Background:Out-of-hospital cardiac arrest (OHCA) is a global health issue with low survival rates, for which bystander cardiopulmonary resuscitation (CPR) is crucial. In China, bystander CPR rates and public proficiency remain low. Children-an important future first-responder group-also lack adequate training. Gamification and virtual reality (VR) technologies show potential in enhancing training effectiveness, but research on the needs, acceptability, and functional requirements of gamified CPR training kits from children's and parents' dual perspectives is insufficient, providing a realistic basis for this study. Objective:This study aimed to investigate children's and parents' needs, acceptability, and functional requirements for the development of gamified CPR training kits. Methods:A cross-sectional qualitative design was adopted. Inclusion criteria were children aged 6 to 12 years, their parents, adequate communication skills, and voluntary informed consent, with purposive sampling to recruit 13 parent-child dyads from a primary school in Changsha, Hunan Province. The participants included children aged 6 to 12 years (average age 9.50, SD 1.50 y, 6 boys and 7 girls) and their parents (average age 38.50, SD 2.50 y, 6 female and 7 male individuals). Semistructured interviews were conducted separately for children and parents, with audio recording and verbatim transcription. The NVivo 12.0 (QSR International Pty Ltd) software was used for thematic coding and analysis, and dual independent coding (by 2 researchers) was performed to ensure rigor, with discrepancies resolved through team discussion. Thematic saturation, defined as codebook stabilization and no new themes across 3 consecutive interviews, was achieved after 13 dyads. The study followed the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines, and all procedures were approved by the ethics committee. Results:Four main themes and 9 subthemes emerged from the data: (1) children's approaches to acquiring CPR-related knowledge and skills (through school-organized first aid activities, family members, or social media platforms), (2) attitudes toward gamified training kits (children's receptiveness and parental preferences regarding such tools), (3) expectations for gamified CPR training kits (child-friendly design, effective skill training, personalized feedback, and scientifically grounded content), and (4) challenges in gamified science education (ensuring product safety and professionalism and contextualizing game scenarios to everyday life). Conclusions:As children are an important reserve force for future first responders, cultivating their first aid awareness is crucial for improving public emergency response capabilities. Effective gamified CPR training kit development requires integrating children's and parents' perceptions to balance entertainment, education, and practicality. This study innovatively explores dual user needs, differing from prior research focused on training outcomes rather than predevelopment requirements. It addresses gaps in pediatric first aid tool design and provides evidence-based references for the development of child-friendly, professional, gamified training resources-laying a foundation for gradually enhancing CPR literacy and emergency response awareness among children in China.

To examine the association between loneliness, frailty, and functional limitation of older adults in China and to determine the mediating role of frailty. The linear regression model and bootstrap analyses were used to test the hypothetical mediating model. A total of 4446 older adults were included in this study. Significantly positive correlations were found between loneliness and frailty (r = 0.18, p < 0.001), frailty and functional limitation (r = 0.36, p < 0.001), as well as loneliness and functional limitations (r = 0.15, p < 0.001). After adjusting the confounders, loneliness was positively associated with functional limitation (β = 0.320, p < 0.001) and frailty (β = 0.080, p < 0.001). The mediation effect of frailty accounted for 38.3 % of the total effect regarding loneliness with functional limitation, and the magnitude of mediation effect was a*b = 0.422 (95 % CI:0.301-0.520). These findings could help guide effective interventions to improve functional limitation of older adults.

This study aimed to compare the prognostic performance of MEWS, GCS, RTS, and qSOFA in predicting 7-day in-hospital mortality among hospitalized patients with traumatic brain injury (TBI). This retrospective cohort study analyzed medical data of patients with TBI in a tertiary hospital in Changde City, China, from January 2023 to December 2023. The MEWS, GCS, RTS, and qSOFA were calculated based on vital signs, and the main outcome was 7-day in-hospital mortality. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) was calculated to compare the prognostic performances of the MEWS, GCS, RTS, and qSOFA in predicting 7-day in-hospital mortality. A multivariate logistic regression model was used to determine factors independently associated with 7-day in-hospital mortality. A total of 2519 patients were included, among whom 581 died within 7 days (23.1

