BACKGROUND Elderly patients tend to have poor self-efficacy and poor confidence in postoperative rehabilitation for hip fractures,and are prone to negative emotions,which affect treatment compliance.AIM To evaluate th...BACKGROUND Elderly patients tend to have poor self-efficacy and poor confidence in postoperative rehabilitation for hip fractures,and are prone to negative emotions,which affect treatment compliance.AIM To evaluate the effects of evidence-based intervention on postoperative fear,compliance,and self-efficacy in elderly patients with hip fractures.METHODS A total of 120 patients with hip fracture surgically treated from June 2018 to June 2020 at the orthopedic department of our hospital were selected and divided into intervention and routine groups(n=60 each)according to different nursing methods.The basic rehabilitation methods of the two groups were consistent,but patients in the intervention group received evidence-based nursing interventions at the same time.Differences between groups in the scores of motion phobia,pain fear,rehabilitation training compliance,self-efficacy,nursing satisfaction,and hip joint function were compared before and after the intervention.RESULTS Before the intervention,there were no statistically significant differences in motion phobia and pain fear scores between the groups(all P>0.05).However,motion phobia scores at 1 wk after intervention initiation(P<0.05),and pain fear scores at 1 wk and 2 wk after intervention initiation(all P<0.05),were significantly lower in the intervention group than in the routine group.On the first day of intervention,there was no significant difference in rehabilitation treatment compliance between the groups(P>0.05);however,at 2 wk after intervention initiation,rehabilitation compliance was significantly better in the intervention group than in the routine group(P<0.05).Before the intervention,there were no statistically significant differences in the scores for the two self-efficacy dimensions(overcoming difficulties and rehabilitation exercise self-efficacy)and the total self-efficacy score between the groups(all P>0.05).After 2 wk of intervention,the scores for these two dimensions of self-efficacy and the total self-efficacy score were significantly higher in the intervention group than in the routine group(all P<0.05).At 3 and 6 mo after surgery,hip function as evaluated by the Harris hip score,was significantly better in the intervention group than in the routine group(P<0.05).Additionally,overall nursing satisfaction was significantly higher in the intervention group than in the routine group(P<0.05).CONCLUSION Evidence-based nursing intervention can alleviate fear of postoperative rehabilitation in elderly patients who underwent hip fracture surgery,and improve rehabilitation treatment compliance and patient self-efficacy,which promote hip function recovery.展开更多
Background:Evidence-based interventions(EBIs)are frequently adapted or modified during the implementation process to meet the needs of the target context,public health professionals,or health practitioners.However,lit...Background:Evidence-based interventions(EBIs)are frequently adapted or modified during the implementation process to meet the needs of the target context,public health professionals,or health practitioners.However,little is known about how the EBIs of the same clinical problem at a different time(sustainability)and a different setting(scalability)should be adapted to facilitate implementation.To address this gap,this research aims to analyze the adaptations process of EBIs by taking post-stroke dysphagia screening as an example based on a series of empirical studies.Methods:We reviewed three best practice implementation projects of post-stroke dysphagia identification and management in China's Mainland,and conducted a comparative analysis of three projects of dysphagia screening practical decision-making according to core elements of evidence-based nursing(EBN).Results:We identified the core elements of EBN that influence decision-making in each best practice implementation project.The decision-making of screening time and tool for dysphagia in the three projects varied.Project 1:Post-stroke dysphagia was screened using Water Swallow Test(WST)before the first intake of liquid or food.Project 2:A sustainability study based on project 1,post-stroke dysphagia was screened using Standardized Swallowing Assessment(SSA)before the first intake of liquid or food,within 24 hours of admission.Project 3:A community scalability study based on project 2,post-stroke dysphagia was screened using Water Swallow Test(WST)before the first intake of liquid or food,within 24 hours after referral.Conclusions:Adaption of EBIs needs to fully consider the best available external evidence from systematic research,clinical expertise,patient preferences,as well as context.展开更多
Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation proce...Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation process is available, it lacks specific instructions on how to adapt interventions so that they are aligned with cultural beliefs. In this paper, we present an integrated strategy that operationalizes the adaptation process by describing specific practical instructions on how to align interventions with cultural beliefs. Methods: The strategy integrates concept and intervention mapping, and uses mixed methods for gathering data from community representatives. The data pertain to a community’s cultural beliefs and values related to a health problem, acceptability of evidence-based interventions targeting the problem, and aspects of the interventions that should be modified to enhance their fit with cultural beliefs. A step-by-step protocol is described to guide application of the integrated strategy for cultural adaptation. Conclusions: The strength of the integrated strategy relies on the use of concept and intervention mapping approaches for specifying a step-by-step protocol to actively engage community representatives in the cultural adaptation of interventions. Future research should evaluate the utility of this strategy.展开更多
