effectiveness of the recommendations one by one,and the program was finally revised and improved.Results:The protocol covered four stages of patients’admission,preoperative,postoperative,and discharge,involving specific contents such as nutritional assessment,risk screening,dysphagia assessment,nutritional therapy,enteral and parenteral nutritional support,symptom management,and health education.The program included a total of 61 entries,with 33 class A recommendations and 28 class B recommendations.Conclusion:The constructed perioperative nutritional care program for esophageal cancer patients is scientific and practical,and can provide practical guidance for clinical care.展开更多
文摘Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.
文摘This study examines whether and how cues focusing enhances Chinese-speaking English learners’engagement in comparison,thereby facilitating their acquisition of English articles within xu-based comparative continuation writing tasks.Fifty English majors from a Chinese university were randomly assigned to three groups and each group was required to complete a comparative continuation task with one of three conditions:paired cues(cues presented in pairs),randomized cues(cues presented in random order),or implicit cues(no explicit cues provided).All participants undertook pretests,posttests,and delayed tests on English article knowledge,and ten of them volunteered to take follow-up interviews.The results indicate that:1)paired cues were more effective than randomized or implicit cues in promoting the acquisition of English articles;and 2)learners in the paired cues condition produced more target-like article usage in their continuation writings compared to those in the other two conditions.The effectiveness of paired cues is attributed to an enhanced contrast effect,which prompts learners to identify similarities and differences between cues within each pair,relates cue explanations and examples with actual article usage in the reading text,and reflects upon and compares their own article productions against those in the provided reading text.The study concludes that the process of learning through continuation is fundamentally supported by learners’capacity for comparison,reinforcing its role as a core element of xu-competence.
文摘With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.
文摘Objective:To explore the application effect of evidence-based nursing in the postoperative care of patients with ureteral calculi undergoing holmium laser lithotripsy,analyze its impact on the incidence of postoperative complications,the degree of stress response,and nursing satisfaction,and provide evidence-based support for optimizing clinical nursing practices.Methods:A total of 100 patients with ureteral calculi who underwent holmium laser lithotripsy in our hospital from January 2023 to June 2025 were selected and divided into an observation group(50 cases)and a control group(50 cases)using a random number table method.The control group received routine nursing interventions,while the observation group adopted an evidence-based nursing model.The incidence of postoperative complications(hematuria,urinary tract infection,renal colic,ureteral stricture),stress response indicators(heart rate,systolic blood pressure,diastolic blood pressure,Self-Rating Anxiety Scale(SAS)score,Self-Rating Depression Scale(SDS)score)before surgery and 24 hours after surgery,and nursing satisfaction were compared between the two groups.Results:The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(p<0.05).At 24 hours after surgery,the heart rate,systolic blood pressure,diastolic blood pressure,SAS score,and SDS score in the observation group were significantly lower than those in the control group(all p<0.01).Nursing satisfaction in the observation group was significantly higher than that in the control group(p<0.01).Conclusion:Evidence-based nursing can effectively reduce the incidence of postoperative complications in patients with ureteral calculi undergoing holmium laser lithotripsy,alleviate patients’stress responses,and improve nursing satisfaction,demonstrating significant clinical application value.
文摘Objective: To develop an evidence-based plan for cleaning operating room and evaluate the impact on high-frequency contact surfaces. Method: The evidence application model of the JBI Evidence-Based Nursing Center was utilized to create a strategy, which was implemented in a tertiary-level hospital in Yunnan Province. The adenosine triphosphate (ATP) biological biofluorescence detection method was used to assess the quality of cleaning before and after the intervention. Results: A total of 17 quality review indicators were established in this study. Following the application of evidence, the implementation rate for 16 quality review indicators increased significantly, from a range of 0-65.8% to 81.5-100%. Moreover, the pass rate of ATP bioluminescence detection on high-frequency contact surfaces increased from 14.07% to 47.19%, with significant difference (p < 0.05). Conclusion: The evidence-based environmental cleaning program proved to enhance the overall cleanliness of operating room and reduce the risk of surgical infections. This strategy holds promise for effective cleaning of operating room.