To explore the effects of a nurse-led psycho-educational interventions (PEI) on uncertainty in illness, anxiety and sexual functioning among women with gynaecological cancer (GC). An assessor-blinded multicentre randomised controlled trial was conducted in Hong Kong and Hunan, China. The intervention group received a 4-session, 12-week-long nurse-led PEI while the control group received attention on four occasions. The outcomes were measured at baseline and upon completion of the programme. Of the 402 participants recruited, 202 were randomly assigned to the intervention group and 200 to the control group. The intervention demonstrated significant effects on ambiguity (Group*Time regression coefficient, B = − 2.13, 95

Introduction: To explore the relationship between the composite dietary antioxidant index (CDAI) and gout to provide support for preventing gout through dietary intervention. Methods: Eligible participants from the 2007 to 2018 National Health and Nutrition Examination Survey aged 20 years and older were included in this cross-sectional study. The weighted chi-square test was used to compare the categorical variables difference between CDAI quartiles groups. The weighted univariate and binary logistic regression analysis were used to test the association between variables and gout. The weighted multivariable logistic regression was used to test the association of CDAI and gout in 4 different models. Subgroup analysis on the associations of CDAI with gout was conducted with stratified factors. Results: The final participants were 26,117, 13,103 (50.17%) were female, 8718 (33.38%) were 40–59 years, 11,200 (42.88%) were white and 1232 (4.72%) had gout. After adjusting for all covariates, the CDAI was associated with gout (odds ratio (OR), .97; 95% CI: .95–1.00). Participants in the highest CDAI quantile group were at low risk of gout (odds ratio (OR), .65; 95% CI: .50–.84) versus those in the lowest quantile group. Subgroup analysis and interaction test showed no significant dependence on diabetes mellitus (DM), marital status, alcohol status, hypertension, poverty income ratio (PIR), education level, body mass index (BMI), smoke status, age, sex, race, and chronic kidney disease (CKD) on this association (all p for interaction >.05). Conclusions: Composite dietary antioxidant index was inversely associated with gout in US adults, and dietary antioxidant intervention might be a promising method in the therapy of gout and greater emphasis should be placed on zinc, selenium, carotenoids, vitamins A, C, and E.

Background: Growing evidence has shown that antioxidant diets protect against heart failure (HF). However, the association between the composite dietary antioxidant index (CDAI), an important measure of overall antioxidants in the diet, and HF has received little attention. Objective: The purpose of this study was to examine the relationship between the CDAI and HF. Methods: A secondary cross-sectional analysis of the 2003 to 2019 National Health and Nutrition Examination Survey (NHANES) was performed. Weighted multivariable logistic regression was used to test the association between the CDAI and HF in four different models, with subgroup analysis and an interaction test subsequently performed. Results: A total of 37,390 participants were included. The HF groups had lower CDAI levels than those in the nonHF group (0.29 +/- 0.04 vs. -0.74 +/- 0.16, p < 0.0001). After adjusting for demographic characteristics, lifestyle factors, and disease history, a negative association was found between the CDAI and HF (OR: 0.97, 95 % CI: 0.94, 1.00). There was an inverse trend whereby increasing the CDAI was associated with decreasing the odds of HF ( p for trend < 0.001). The subgroup analysis and interaction test showed no significant dependence on demographic characteristics, lifestyle factors, and disease history with regard to this association (all p for interaction > 0.05). Conclusion: The CDAI was inversely associated with HF in US adults, with higher CDAI levels possibly being associated with a lower incidence of HF, suggesting that dietary antioxidants may help prevent HF.

目的 创建湖南省三级医院"三梗一出血"预警防控模式,为逐步建立规范化和专业化的防控和救治模式提供依据.方法 将2017年2月至2020年1月在湖南省人民医院院内发生"三梗一出血"患者328例作为对照组,2020年2月至2023年1月发生的"三梗一出血"患者272例作为观察组.对照组实施常规干预,观察组在结合对照组情况的基础上实施预警防控干预模式.比较两组患者急救时间、住院时间、并发症发生率、致残率、致死率和诊疗服务满意度.结果 观察组患者急救时间、住院时间、并发症发生率、致残率和致死率均显著低于对照组,而诊疗服务满意度显著高于对照组,两组间比较差异有统计学意义(P＜0.05).结论 预警防控模式能够明显缩短"三梗一出血"患者的急救时间和住院时间,有助于降低并发症发生率和致残率、致死率,提升诊疗服务满意度,为建立逐步规范化和专业化的防控和救治模式提供了依据.