Objective:To study the effect of early warning and evidence-based intervention combined with drug therapy on the infection process in children with mycoplasma pneumonia.Methods:Children who were treated and clearly di...Objective:To study the effect of early warning and evidence-based intervention combined with drug therapy on the infection process in children with mycoplasma pneumonia.Methods:Children who were treated and clearly diagnosed with mycoplasma pneumonia in Zigong Third People's Hospital between May 2014 and October 2017 were chosen and randomly divided into two groups, experimental group accepted early warning and evidence-based intervention combined with drug therapy, and control group accepted routine drug therapy. The levels of inflammatory cytokines and oxidative stress response indicators in serum as well as the expression of inflammation and oxidative stress signal molecules in peripheral blood were measured before treatment and 3 d after treatment.Results:Compared with those of same group before treatment, serum TNF-α, CysLTs, sTREM1, sP-selectin, sICAM1, MDA, SF and COR levels as well as peripheral blood TLR4, NF-κB, COX2, NOX4, MPO and iNOS expression intensity of both groups of patients significantly decreased whereas SOD and IgA levels significantly increased after treatment. Moreover, serum TNF-α, CysLTs, sTREM1, sP-selectin, sICAM1, MDA, SF and COR levels as well as peripheral blood TLR4, NF-κB, COX2, NOX4, MPO and iNOS expression intensity of experimental group were lower than those of control group whereas SOD and IgA levels were higher than those of control group. Conclusion: Early warning and evidence-based intervention combined with drug therapy can reduce the inflammatory response and oxidative stress response in the infection process of children with mycoplasma pneumonia.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
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
Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.T...Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.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
This study systematically analyzed the primary causes of malnutrition in children with leukemia during chemotherapy,clarified the status of malnutrition and specific nutritional intervention measures,and comprehensive...This study systematically analyzed the primary causes of malnutrition in children with leukemia during chemotherapy,clarified the status of malnutrition and specific nutritional intervention measures,and comprehensively evaluated the research progress.The research indicates a shift from basic supportive care toward precision intervention strategies.Immunonutrition approaches,such as omega-3 fatty acid supplementation and probiotics for gut microbiota modulation,significantly mitigate chemotherapy-related side effects and enhance nutritional status.These targeted novel regimens demonstrate clear clinical advantages.The success of nutritional management depends on a multidisciplinary collaboration mechanism.The organic integration of innovative nutritional protocols with standard treatments from hematology,pediatrics,and nutrition departments significantly optimizes treatment outcomes and long-term quality of life for children with leukemia.This interdisciplinary synergy is reshaping contemporary medical models.展开更多
Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interv...Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.展开更多
Objective:To explore the interventional room nursing and its application effects in patients with ischemic stroke treated with tirofiban combined with direct thrombectomy.Methods:A total of 61 patients with ischemic s...Objective:To explore the interventional room nursing and its application effects in patients with ischemic stroke treated with tirofiban combined with direct thrombectomy.Methods:A total of 61 patients with ischemic stroke admitted to our hospital from June 2024 to June 2025 were selected and divided into two groups using the red and blue ball method:the control group(n=30,receiving routine interventional room nursing)and the observation group(n=31,receiving additional tirofiban medication-specific nursing+individualized interventional nursing on the basis of routine nursing).The cerebral hemodynamic indicators,adverse reactions,effectiveness of complication nursing,and nursing satisfaction were compared between the two groups.Results:After 7 days of treatment,the observation group had lower cerebrovascular peripheral resistance and higher mean blood flow velocity and mean blood flow volume compared to the control group(all p<0.05).The observation group had a higher effectiveness rate of complication nursing than the control group,with a statistically significant difference(p<0.05).The nursing satisfaction in the observation group(96.77%)was higher than that in the control group(80.00%),with a statistically significant difference(χ^(2)=4.223,p=0.040<0.05).Conclusion:Tirofiban combined with direct thrombectomy can significantly improve cerebral hemodynamics,enhance the effectiveness of complication nursing,and increase patient satisfaction in patients with ischemic stroke.展开更多
Objective:To systematically sort out the application forms and effects of digital health intervention technologies in oral health management,and provide references for the digital development of stomatology.Methods:By...Objective:To systematically sort out the application forms and effects of digital health intervention technologies in oral health management,and provide references for the digital development of stomatology.Methods:By reviewing relevant domestic and foreign studies and clinical practices,this paper summarizes and analyzes the main application forms of digital health interventions,including digital health education,intelligent detection equipment,telemedicine platforms,oral health big data platforms,and school-hospital collaborative screening robots.Results:Studies have shown that digital health interventions can effectively improve the public’s oral health knowledge level,optimize personal health behaviors,enhance clinical diagnosis efficiency,reduce overall medical costs,and promote the innovation and upgrading of oral health management models.Conclusion:Digital health intervention represents an inevitable trend in the future development of stomatology.In the future,it is still necessary to improve data security and privacy protection,technology adaptability and popularity,as well as relevant policies and norms,to give full play to its potential value.展开更多
Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains ...Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains limited by fragmented service delivery,uneven technological capacity,and sociocultural factors that delay timely diagnosis.This study explored the perspectives of paediatric audiologists and parents to provide a comprehensive understanding of the opportunities and challenges influencing early hearing care across diverse Nigerian settings.Methods:A mixed-methods design was employed across audiology facilities selected systematically from four Nigerian geopolitical zones.Twenty-five paediatric audiologists and twenty-three parents of children with congenital hearing loss participated.Quantitative data were collected using a structured questionnaire assessing awareness,diagnostic access,and intervention experiences.Qualitative data were obtained through semi-structured interviews and two focus group discussions.Thematic analysis followed Braun and Clarke's six-step framework,with dual coding,external auditing,and member validation to enhance credibility.Results:Quantitative findings demonstrated broad agreement on the diagnostic value of otoacoustic emissions(OAEs)and automated auditory brainstem responses(AABRs),the developmental benefits of early intervention,and the importance of active parental involvement.However,respondents identified persistent barriers including high costs of screening and therapy,poor public awareness of early hearing loss symptoms,and a critical shortage of trained personnel,and unequal distribution of diagnostic tools,particularly in rural and northern regions.Thematic analysis further underscored disparities in diagnostic capacity,sociocultural interpretations of deafness that delay clinical consultation,and economic constraints that hinder continuity of care.While families who accessed early intervention reported improved communication,social engagement,and learning readiness in their children,systemic gaps continue to limit widespread success.Conclusions:Despite growing technological capacity and awareness of EHDI benefits,significant structural,financial,and sociocultural challenges continue to impede timely diagnosis and intervention in Nigeria.Strengthening national policies,ensuring equitable distribution of diagnostic tools,expanding professional training,subsidising services,implementing culturally sensitive awareness campaigns and integration of Universal Newborn Hearing Screening into routine postnatal care are essential to improving outcomes for deaf infants.展开更多
Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strate...Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.展开更多
BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emoti...BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.展开更多
Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neu...Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.展开更多
Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the...Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.展开更多
The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 ...The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.展开更多
Objective To explore the application of evidence-based nursing intervention in patients with congenital heart diseases treated by transcatheter interventional therapy.Methods A total of 64 patients with congenital hea...Objective To explore the application of evidence-based nursing intervention in patients with congenital heart diseases treated by transcatheter interventional therapy.Methods A total of 64 patients with congenital heart diseases who were administered in our hospital from June 2011 to July 2013 were recruited in our research.展开更多
Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an ear...Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses.Methods: Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire(OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance(M) >3.5, and coefficient of variation(CV) <0.25. Reliability of experts' opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated.Results: A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120.Conclusions: The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.展开更多
文摘BACKGROUND Elderly patients tend to have poor self-efficacy and poor confidence in postoperative rehabilitation for hip fractures,and are prone to negative emotions,which affect treatment compliance.AIM To evaluate the effects of evidence-based intervention on postoperative fear,compliance,and self-efficacy in elderly patients with hip fractures.METHODS A total of 120 patients with hip fracture surgically treated from June 2018 to June 2020 at the orthopedic department of our hospital were selected and divided into intervention and routine groups(n=60 each)according to different nursing methods.The basic rehabilitation methods of the two groups were consistent,but patients in the intervention group received evidence-based nursing interventions at the same time.Differences between groups in the scores of motion phobia,pain fear,rehabilitation training compliance,self-efficacy,nursing satisfaction,and hip joint function were compared before and after the intervention.RESULTS Before the intervention,there were no statistically significant differences in motion phobia and pain fear scores between the groups(all P>0.05).However,motion phobia scores at 1 wk after intervention initiation(P<0.05),and