The theory-based intervention of individualized music has been evaluated clinically and empirically leading to advancement and refinement of an evidence-based protocol, currently in its 5th edition. An expanded versio...The theory-based intervention of individualized music has been evaluated clinically and empirically leading to advancement and refinement of an evidence-based protocol, currently in its 5th edition. An expanded version of the protocol was written for professional health care providers with a consumer version tailored for family caregivers. The underlying mid-range theory is presented along with a seminal study that was followed by further research in the United States, Canada, Great Britain, France, Sweden, Norway, Japan and Taiwan. Key studies are summarized. Given its efficacy when implemented by research staff, studies have advanced to testing the intervention under real-life conditions when implemented and evaluated by trained nursing assistants in long-term care facilities and visiting family members. In addition, one study evaluated the implementation of music by family members in the home setting. Initial research focused on agitation as the dependent variable with subsequent research indicating a more holistic response such as positive affect, expressed satisfaction, and meaningful interaction with others. The article advances by describing on-line programs designed to train health care professionals in the assessment, implementation and evaluation of individualized music. In addition, Gerdner has written a story for apicture book intended for children and their families(in press). The story models principles of individualized music to elicit positive memories, reduce anxiety and agitation, and promote communication. The article concludes with implications for future research.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
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
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
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 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
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
BACKGROUND Endoscopic colon polypectomy is a common procedure used to remove polyps that may develop into colorectal cancer if left untreated.Despite these advantages,patients frequently experience anxiety and other a...BACKGROUND Endoscopic colon polypectomy is a common procedure used to remove polyps that may develop into colorectal cancer if left untreated.Despite these advantages,patients frequently experience anxiety and other adverse reactions.Standardized evidence-based nursing practices are essential for enhancing patient care by addressing both physical and psychological health issues.AIM To analyze the impact of standardized evidence-based nursing on psychological status and adverse reactions of patients undergoing endoscopic colonic polypectomy.METHODS Data from 200 patients who underwent endoscopic colonic polypectomy at the authors’hospital between January and June 2024 were randomly assigned to two groups:Control[received routine nursing care(n=100)]and study[received standardized evidence-based nursing intervention(s)(n=100)].Psychological status,visual analog scale,and Short-Form 36 Health Survey scores,adverse events,and satisfaction with nursing were compared between the two groups.RESULTS After the interventions,the study group exhibited significantly lower scores on the Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale,along with a reduced incidence of adverse events compared with the control group(P<0.05).Short-Form 36 Health Survey scores and overall satisfaction with nursing care were also significantly higher in the intervention group(P<0.05).CONCLUSION Standardized evidence-based nursing interventions effectively reduced negative patient emotions and enhanced quality of life and satisfaction,demonstrating high safety.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
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
This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total ...This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.展开更多
BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptom...BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.展开更多
Hepatocellular carcinoma(HCC) is one of the major malignant diseases in many healthcare systems. The growing number of new cases diagnosed each year is nearly equal to the number of deaths from this cancer. Worldwide,...Hepatocellular carcinoma(HCC) is one of the major malignant diseases in many healthcare systems. The growing number of new cases diagnosed each year is nearly equal to the number of deaths from this cancer. Worldwide, HCC is a leading cause of cancerrelated deaths, as it is the fifth most common cancer and the third most important cause of cancer related death in men. Among various risk factors the two are prevailing: viral hepatitis, namely chronic hepatitis C virus is a well-established risk factor contributing to the rising incidence of HCC. The epidemic of obesity and the metabolic syndrome, not only in the United States but also in Asia, tend to become the leading cause of the long-term rise in the HCC incidence. Today, the diagnosis of HCC is established within the national surveillance programs in developed countries while the diagnosis of symptomatic, advanced stage disease still remains the characteristic of underdeveloped countries. Although many different staging systems have been developed and evaluated the BarcelonaClinic Liver Cancer staging system has emerged as the most useful to guide HCC treatment. Treatment allocation should be decided by a multidisciplinary board involving hepatologists, pathologists, radiologists, liver surgeons and oncologists guided by personalized-based medicine. This approach is important not only to balance between different oncologic treatments strategies but also due to the complexity of the disease(chronic liver disease and the cancer) and due to the large number of potentially efficient therapies. Careful patient selection and a tailored treatment modality for every patient, either potentially curative(surgical treatment and tumor ablation) or palliative(transarterial therapy, radioembolization and medical treatment, i.e., sorafenib) is mandatory to achieve the best treatment outcome.展开更多
