Background Multiple myeloma (MM) is the second most prevalent hematologic malignancy, and pathological fracture represents the most severe complication of MM-related osteolytic bone disease, which significantly impairs patient survival and quality of life.While most existing studies have focused on Western populations, data on Chinese MM patients remains limited. This study aimed to investigate the incidence and independent influencing factors of pathological fractures in patients with multiple myeloma (MM). Methods This research is a single-center retrospective observational study. We retrospectively reviewed 735 patients with newly diagnosed MM between 2007 and 2020at a tertiary teaching hospital in Changsha, China and included 692 patients in the final analysis. All patients underwent imaging examinations (X-ray, CT, or MRI) to confirm pathological fracture diagnosis. We calculated the overall fracture incidence, and performed binary logistic regression to identify independent influencing factors. Results Overall, the incidence of pathological fractures among the included MM patients was 48.41%, with the most common fracture sites were the spine (73.5%), ribs (30.0%), and limbs (6.9%), respectively. Binary logistic regression identified six independent factors associated with pathological fracture risk. The risk factors of pathological fracture were overweight (BMI ≥ 24), hypoalbuminemia (serum albumin < 35 g/L), hyperglobulinemia (serum globulin > 40 g/L), and poorer Eastern Cooperative Oncology Group (ECOG) performance status. Meanwhile, therapeutic use of glucocorticoids and bisphosphonates were confirmed as protective factors against pathological fractures. Conclusion Pathological fractures are highly prevalent among Chinese MM patients. Targeted preventive interventions—including nutritional support, weight management, and standardized use of bone-protective agents—should be implemented to reduce fracture incidence and alleviate the associated health burden for patients.

Background Social resources influence the development of family resilience through individuals and families. This study aims to explore the effect of social support on family resilience in patients undergoing hematopoietic stem cell transplantation, as well as the possible mediating roles of family coping, family communication and psychological resilience in this relationship. Methods A cross-sectional survey was conducted among 268 patients with hematopoietic stem cell transplantation. Multiple assessment scales including social support, family resilience, family coping, family communication and psychological resilience were adopted. AMOS 24.0 was used to establish a structural equation model to explore the relationships among various variables. Results The results demonstrated that family coping, family communication, and psychological resilience exerted a significant indirect effect between social support and family resilience (β = 0.476, p < 0.001). Specifically, family coping (β = 0.276, p < 0.001) and family communication (β = 0.095, p < 0.001) independently mediated the relationship between the two variables. Moreover, family coping and psychological resilience played a notable sequential mediating role in the association between social support and family resilience (β = 0.081, p < 0.001). Similarly, family communication and psychological resilience also exhibited a significant sequential mediating effect on the correlation between social support and family resilience (β = 0.022, p < 0.001). Conclusion Social support was significantly correlated with family resilience in patients receiving hematopoietic stem cell transplantation. Furthermore, family coping, family communication and psychological resilience collectively exerted substantial indirect effects on this core association. Considering the limitation of the cross-sectional design, the present results merely reflect associations rather than causal links. Clinical Trial Registration Not applicable.

BackgroundDemoralization is a psychological syndrome that is highly prevalent in patients with cancer and detrimental to individuals' physical and mental health. To explore effective intervention, we first determined the relationships between locus of control, coping strategies, symptom burden, and demoralization.ObjectiveThe aim of this study was to determine the relationship between symptom burden, locus of control, coping strategies, and demoralization in patients with cancer. MethodsIn this descriptive-correlational study, 273 valid patients were selected with convenience sampling method from a hospital in China. Data were collected using the Chinese version of the M.D. Anderson Symptom Inventory, the Chinese version of the Multidimensional Health Locus of Control Scale, the Chinese version of the Medical Coping Modes Questionnaire, and the Mandarin version of the Demoralization Scale. Data were analyzed using descriptive and inferential statistics using SPSS and AMOS.ResultsA total of 115 patients (42.12%) experienced clinical demoralization (Mandarin version of the Demoralization Scale > 30). Symptom burden (beta = 0.295, P < .001), confrontation (beta = -0.117, P = .028), and resignation (beta = 0.456, P < .001) had direct effects on demoralization. Symptom burden also had an indirect effect on demoralization through the mediating role of resignation (beta = 0.026, P = .002). Meanwhile, locus of control can affect demoralization entirely through the indirect mediating role of coping strategies (chance locus of control via resignation [beta = 0.138, P < .01], powerful locus of control via confrontation [beta = -0.017, P < .05]). ConclusionsSymptom burden affects demoralization not only directly but also indirectly. Coping strategies play an important mediating role between symptom burden, locus of control, and demoralization in patients with cancer.Implications for PracticeIt is urgent to screen demoralization and identify patients with high symptom burden, maladaptive locus of control, or coping strategies. For the patients targeted, a more comprehensive and systematic approach to symptom management and more appropriate guidance related to adaptive coping strategies are needed.