pain fear scores at 1 wk and 2 wk after intervention initiation(all P<0.05),were significantly lower in the intervention group than in the routine group.On the first day of intervention,there was no significant difference in rehabilitation treatment compliance between the groups(P>0.05);however,at 2 wk after intervention initiation,rehabilitation compliance was significantly better in the intervention group than in the routine group(P<0.05).Before the intervention,there were no statistically significant differences in the scores for the two self-efficacy dimensions(overcoming difficulties and rehabilitation exercise self-efficacy)and the total self-efficacy score between the groups(all P>0.05).After 2 wk of intervention,the scores for these two dimensions of self-efficacy and the total self-efficacy score were significantly higher in the intervention group than in the routine group(all P<0.05).At 3 and 6 mo after surgery,hip function as evaluated by the Harris hip score,was significantly better in the intervention group than in the routine group(P<0.05).Additionally,overall nursing satisfaction was significantly higher in the intervention group than in the routine group(P<0.05).CONCLUSION Evidence-based nursing intervention can alleviate fear of postoperative rehabilitation in elderly patients who underwent hip fracture surgery,and improve rehabilitation treatment compliance and patient self-efficacy,which promote hip function recovery.
文摘Background:Evidence-based interventions(EBIs)are frequently adapted or modified during the implementation process to meet the needs of the target context,public health professionals,or health practitioners.However,little is known about how the EBIs of the same clinical problem at a different time(sustainability)and a different setting(scalability)should be adapted to facilitate implementation.To address this gap,this research aims to analyze the adaptations process of EBIs by taking post-stroke dysphagia screening as an example based on a series of empirical studies.Methods:We reviewed three best practice implementation projects of post-stroke dysphagia identification and management in China's Mainland,and conducted a comparative analysis of three projects of dysphagia screening practical decision-making according to core elements of evidence-based nursing(EBN).Results:We identified the core elements of EBN that influence decision-making in each best practice implementation project.The decision-making of screening time and tool for dysphagia in the three projects varied.Project 1:Post-stroke dysphagia was screened using Water Swallow Test(WST)before the first intake of liquid or food.Project 2:A sustainability study based on project 1,post-stroke dysphagia was screened using Standardized Swallowing Assessment(SSA)before the first intake of liquid or food,within 24 hours of admission.Project 3:A community scalability study based on project 2,post-stroke dysphagia was screened using Water Swallow Test(WST)before the first intake of liquid or food,within 24 hours after referral.Conclusions:Adaption of EBIs needs to fully consider the best available external evidence from systematic research,clinical expertise,patient preferences,as well as context.
文摘Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation process is available, it lacks specific instructions on how to adapt interventions so that they are aligned with cultural beliefs. In this paper, we present an integrated strategy that operationalizes the adaptation process by describing specific practical instructions on how to align interventions with cultural beliefs. Methods: The strategy integrates concept and intervention mapping, and uses mixed methods for gathering data from community representatives. The data pertain to a community’s cultural beliefs and values related to a health problem, acceptability of evidence-based interventions targeting the problem, and aspects of the interventions that should be modified to enhance their fit with cultural beliefs. A step-by-step protocol is described to guide application of the integrated strategy for cultural adaptation. Conclusions: The strength of the integrated strategy relies on the use of concept and intervention mapping approaches for specifying a step-by-step protocol to actively engage community representatives in the cultural adaptation of interventions. Future research should evaluate the utility of this strategy.
文摘Objective:To study the effect of early warning and evidence-based intervention combined with drug therapy on the infection process in children with mycoplasma pneumonia.Methods:Children who were treated and clearly diagnosed with mycoplasma pneumonia in Zigong Third People's Hospital between May 2014 and October 2017 were chosen and randomly divided into two groups, experimental group accepted early warning and evidence-based intervention combined with drug therapy, and control group accepted routine drug therapy. The levels of inflammatory cytokines and oxidative stress response indicators in serum as well as the expression of inflammation and oxidative stress signal molecules in peripheral blood were measured before treatment and 3 d after treatment.Results:Compared with those of same group before treatment, serum TNF-α, CysLTs, sTREM1, sP-selectin, sICAM1, MDA, SF and COR levels as well as peripheral blood TLR4, NF-κB, COX2, NOX4, MPO and iNOS expression intensity of both groups of patients significantly decreased whereas SOD and IgA levels significantly increased after treatment. Moreover, serum TNF-α, CysLTs, sTREM1, sP-selectin, sICAM1, MDA, SF and COR levels as well as peripheral blood TLR4, NF-κB, COX2, NOX4, MPO and iNOS expression intensity of experimental group were lower than those of control group whereas SOD and IgA levels were higher than those of control group. Conclusion: Early warning and evidence-based intervention combined with drug therapy can reduce the inflammatory response and oxidative stress response in the infection process of children with mycoplasma pneumonia.