基金Hospital Quality Management Research Fund Project of China Medical Quality Management Association(Project No.:YLZG202511)。
文摘Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.
文摘BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.
基金This paper is the research result of“Research on Innovation of Evidence-Based Teaching Paradigm in Vocational Education under the Background of New Quality Productivity”(2024JXQ176)the Shandong Province Artificial Intelligence Education Research Project(SDDJ202501035),which explores the application of artificial intelligence big models in student value-added evaluation from an evidence-based perspective。
文摘Based on the educational evaluation reform,this study explores the construction of an evidence-based value-added evaluation system based on data-driven,aiming to solve the limitations of traditional evaluation methods.The research adopts the method of combining theoretical analysis and practical application,and designs the evidence-based value-added evaluation framework,which includes the core elements of a multi-source heterogeneous data acquisition and processing system,a value-added evaluation agent based on a large model,and an evaluation implementation and application mechanism.Through empirical research verification,the evaluation system has remarkable effects in improving learning participation,promoting ability development,and supporting teaching decision-making,and provides a theoretical reference and practical path for educational evaluation reform in the new era.The research shows that the evidence-based value-added evaluation system based on data-driven can reflect students’actual progress more fairly and objectively by accurately measuring the difference in starting point and development range of students,and provide strong support for the realization of high-quality education development.
文摘BACKGROUND Cardiopulmonary bypass(CPB)is a life-support technology widely used in surgery.Review articles reflect research advances in a certain topic or field within a certain period of time.AIM To perform a bibliometric analysis of the review articles that focused on CPB for cardiovascular surgery.METHODS This study was based on a bibliometric analysis.Data were acquired from the Web of Science and basic bibliometric parameters were analyzed and visualized using VOSviewer and Excel.RESULTS We identified 141 review articles on CPB.Generally,the number of publications increased,and most of them were published in the 2010s(n=57,40.4%)and the 2020s(n=45,31.9%).There were 113(80.1%)narrative review articles,21(14.9%)meta-analysis studies and 7(5.0%)systematic review papers.The United States(n=25,17.7%)and China(n=21,14.9%)were the leading countries in terms of publication number.The articles were published in 98 different journals.The Journal of Cardiothoracic and Vascular Anesthesia(n=14,10.0%)and Perfusion-United Kingdom(n=11,7.8%)were preferred by the authors.The high-frequency keywords included inflammatory response,children,acute kidney injury,meta-analysis and off-pump,except for CPB and cardiac surgery.Inflammatory response had the closest relationship with CPB during cardiac surgery.The complications of CPB,including inflammatory response,kidney injury and ischemia,caught lots of concern.CONCLUSION The rapid increase of review papers shows that the research on CPB in cardiac surgery is increasingly being emphasized by scholars and clinical staff worldwide.Meta-analysis has been widely conducted to analyze clinical controversies and further guide clinical practice.Strategies to improving the outcomes of patients undergoing cardiac surgery with CPB are the hot spots in this field.
文摘Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.