This quasi-experimental study investigated the impact of traditional Chinese culture-based life-and-death education on 38 ICU nurses. Participants underwent 14 hours of training, and data were collected before and after the intervention using various questionnaires. Frequency and percentage were used for categorical data; mean and standard deviation for measurement data; and paired-sample t test for comparison of teaching effects before and after the intervention of life-and-death education programs. Results indicated significant improvements in understanding of death, reduced death anxiety, enhanced death coping abilities, and increased search for meaning (p < .05). However, there was no statistically significant change in attitude toward death (p > .05). Life-and-death education rooted in traditional Chinese culture positively influenced ICU nurses, fostering improved death cognition, reduced death anxiety, enhanced coping skills, and a heightened sense of meaning in life. Subsequent research will explore the relationship and distinctions between explicit and implicit death attitudes.

AIM:This study aims to investigate the prevalence of significant psychological distress and identify risk factors associated with it among early-stage lung cancer patients in the preoperative period. BACKGROUND:Lung cancer is a major cause of cancer deaths worldwide, with low survival rates and significant psychological distress. While much research has focused on distress in advanced-stage patients, less is known about the prevalence and risk factors of psychological distress in early-stage lung cancer patients before surgery. DESIGN:A cross-sectional study. METHODS:The study included 427 early-stage lung cancer patients preparing for surgery. Researchers used a study-specific questionnaire to gather general information and employed the Distress Management Screening Measurement, Patient Health Questionnaire-9 and Generalised Anxiety Disorder-7 to assess personal situations and psychological distress levels. Statistical analyses investigated distress across various patient characteristics and examined correlations with anxiety and depression. Binary logistic regression identified significant predictors of psychological distress. RESULTS:The study found that 41.9% of early-stage lung cancer patients experienced significant psychological distress preoperatively, with an average score of 3.31 ± 2.18. Psychological distress was significantly positively correlated with depression (r = 0.474, p < 0.001) and anxiety (r = 0.591, p < 0.001). Significant risk factors for psychological distress included pulmonary nodules (OR = 2.884, 95% CI: 1.496-5.559), smoking history (OR = 2.092, 95% CI: 1.016-4.306) and chronic diseases (OR = 2.013, 95% CI: 1.073-3.776). CONCLUSION:Early-stage lung cancer patients often experience a high incidence of clinically significant psychological distress during the preoperative period, strongly associated with depression and anxiety. Adverse factors contributing to psychological distress include multiple indeterminate pulmonary nodules, smoking history and concurrent chronic diseases. Routine screening for psychological distress in these patients is recommended, along with personalised interventions and self-management strategies to help alleviate their distress during the perioperative period.

To explore nurses' ability to cope with death and its relationship with death cognition and meaning in life in the context of Chinese traditional culture. 1146 nurses from six tertiary hospitals were recruited. Participants completed the Coping with Death Scale, the Meaning in Life Questionnaire, and the self-made Death Cognition Questionnaire. Multiple regression analysis revealed that the search for meaning, the understanding of "good death", receiving education related to life-and-death, cultural aspect, the presence of meaning, and the number of patient deaths experienced in career explained 20.3% of the variance in the ability to cope with death. Lacking a correct understanding of death, nurses are not sufficiently prepared to deal with death and their ability to cope with death is influenced by the unique cognition of death and the sense of the meaning in life in the context of Chinese traditional culture.