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Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.
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This study systematically analyzed the primary causes of malnutrition in children with leukemia during chemotherapy,clarified the status of malnutrition and specific nutritional intervention measures,and comprehensively evaluated the research progress.The research indicates a shift from basic supportive care toward precision intervention strategies.Immunonutrition approaches,such as omega-3 fatty acid supplementation and probiotics for gut microbiota modulation,significantly mitigate chemotherapy-related side effects and enhance nutritional status.These targeted novel regimens demonstrate clear clinical advantages.The success of nutritional management depends on a multidisciplinary collaboration mechanism.The organic integration of innovative nutritional protocols with standard treatments from hematology,pediatrics,and nutrition departments significantly optimizes treatment outcomes and long-term quality of life for children with leukemia.This interdisciplinary synergy is reshaping contemporary medical models.
文摘Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.
文摘Objective:To explore the interventional room nursing and its application effects in patients with ischemic stroke treated with tirofiban combined with direct thrombectomy.Methods:A total of 61 patients with ischemic stroke admitted to our hospital from June 2024 to June 2025 were selected and divided into two groups using the red and blue ball method:the control group(n=30,receiving routine interventional room nursing)and the observation group(n=31,receiving additional tirofiban medication-specific nursing+individualized interventional nursing on the basis of routine nursing).The cerebral hemodynamic indicators,adverse reactions,effectiveness of complication nursing,and nursing satisfaction were compared between the two groups.Results:After 7 days of treatment,the observation group had lower cerebrovascular peripheral resistance and higher mean blood flow velocity and mean blood flow volume compared to the control group(all p<0.05).The observation group had a higher effectiveness rate of complication nursing than the control group,with a statistically significant difference(p<0.05).The nursing satisfaction in the observation group(96.77%)was higher than that in the control group(80.00%),with a statistically significant difference(χ^(2)=4.223,p=0.040<0.05).Conclusion:Tirofiban combined with direct thrombectomy can significantly improve cerebral hemodynamics,enhance the effectiveness of complication nursing,and increase patient satisfaction in patients with ischemic stroke.
文摘Objective:To systematically sort out the application forms and effects of digital health intervention technologies in oral health management,and provide references for the digital development of stomatology.Methods:By reviewing relevant domestic and foreign studies and clinical practices,this paper summarizes and analyzes the main application forms of digital health interventions,including digital health education,intelligent detection equipment,telemedicine platforms,oral health big data platforms,and school-hospital collaborative screening robots.Results:Studies have shown that digital health interventions can effectively improve the public’s oral health knowledge level,optimize personal health behaviors,enhance clinical diagnosis efficiency,reduce overall medical costs,and promote the innovation and upgrading of oral health management models.Conclusion:Digital health intervention represents an inevitable trend in the future development of stomatology.In the future,it is still necessary to improve data security and privacy protection,technology adaptability and popularity,as well as relevant policies and norms,to give full play to its potential value.