基金Supported by Suzhou Hepatobiliary Surgery Clinical Medical Center Construction Fund Project,No.szlcyxzxj202107。
文摘BACKGROUND With an aging society,older patients undergoing cholecystectomy often have multiple chronic diseases and require long-term multi-medication.Medication complexity significantly increases the risk of medication errors and adverse reactions,and effective nursing interventions are urgently required to ensure medication safety.AIM To investigate the efficacy of evidence-based nursing practices in mitigating polypharmacy risks among Suzhou Municipal Hospital Road Front Yard Area,thereby providing clinical guidance.METHODS The sixty older patients who underwent cholecystectomy between September 2024 and September 2025 treated with polypharmacy were enrolled.Using random number tables,hey were divided into study and control groups(n=30 each),who received routine medication nursing and evidence-based nursing,respectively.Pre-intervention and post-intervention comparisons were made between groups for medication knowledge,competence,and adherence scores.The incidences of duplicate medications,missed doses,self-discontinuation,unauthorized alterations,schedule changes,and adverse reaction rates assessed potential medication risks.RESULTS Both the study and control groups showed significant increases in medication knowledge,management competence,and adherence scores after intervention(all P<0.05).The study group had higher post-intervention scores(medication knowledge:87.29±5.09 vs 70.62±5.38;medication management competence:63.22±3.11 vs 56.19±4.08;medication adherence:7.13±1.04 vs 6.05±1.03,all P<0.05).The incidence of duplicate medication,missed doses,self-discontinuation,unauthorized dose alterations,and schedule modifications decreased in both groups post-intervention(all P<0.05),with lower rates in the study group(duplicate medication:13.33%vs 30.0%;missed doses:10.0%vs 26.67%;all P<0.05).The study group had a lower adverse reaction rate(3.33%vs 26.67%,P<0.05)and more patients with potential medication hazard level 0(83.33%vs 53.33%),while fewer patients had level 2 and 3 hazards(3.33%vs 16.67%and 0%vs 10.00%,respectively;all P<0.05).CONCLUSION Evidence-based nursing for polypharmacy risks in older adults undergoing cholecystectomy can enhance medication awareness,improve management and adherence,reduce adverse behaviors,and lower adverse reactions and hazard levels.
基金supported by the Peking University Nursing Discipline Research Development Fund(No.TYZH2023001)。
文摘Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.
文摘Objective:To explore the effect of evidence-based care on lower-limb thrombosis and negative emotions following hip arthroplasty.Methods:A total of 108 patients undergoing hip arthroplasty at our hospital were randomly assigned to the observation group(n=54,evidence-based care)and the control group(n=54,conventional care).Postoperative complications,negative emotions,quality of life,activities of daily living,and patient satisfaction were compared between the two groups.Results:The observation group had a lower incidence of lower-limb thrombosis and overall complications,as well as higher patient satisfaction than the control group(all P<0.05).One month after discharge,patients in the observation group showed significantly lower scores on the Hamilton Anxiety Scale,the Hamilton Depression Scale,and activities of daily living scale,but with increased Generic Quality of Life Inventory-74 scores,compared with before intervention(all P<0.05).Conclusion:Evidence-based care significantly relieves anxiety and depression,reduces the incidence of lower-limb thrombosis,and improves quality of life in patients after hip arthroplasty.
文摘Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.
文摘With the aging of China’s population,tumors have become a major disease affecting people’s normal life.In particular,“cancer pain”caused by tumors has a severe impact on tumor patients,not only reducing their quality of life but also exerting negative effects on their physical and mental health and emotions.Therefore,in the clinical care of tumor patients,helping them relieve“cancer pain”and improving the quality and efficiency of medical care services have become important research topics.This paper takes evidence-based nursing as the starting point,analyzes the basic concepts and practical characteristics of evidence-based nursing,and then proposes the application process and effects of evidence-based nursing in cancer pain care for tumor patients.
文摘Objective: In the Healthy Child Action Enhancement Program (2021-2025), it is proposed to ensure the safety and health of newborns and to promote high-quality development of health. Our department established risk assessment criteria for medical adhesives in neonates by applying the best evidence in the management program for the reduction of medical adhesive-associated skin injuries in neonates, in terms of the use and removal of adhesives. Methods: A systematic search and quality assessment of topics related to medical adhesive-related skin injury in neonates was conducted to summarize the best evidence and to conduct a quality review in the neonatal unit. Results: After 2 rounds of review, medical and nursing staff in the neonatal unit had a 98% compliance rate for the knowledge of neonatal medical adhesive-related skin injury and a satisfactory compliance rate for the other 9 indicators;after the application of the evidence, the incidence of neonatal medical adhesive-related skin injury was significantly lower than that before the application of the evidence, and the differences were statistically significant (P Conclusion: The application of the best evidence-based management program in neonatal medical adhesive-associated skin injury can reduce the incidence of neonatal medical adhesive-associated skin injury, reduce neonatal infections, and improve the integrity of the protective skin barrier in neonates.