BACKGROUND:Caregivers of lung cancer patients frequently experience psychological distress and high caregiver burden. Previous studies have focused on caregiver burden for patients with advanced lung cancer, while few studies focused on the caregiver burden among informal caregivers of postoperative patients with early-stage non-small cell lung cancer (NSCLC).OBJECTIVES:This study aimed to (a) examine caregiver burden for caregivers of patients with early-stage NSCLC after surgical treatment and (b) identify predictive factors related to caregiver burden of patients with early-stage NSCLC.METHODS:A cross-sectional study was conducted in a university-affiliated hospital in Changsha, China. A total of 385 patients with early-stage NSCLC and postsurgical treatment and their caregivers were included in this study. Caregiver burden was evaluated using the Zarit caregiver burden interview (ZBI). A set of questionnaires was used to assess psychosocial characteristics of participants, including simplified coping style questionnaire, social support rate scale, and hospital anxiety and depression scale. Hierarchical regression analysis was applied to identify factors associated with caregiver burden. We followed STROBE checklist for reporting the study.RESULTS:The average ZBI score was 29.1 ± 11.4. Most caregivers (62.6%) demonstrated mild to moderate caregiving burden. The duration of caregiving (β = 0.18, p < .001), passive coping of caregiver (β = 0.17, p = .001) and anxiety (β = 0.13, p = .007) were significant predictors of caregiving burden. A variance of 17.6% in caregiving burden was explained by these identified factors.CONCLUSIONS:Caregivers of early-stage NSCLC patients experience a mild to moderate level of caregiver burden. The duration of caregiving, passive coping and anxiety are factors associated with caregiver burden.RELEVANCE TO CLINICAL PRACTICE:Clinicians should provide early care to support new roles of family members as caregivers.

Objective:To explore the latent classes of emotional behavior of children with mental disorders, and their relationship with parents' sense of parenting competence and psychological distress.Methods:A survey of 327 parents of children with mental disorders was conducted from September to December 2022 using the general information questionnaire, the sense of parenting competence scale, the Kessler psychological distress scale, and the strengths and difficulties questionnaire (parent version). Mplus 8.0 and SPSS 25.0 softwares were used for statistical analysis.The latent class analysis was used to identify subgroups of children with mental disorders based on their emotional behavior.Multinomial logistic regression was used to analyze the related factors.Results:Latent class analysis showed that the emotional behaviors of children with mental disorders were divided into 3 categories: emotion-conduct problem prominent group (38.53%(126/327)), simple emotional problem group (44.65%(146/327)), and emotion-peer interaction significant group (16.82%(55/327)). The differences among the 3 latent classes were statistically significant (all P<0.05) in terms of parents' parenting competence, satisfaction, and psychological distress scores.Compared with the emotion-conduct problem prominent group, the higher the parental parenting knowledge and parenting competence, the emotional behavior of children with mental disorders tended to be in the simple emotional problem group ( B=0.699, OR=2.011, 95% CI=1.046-3.868; B=0.088, OR=1.092, 95% CI=1.017-1.173). Compared with the " emotion-conduct problem prominent group" , the emotional behavior of children with mental disorders aged 13 to 18 years old tended to be in the " emotion-peer interaction significant group" ( B=1.982, OR=7.255, 95% CI=1.637-32.141). Conclusion:The emotional behavior of children with mental disorders is heterogeneous, and there are differences in sense of parenting competence and psychological distress of parents among different latent classes of children with mental disorders.

Abstract Background The healthy development of psychological behaviour among children has been widely concerned by the whole society. However, little is known about different categories or attributes of their psycho-behavioural adaptation. The purpose of this study to identifies the latent classes of psycho-behavioural adaptation in children and explores the relationships of these classes with sense of parenting competence and psychological distress of parents Methods The cross-sectional study was conducted in one primary and secondary education school in mainland China from September 2022 to December 2022. The parents of children (3–18 years old) were invited to participate in the study. We used standardized questionnaires to collect data. A latent class analysis was performed to identify children's psycho-behavioural adaptation classes. Results The study recruited 242 participants. Two classes of psycho-behavioural adaptation were identified, namely, the psycho-behavioural problems group and the psycho-behavioural health group. The differences between latent classes were statistically significant regarding the child's age and parental health. The differences between latent classes were statistically significant in terms of sense of parenting competence, satisfaction, efficacy, and psychological distress score. The sense of parenting competence and parental psychological distress influenced the latent class of psycho-behavioural adaptation in children. Conclusion There is heterogeneity in the psycho-behavioural adaptation of children and differences in the sense of parenting competence and psychological distress of parents in each category. Targeted interventions should be developed and implemented based on the characteristics of each psycho-behavioural adaptation class to maximize interventions' effectiveness and promote parental and child well-being.