文摘Background:Early Hearing Detection and Intervention(EHDI)plays a critical role in improving language,cognitive,and socio-emotional outcomes for infants with hearing loss.In Nigeria,however,EHDI implementation remains limited by fragmented service delivery,uneven technological capacity,and sociocultural factors that delay timely diagnosis.This study explored the perspectives of paediatric audiologists and parents to provide a comprehensive understanding of the opportunities and challenges influencing early hearing care across diverse Nigerian settings.Methods:A mixed-methods design was employed across audiology facilities selected systematically from four Nigerian geopolitical zones.Twenty-five paediatric audiologists and twenty-three parents of children with congenital hearing loss participated.Quantitative data were collected using a structured questionnaire assessing awareness,diagnostic access,and intervention experiences.Qualitative data were obtained through semi-structured interviews and two focus group discussions.Thematic analysis followed Braun and Clarke's six-step framework,with dual coding,external auditing,and member validation to enhance credibility.Results:Quantitative findings demonstrated broad agreement on the diagnostic value of otoacoustic emissions(OAEs)and automated auditory brainstem responses(AABRs),the developmental benefits of early intervention,and the importance of active parental involvement.However,respondents identified persistent barriers including high costs of screening and therapy,poor public awareness of early hearing loss symptoms,and a critical shortage of trained personnel,and unequal distribution of diagnostic tools,particularly in rural and northern regions.Thematic analysis further underscored disparities in diagnostic capacity,sociocultural interpretations of deafness that delay clinical consultation,and economic constraints that hinder continuity of care.While families who accessed early intervention reported improved communication,social engagement,and learning readiness in their children,systemic gaps continue to limit widespread success.Conclusions:Despite growing technological capacity and awareness of EHDI benefits,significant structural,financial,and sociocultural challenges continue to impede timely diagnosis and intervention in Nigeria.Strengthening national policies,ensuring equitable distribution of diagnostic tools,expanding professional training,subsidising services,implementing culturally sensitive awareness campaigns and integration of Universal Newborn Hearing Screening into routine postnatal care are essential to improving outcomes for deaf infants.
文摘Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.
文摘BACKGROUND Approximately 30%of patients with head and neck cancer experience adverse effects caused by anxiety and depression.Considering the high prevalence,implementing customized interventions to ease adverse emotional states is imperative.AIM To evaluate the efficacy of cognitive behavioral therapy(CBT)-based psychological interventions in improving the psychological well-being and quality of life(QoL)of patients with laryngeal carcinoma.METHODS This study enrolled 120 patients admitted from February 2022 to February 2024.The control group,comprising 50 participants,received standard supportive psychological care,while the research group,consisting 70 participants,underwent CBT-based interventions.Several clinical outcomes were systematically assessed that included postoperative recovery metrics(duration of tracheostomy and nasogastric tube dependence and length of hospitalization),psychological status(Self-Rating Anxiety Scale and Self-Rating Depression Scale),nutritional markers(serum albumin and hemoglobin levels),sleep quality(Self-Rating Scale of Sleep and Athens Insomnia Scale),and QoL(Functional Assessment of Cancer Therapy-Head and Neck).RESULTS The results demonstrated that the research group experienced superior outcomes,with significantly reduced durations of tracheostomy and nasogastric tube dependence,as well as shorter hospital stays,compared with the control group.Additionally,the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale,Self-Rating Depression Scale,Self-Rating Scale of Sleep,and Athens Insomnia Scale scores,along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group.All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group,exceeding those observed in the control group.CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma,highlighting its potential for broader clinical application.
基金Deutsche Forschungsgemeinschaft(DFG,German Research Foundation),project numbers 324633948 and 409784463(DFG grants Hi 678/9-3 and Hi 678/10-2,FOR2953)to HHBundesministerium für Bildung und Forschung-BMBF,project number 16LW0463K to HT.
文摘Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.
文摘Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.
文摘The intersection of visual impairment and mental health has profound effects on quality of life and warrants attention from healthcare providers,educators,and policymakers.With 20 million children under the age of 14 affected globally,older adults also experience significant psychological impact including depression,anxiety,and cognitive impairment.The implications of vision-related challenges extend far beyond mere sight.Depression and anxiety,exacerbated by social isolation and reduced physical activity,underscore the need for comprehensive interventions that address both medical and psychosocial dimensions.By recognizing the profound impact of ocular morbidities like strabismus,myopia,glaucoma,and age-related macular degeneration on mental health and investing in effective treatments and inclusive practices,society can pave the way for a healthier,more equitable future for affected individuals.There is evidence that myopic children experience a higher prevalence of depressive symptoms compared to their normal peers,and interventions like the correction of strabismus can enhance psychological outcome-demonstrating the value of an integrated management approach.
文摘Objective To explore the application of evidence-based nursing intervention in patients with congenital heart diseases treated by transcatheter interventional therapy.Methods A total of 64 patients with congenital heart diseases who were administered in our hospital from June 2011 to July 2013 were recruited in our research.
基金supported by Nursing Research Program of Shanghai Nursing Association(No.2016SD-B03)
文摘Objective: Postpartum hemorrhage(PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses.Methods: Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire(OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance(M) >3.5, and coefficient of variation(CV) <0.25. Reliability of experts' opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated.Results: A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120.Conclusions: The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.