基金funded by the North Khorasan University of Medical Sciences,grant No. 4010231。
文摘Purpose:With the growth of knowledge and increasing competition,the assessment of scientific articles has become a challenging issue.Previous research suggests that multiple variables influence the number of academic articles.In this study,we aimed to evaluate the relationship between the beginning of chancellorship in top-ranked universities and the number of chancellors’articles.Design/methodology/approach:Chancellors of 200 top universities worldwide were randomly selected from the top 1,000 universities listed on the topuniversities.com profile page.Data were collected through the Scopus Database using a checklist that contained variables such as gender,age,being active or nonactive,and continent.The mean number of articles during the period of three years before the beginning of the chancellorship until three years after that was compared using the Friedman test.Findings:Considering the starting point of the chancellorship,the data showed that the mean number of published articles per year decreased significantly after beginning the chancellorship.Among the chancellors,active chancellors(having a minimum of one article each year),male chancellors,and those from North America indicated a decrease in the number of publications.Research limitations:A major limitation was that in some universities,governance falls under vicechancellor(s)rather than chancellor(s).Practical implications:The study underscores the difficulty of balancing administrative responsibilities,such as university chancellorship,with academic pursuits.Originality/value:For the first time,the results revealed that beginning chancellorship negatively impacts publication output.
基金Sponsored by the National Natural Science Foundation of China:Visual Perception Based Natural Intervention for Patients in HSCT Wards(52278045)Innovation and Entrepreneurship Training Programme for Students in 2024(10805136024XN139-91).
文摘In this study,the evidence-based design(EBD)of naturalized decoration in hematopoietic stem cell transplantation(HSCT)wards of Peking University First Hospital was explored to improve patients’psychological state and rehabilitation environment by introducing natural elements.Based on questionnaire surveys and literature research,the EBD method was adopted to propose a naturalized decoration scheme for HSCT wards,and a satisfaction evaluation was conducted after construction and use.The research results show that naturalized decoration can effectively enhance the satisfaction and comfort of patients and medical staff,verifying its positive effects in HSCT wards.
文摘Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge translation model to guide evidence-based practice in nutrition management, and compare the nutritional status, cardiac function status, quality of life, and quality review indicators of chronic heart failure patients before and after the application of evidence. Results: After the application of evidence, the nutritional status indicators (MNA-SF score, albumin, hemoglobin) of two groups of heart failure patients significantly increased compared to before the application of evidence, with statistically significant differences (p Conclusion: The KTA knowledge translation model provides methodological guidance for the implementation of evidence-based practice for heart failure patients. This evidence-based practice project is beneficial for improving the outcomes of malnutrition in chronic heart failure patients and is conducive to standardizing nursing pathways, thereby promoting the improvement of nursing quality.
文摘Objective:To construct an evidence-based practice plan for perioperative nutritional optimization in esophageal cancer patients.Methods:By systematically searching relevant guidelines at home and abroad,two experts independently assessed the quality of the guidelines,extracted valuable evidence and recommendations,and initially formed a draft nursing program.Subsequently,an expert panel was organized to conduct a detailed discussion to review the practicality and effectiveness of the recommendations one by one,and the program was finally revised and improved.Results:The protocol covered four stages of patients’admission,preoperative,postoperative,and discharge,involving specific contents such as nutritional assessment,risk screening,dysphagia assessment,nutritional therapy,enteral and parenteral nutritional support,symptom management,and health education.The program included a total of 61 entries,with 33 class A recommendations and 28 class B recommendations.Conclusion:The constructed perioperative nutritional care program for esophageal cancer patients is scientific and practical,and can provide practical guidance for clinical care.