Objective To systematically evaluate and synthesize the barriers of early rehabilitation based on the view of ICU patients and family members. Methods PubMed,Web of Science,Embase,CINAHL,Cochrane Library,CNKI,Wanfang,VIP and SinoMed Database were searched for qualitative studies on early rehabilitation involving ICU patients and their family members from the establishment of database to June,2022. The quality of included literature were assessed using Australian JBI Evidence-Based Health Care Center（2017 edition） Quality Evaluation Standards and the results were integrated by an aggregative approach. Results A total of 13 studies were included,48 findings were refined,7 new categories were formed,and 3 integrated results were obtained. The first integrated result was inadequate understanding of early rehabilitation concepts,knowledge and identity responsibilities among ICU patients and family members. The second integration result was the heavy physical and mental burden of early rehabilitation and the third one was unmet multiple needs of patients and family members.Conclusion There are many barriers of early rehabilitation involving ICU patients and family members. Managers and clinical staff should take measures to address barriers and promote the clinical implementation of early rehabilitation in ICU actively.

目的 对护士安宁疗护能力的影响因素进行范围综述,为今后的干预研究提供参考依据.方法 按照范围综述方法框架确立研究问题,对各数据库建库至2023 年3 月的中英文文献进行检索并筛选,之后对纳入文献进行数据提取,最终收集、总结并报告研究结果.结果 本研究共纳入22 篇文献,护士安宁疗护能力的影响因素包括年龄与工作经验、性别、婚姻、职称、学历、知识、态度、经验、培训等.结论 国内外护士的安宁疗护能力受诸多复杂因素的影响,为促进护士安宁疗护能力和临床安宁疗护质量的提升,亟须开展多中心、大样本研究及纵向研究进行探索.

目的 通过对数字健康在安宁疗护中的应用进展进行综述,为提高国内数字健康与安宁疗护的临床实践提供参考依据.方法 检索国内外相关文献,对数字健康的相关概念及在安宁疗护中的应用现状、应用效果等进行综述,并提出展望.结果 数字健康在安宁疗护中的应用包括大数据、移动医疗、虚拟现实、人工智能和数字遗产,在提高安宁疗护质量、减轻负担、远程教育和优化医疗资源等方面效果显著.结论 数字健康在安宁疗护中应用广泛,而国内研究尚有所欠缺,要提高数字健康的研究质量、提高患者和社会的认知度,并完善应用的相关制度,为我国数字健康在安宁疗护中的发展与应用起促进作用.

Despite the increasing survival rates, liver transplant patients experience numerous postoperative complications and encounter significant challenges in long-term self-management. This study aims to examine the effectiveness of empowerment education in enhancing self-management skills and self-efficacy among liver transplant recipients.A randomized, single-blind, single-center trial was conducted in China between August 2019 and September 2020, involving liver transplant recipients. The intervention group received 12 weeks of empowerment education, while the control group received 12 weeks of routine education. .The study assessed the patients' self-management and self-efficacy using the Liver Transplant Recipient Self-Management Questionnaire and the Self-efficacy for Managing Chronic Disease 6-Item Scale. Follow-up assessments were conducted at 1, 3, and 6 months after the intervention.Eighty-four patients were initially randomized to either the intervention group (n1 = 42) or the routine education group (n2 = 42). Twelve patients were excluded from the analysis due to loss of follow-up or discontinuation of the intervention, leaving 72 patients (n1 = 35, n2 = 37) for the final analysis. The scores for exercise and lifestyle management were significantly higher in the intervention group than in the control group at 1, 3, and 6 months after the intervention (t = 3.047, 5.875, 8.356, and t = 5.759, 4.681, 11.759, respectively; P < 0.05). At 3 and 6 months after the intervention, the scores for cognitive symptom management, communication with physicians, and self-efficacy were significantly higher in the intervention group than in the control group (t = 5.609, 6.416, and t = 5.576, 11.601, and t = 6.867, 15.071, respectively; P < 0.001). Within the intervention group, self-management scores increased significantly over time, while within the control group, the scores for communication with physicians, lifestyle, and self-efficacy showed a significant decline from 3 to 6 months after routine health education.The results of this study suggest that empowerment education is an effective means of improving the self-management and self-efficacy of liver transplant patients, with better outcomes compared to routine health education. These findings have important implications for nursing practice and provide valuable guidance for clinical education of liver transplant patients.ChiCTR2200061561.