Restless legs syndrome(RLS)is a common neurological disorder in clinical practice,particularly prominent among hemodialysis patients.RLS severely impacts patients’sleep quality and mental state,exacerbating their pre...Restless legs syndrome(RLS)is a common neurological disorder in clinical practice,particularly prominent among hemodialysis patients.RLS severely impacts patients’sleep quality and mental state,exacerbating their pre-existing physical discomfort and life burden.Current pharmacological treatments often yield suboptimal results and carry numerous adverse effects.Consequently,combining evidence-based nursing with rehabilitation therapy has emerged as a promising intervention strategy.Rehabilitation therapy,a multimodal non-pharmacological treatment,aims to enhance patients’physical and psychological health,while evidence-based nursing emphasizes individualized,scientifically grounded nursing interventions.The integration of these two approaches not only alleviates RLS symptoms but also improves patients’quality of life and self-management abilities.Based on this,the paper conducts an in-depth study of the pathogenesis and clinical characteristics of RLS in hemodialysis patients and provides a detailed analysis of the combined application of rehabilitation therapy and evidence-based nursing for this condition.展开更多
BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we...BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.展开更多
BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for imp...BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.展开更多
The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone m...The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone marrow aspirate con-centrate,stromal vascular fraction(SVF),and autologous chondrocyte implanta-tion,are gaining traction for their potential to enhance the body's natural healing processes.They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions.Current evidence su-ggests significant benefits of orthobiologics in treating conditions like osteoarth-ritis,tendon injuries,and spinal disorders,yet inconsistencies in treatment pro-tocols and outcomes persist.The global market for orthobiologics is projected to grow substantially,driven by advancements in biologic therapies such as adipose-derived stem cells and SVF,and the demand for minimally invasive treatments.Despite their promise,regulatory and ethical challenges,as well as the need for high-quality,standardized research,remain significant obstacles.Future dire-ctions in the field include advancements in delivery systems,personalized medi-cine approaches,and the exploration of novel sources like induced pluripotent stem cells,aiming for more targeted and effective treatments.Collaborative efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.展开更多
Traditional Chinese medicine(TCM)is the wisdom crystallization and cultural treasure of the Chinese nation.Establishing a positive relationship among doctors,nurses,and patients is essential for promoting the sustaina...Traditional Chinese medicine(TCM)is the wisdom crystallization and cultural treasure of the Chinese nation.Establishing a positive relationship among doctors,nurses,and patients is essential for promoting the sustainable development of TCM culture.As an important branch of evidence-based narrative medicine,evidence-based narrative of TCM significantly contributes to the co-construction of doctors,nurses and patients.This paper discusses the necessity and clinical practice value of promoting co-construction of doctors,nurses and patients based on the principles of evidence-based narrative TCM.By working together to select optimal diagnosis and treatment options,we aim to enhance patient compliance,alleviate tensions among the parties involved,and establish equitable collaborative relationships.Creating a harmonious medical environment is crucial for promoting the continuous development of this collaborative model in clinical practice,thereby improving patients'overall health,increasing public recognition of TCM,and supporting its sustainable growth.展开更多
文摘The theory-based intervention of individualized music has been evaluated clinically and empirically leading to advancement and refinement of an evidence-based protocol, currently in its 5th edition. An expanded version of the protocol was written for professional health care providers with a consumer version tailored for family caregivers. The underlying mid-range theory is presented along with a seminal study that was followed by further research in the United States, Canada, Great Britain, France, Sweden, Norway, Japan and Taiwan. Key studies are summarized. Given its efficacy when implemented by research staff, studies have advanced to testing the intervention under real-life conditions when implemented and evaluated by trained nursing assistants in long-term care facilities and visiting family members. In addition, one study evaluated the implementation of music by family members in the home setting. Initial research focused on agitation as the dependent variable with subsequent research indicating a more holistic response such as positive affect, expressed satisfaction, and meaningful interaction with others. The article advances by describing on-line programs designed to train health care professionals in the assessment, implementation and evaluation of individualized music. In addition, Gerdner has written a story for apicture book intended for children and their families(in press). The story models principles of individualized music to elicit positive memories, reduce anxiety and agitation, and promote communication. The article concludes with implications for future research.
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.
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.
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 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 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BACKGROUND Endoscopic colon polypectomy is a common procedure used to remove polyps that may develop into colorectal cancer if left untreated.Despite these advantages,patients frequently experience anxiety and other adverse reactions.Standardized evidence-based nursing practices are essential for enhancing patient care by addressing both physical and psychological health issues.AIM To analyze the impact of standardized evidence-based nursing on psychological status and adverse reactions of patients undergoing endoscopic colonic polypectomy.METHODS Data from 200 patients who underwent endoscopic colonic polypectomy at the authors’hospital between January and June 2024 were randomly assigned to two groups:Control[received routine nursing care(n=100)]and study[received standardized evidence-based nursing intervention(s)(n=100)].Psychological status,visual analog scale,and Short-Form 36 Health Survey scores,adverse events,and satisfaction with nursing were compared between the two groups.RESULTS After the interventions,the study group exhibited significantly lower scores on the Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale,along with a reduced incidence of adverse events compared with the control group(P<0.05).Short-Form 36 Health Survey scores and overall satisfaction with nursing care were also significantly higher in the intervention group(P<0.05).CONCLUSION Standardized evidence-based nursing interventions effectively reduced negative patient emotions and enhanced quality of life and satisfaction,demonstrating high safety.