Background: Caring for patients with delirium is challenging and overwhelming for intensive care unit (ICU) nurses. Investigating the psychological impact of delirium care on ICU nurses is crucial to maintaining their psychological health and improving the quality of care. Objective: The objective of this study was to investigate the psychological stress of ICU nurses in caring for patients with delirium and potential factors. Methods: A total of 355 nurses from three tertiary care hospitals in Hunan Province, China, participated in this cross-sectional survey. Data were collected using the demographic sheet, Impact of Event Scale-Revised, Connor-Davidson Resilience Scale, and Occupational Coping Self-Efficacy Scale for Nurses. Descriptive and multiple linear regression analyses were used to examine the factors associated with psychological stress. Results: ICU nurses suffered moderate psychological stress related to delirium care. The recent time to care for patients with delirium (P < 0.001), familiarity with delirium-related knowledge (P = 0.002), satisfaction with delirium-related support (P = 0.046), psychological resilience (P < 0.001), and occupational coping self-efficacy (P < 0.001) were significant contributors to psychological stress. Conclusion: Nurse managers and researchers need to focus on the psychological well-being of ICU nurses in caring for patients with delirium, especially those who are currently caring for patients with delirium, and provide tailored support, increase their knowledge of delirium, and also boost psychological resilience and coping skills. (c) 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Introduction: Orthopedic patients are at high risk for intraoperatively acquired pressure injuries (IAPI), which cause a serious issue and lead to high-expense burden in patient care. However, there are currently no clinically available scales or models to assess IAPI associated with orthopedic surgery. Methods: In this real-world, prospective observational, cross-sectional study, we identified pressure injuries (PI)-related risk factors using a systematic review approach and clinical practice experience. We then prepared a real-world cohort to identify and confirm risk factors using multiple modalities. We successfully identified new risk factors while constructing a predictive model for PI in orthopedic surgery. Results: We included 28 orthopedic intraoperative PI risk factors from previous studies and clinical practice. A total of 422 real-world cases were also included, and three independent risk factors-preoperative limb activity, intraoperative wetting of the compressed tissue, and duration of surgery-were successfully identified using chi-squared tests and logistic regression. Finally, the three independent risk factors were successfully used to construct a nomogram clinical prediction model with good predictive validity (area under the ROC curve = 0.77), which is expected to benefit clinical patients. Conclusion: In conclusion, we successfully identified new independent risk factors for IAPI-related injury in orthopedic patients and developed a clinical prediction model to serve as an important complement to existing scales and provide additional benefits to patients. Our study also suggests that a single measure is not sufficient for the prevention of IAPI in orthopedic surgery patients and that a combination of measures may be required for the effective prevention of IAPI.

目的 利用CiteSpace软件分析护士处方研究热点和趋势.方法 检索中国知网、维普、万方、中国生物医学文献数据库中2000年1月至2021年12月护士处方相关文献,利用CiteSpace软件对作者、关键词进行可视化分析.结果 共纳入184位作者发表的150篇研究,年发文量总体呈波折上升趋势;该领域核心期刊有7种,载文最多的期刊为《护理研究》;分析结果显示,护士处方研究受到学者关注和重视,以韩世范为代表的研究团体间合作较紧密;近年来,研究方向主要集中于临床各系统的护士药物处方内容和形式;且处方护士角色、药物处方内容不断丰富,研究内容和方法逐渐向系统化、多样化发展.结论 研究团队仍需加强合作,进一步拓展护士非药物处方权在中医领域的内容和形式,探索基层卫生医疗机构的护士处方教育培训和实践,以期推动我国分级诊疗和医疗体制建设.

It is important to understand how the perception of death affects the competence to cope with death. To explore whether the perception of death has an indirect effect on competence to cope with death through the mediation of attitude toward death and meaning of life. A total of 786 nurses from Hunan Province, China, selected by random sampling method and asked to complete an online electronic questionnaire between October and November 2021 were included in the study. The nurses’ scored 125.39 ± 23.88 on the competence to cope with death. There was a positive correlation among perception of death, competence to cope with death, the meaning of life, and attitude toward death. There were three mediating pathways: the separate mediating effect of natural acceptance and meaning of life, and the chain mediating effect of natural acceptance and meaning of life. The nurses’ competence to cope with death was moderate. Perception of death could indirectly and positively predict nurses’ competence to cope with death by enhancing natural acceptance or sense of meaning in life. In addition, perception of death could improve natural acceptance and then enhance the sense of meaning in life to positively predict nurses’ competence to cope with death.