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This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.
文摘BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.
文摘Hepatocellular carcinoma(HCC) is one of the major malignant diseases in many healthcare systems. The growing number of new cases diagnosed each year is nearly equal to the number of deaths from this cancer. Worldwide, HCC is a leading cause of cancerrelated deaths, as it is the fifth most common cancer and the third most important cause of cancer related death in men. Among various risk factors the two are prevailing: viral hepatitis, namely chronic hepatitis C virus is a well-established risk factor contributing to the rising incidence of HCC. The epidemic of obesity and the metabolic syndrome, not only in the United States but also in Asia, tend to become the leading cause of the long-term rise in the HCC incidence. Today, the diagnosis of HCC is established within the national surveillance programs in developed countries while the diagnosis of symptomatic, advanced stage disease still remains the characteristic of underdeveloped countries. Although many different staging systems have been developed and evaluated the BarcelonaClinic Liver Cancer staging system has emerged as the most useful to guide HCC treatment. Treatment allocation should be decided by a multidisciplinary board involving hepatologists, pathologists, radiologists, liver surgeons and oncologists guided by personalized-based medicine. This approach is important not only to balance between different oncologic treatments strategies but also due to the complexity of the disease(chronic liver disease and the cancer) and due to the large number of potentially efficient therapies. Careful patient selection and a tailored treatment modality for every patient, either potentially curative(surgical treatment and tumor ablation) or palliative(transarterial therapy, radioembolization and medical treatment, i.e., sorafenib) is mandatory to achieve the best treatment outcome.
基金Evidence Application and Clinical Transformation Project of the Evidence-Based Nursing Center at Fudan University(Project No.Nmyyjd202406)。
文摘Restless legs syndrome(RLS)is a common neurological disorder in clinical practice,particularly prominent among hemodialysis patients.RLS severely impacts patients’sleep quality and mental state,exacerbating their pre-existing physical discomfort and life burden.Current pharmacological treatments often yield suboptimal results and carry numerous adverse effects.Consequently,combining evidence-based nursing with rehabilitation therapy has emerged as a promising intervention strategy.Rehabilitation therapy,a multimodal non-pharmacological treatment,aims to enhance patients’physical and psychological health,while evidence-based nursing emphasizes individualized,scientifically grounded nursing interventions.The integration of these two approaches not only alleviates RLS symptoms but also improves patients’quality of life and self-management abilities.Based on this,the paper conducts an in-depth study of the pathogenesis and clinical characteristics of RLS in hemodialysis patients and provides a detailed analysis of the combined application of rehabilitation therapy and evidence-based nursing for this condition.
基金The study was reviewed and approved by the Ethics Committee of Shanghai Tongren Hospital(Approval Number:Tongren Lun Audit 2022-075-01).
文摘BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.
文摘BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.
文摘The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone marrow aspirate con-centrate,stromal vascular fraction(SVF),and autologous chondrocyte implanta-tion,are gaining traction for their potential to enhance the body's natural healing processes.They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions.Current evidence su-ggests significant benefits of orthobiologics in treating conditions like osteoarth-ritis,tendon injuries,and spinal disorders,yet inconsistencies in treatment pro-tocols and outcomes persist.The global market for orthobiologics is projected to grow substantially,driven by advancements in biologic therapies such as adipose-derived stem cells and SVF,and the demand for minimally invasive treatments.Despite their promise,regulatory and ethical challenges,as well as the need for high-quality,standardized research,remain significant obstacles.Future dire-ctions in the field include advancements in delivery systems,personalized medi-cine approaches,and the exploration of novel sources like induced pluripotent stem cells,aiming for more targeted and effective treatments.Collaborative efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.
基金financed by the grant from the Fifth Batch of National Traditional Chinese Medicine Excellent Clinical Talents Training Project(No.2022-1)。
文摘Traditional Chinese medicine(TCM)is the wisdom crystallization and cultural treasure of the Chinese nation.Establishing a positive relationship among doctors,nurses,and patients is essential for promoting the sustainable development of TCM culture.As an important branch of evidence-based narrative medicine,evidence-based narrative of TCM significantly contributes to the co-construction of doctors,nurses and patients.This paper discusses the necessity and clinical practice value of promoting co-construction of doctors,nurses and patients based on the principles of evidence-based narrative TCM.By working together to select optimal diagnosis and treatment options,we aim to enhance patient compliance,alleviate tensions among the parties involved,and establish equitable collaborative relationships.Creating a harmonious medical environment is crucial for promoting the continuous development of this collaborative model in clinical practice,thereby improving patients'overall health,increasing public recognition of TCM,and supporting its sustainable growth.