Background With the advent of China’s aging population and the popularization of smartphones, there is a huge demand for smart elderly care apps. Along with older adults and their dependents, medical staff also need to use a health management platform to manage the health of patients. However, the development of health apps and the large and growing app market pose a problem of declining quality; in fact, important differences can be observed between apps, and patients currently do not have adequate information and formal evidence to discriminate among them. Objective The aim of this study was to investigate the cognition and usage status of smart elderly care apps among older individuals and medical staff in China. Methods From March 1, 2022, to March 30, 2022, we used the web survey tool Sojump to conduct snowball sampling through WeChat. The survey links were initially sent to communities in 23 representative major cities in China. We asked the medical staff of community clinics to post the survey link on their WeChat Moments. From April 1 to May 10, 2022, we contacted those who selected “Have used a smart elderly care app” in the questionnaire through WeChat for a request to participate in semistructured interviews. Participants provided informed consent in advance and interviews were scheduled. After the interviews, the audio recordings were transcribed into text and the emerging themes were analyzed and summarized. Results A total of 810 individuals participated in this study, 54.8% (n=444) of whom were medical staff, 33.1% (n=268) were older people, and the remaining participants were certified nursing assistants (CNAs) and community workers. Overall, 60.5% (490/810) of the participants had used a smart elderly care app on their smartphone. Among the 444 medical staff who participated in the study, the vast majority (n=313, 70.5%) had never used a smart elderly care app, although 34.7% of them recommended elderly care–related apps to patients. Among the 542 medical staff, CNAs, and community workers that completed the questionnaire, only 68 (12.6%) had used a smart elderly care app. We further interviewed 23 people about their feelings and opinions about smart elderly care apps. Three themes emerged with eight subthemes, including functional design, operation interface, and data security. Conclusions In this survey, there was a huge difference in the usage rate and demand for smart elderly care apps by the participants. Respondents are mainly concerned with app function settings, interface simplicity, and data security.

Background:With the shift of strategy in fighting COVID-19, the post-pandemic era is approaching. However, the "hard times" for healthcare systems worldwide are not yet ending. Healthcare professionals suffer negative impacts caused by the epidemic, which may seriously threaten their work motivation, concentration, and patient safety.Objective:Investigating the status and factors associated with Chinese healthcare professionals' work engagement in the post-pandemic era.Methods:A cross-sectional study was conducted to investigate healthcare professionals from 10 hospitals in Hunan Province. Data were collected using demographic characteristics, Generalized Anxiety Disorder-2, Patient Heath Qstionaire-2, Utrecht Work Engagement Scale, Work-Related Basic Need Satisfaction Scale, National Aeronautics and Space Administration-Task Load Index, and self-compassion scale. Descriptive and multiple linear regression analyses explored the factors associated with work engagement.Results:A total of 1,037 eligible healthcare professionals participated in this study, including 46.4% of physicians, 47.8% of nurses, and 5.8% of others. The total mean score of work engagement was 3.36 ± 1.14. The main predictor variables of work engagement were gender (p = 0.007), years of work experience (p < 0.001), whether currently suffering challenges in the care of patients with COVID-19 (p = 0.003), depression (p < 0.001), work-related basic need satisfaction (p < 0.001), and mindfulness (p < 0.001).Conclusion:Healthcare professionals have a medium level of work engagement. Managers need to pay attention to the physical and psychological health of healthcare professionals, provide adequate support, help them overcome challenges, and acknowledge their contribution and value to improve their work engagement, enhance the quality of care and ensure patient safety.

目的 构建以柯氏四级评估模型为框架的专科护士培训评价指标体系,为推进专科护士培训工作提供参考.方法 基于柯氏四级评估模型,通过文献回顾,参考专科护士培训教材、指南、标准和规范,初步建立专科护士培训评价指标体系框架,结合专家预函询结果,拟订评价指标体系,选取专科护士培训基地负责人、培训师资、参与培训学员进行两轮函询以筛选指标,采用层次分析法和百分法计算各级指标权重.结果 形成了包含 4 项一级指标、17 项二级指标、96 项三级指标的基于柯氏四级评估模型的专科护士培训评价指标体系.两轮函询专家积极系数分别为 100.0%、92.3%,权威系数分别为 0.86、0.87,第二轮函询各级指标Kendall's W系数分别为 0.056、0.113、0.112(P<0.05).一级指标权重从大到小排名依次为行为层(0.438)、反应层(0.313)、学习层(0.125)、结果层(0.125).结论 构建的专科护士培训评价指标体系具有一定科学性,可为规范、有效开展专科护士培训评价提供依据.