目的 遴选并整合国内外关于预防ICU患者头面部器械相关压力性损伤的最佳证据,为临床实践提供可靠的参考依据.方法 采用PIPOST方法构建循证问题,计算机检索BMJ、NICE、NGC、RNAO、EPUAP、JBI、Embase、CNKI等数据库中的临床指南、系统评价、专家共识、证据总结等.由2名接受过循证培训的护理人员独自对纳入的文献进行评价、证据提取及结合小组成员对证据进行整合和分级.结果 共纳入11篇文献,其中指南3篇,系统评价3篇,专家共识4篇,证据总结1篇.最佳证据主要从6个方面展开,包括风险/皮肤评估、皮肤护理、医疗器械的规范与佩戴、预防性敷料的使用、多学科合作、培训与管理,共19个条目.结论 医务人员将证据转换至临床实践过程中,需充分考虑医疗机构所处的条件/环境、患者意愿、证据转换过程中的促进因素和障碍因素等,不断更新循证证据,以科学的方法指导临床实践,减少ICU患者头面部器械相关压力性损伤的发生,提升护理质量.

Objective:To explore the perception and demand of children's parents on Internet children's hospital, and provide reference for improving the service model of Internet children's hospitals.Methods:This is a qualitative study. Totally 11 parents of children who visited the outpatient services of Guangzhou Women and Children's Medical Center from November to December 2021 were selected by convenience sampling, and a semi-structured interview was conducted with them based on a self-made outline. The Colaizzi phenomenological 7-step analysis method was used to analyze the data and refine the themes.Results:A total of four themes were extracted, namely, the high degree of parental recognition of the Internet children's hospital service model, the need for convenient, timely and safe information acquisition, the need for professional, reliable and friendly diagnosis and treatment services, and the need for reasonable and transparent fees.Conclusions:The online diagnosis and treatment services of Internet children's hospitals meet the needs of parents for medical treatment and have good prospects. At the same time, the service model of Internet children's hospitals should pay more attention to the convenience, professionalism, safety and economy of users, so as to promote its healthy development.

器械相关压力性损伤是压力性损伤的一种,随着医疗器械在临床应用的种类日渐增多,其导致的压力性损伤也日益引起广泛关注.本文对ICU患者头面部器械相关压力性损伤的流行病学特点、常见部位、风险因素及防护对策等进行综述,以期为进一步构建预防ICU患者头面部器械相关压力性损伤的方案提供参考依据.

通过范围综述审查了护士对老年痴呆症护理伦理决策的相关研究,从痴呆症护理实践中平衡职业道德规范及监管准则与患者的自主尊严及安全需求的伦理冲突、晚期老年痴呆症患者临终照护的道德需求决策困境、痴呆症护理中文化环境的适应冲突从三个方面总结了老年痴呆症护理伦理决策主要内容,并基于当前的主要问题提出了痴呆症护理伦理决策的主要对策,即完善以人为本的护理标准化痴呆症决策能力评估流程,改进老年痴呆症患者个性化的沟通策略,并建立与组织工作环境一致的护理伦理文化,以期为完善老年痴呆症护理体系提供一定的参考.

目的:了解湖南省公众现场救护参与行为现状和影响因素,为提高院前急救和现场救护参与度提供参考依据.方法:于2022年10月15日至21日进行为期1周的线上问卷调研,采用自行设计的调研问卷,以微信为传播媒介进行网络调查,通过问卷星在线调查工具发布及收集问卷数据.在公众遇到现场救护事件时,根据是否参与现场救护分为参与组和未参与组,使用卡方检验分析组间计数资料的差异,使用多因素非条件Logistic回归分析现场救护参与行为的影响因素.结果:(1)共6 114人填写问卷,有效问卷数为5 852份(95.71％),其中1 460人遇到过现场救护事件,而参与过现场救护的有862人(59.04％).(2)现场救护事件参与地点主要在家中(38.36％),事件原因主要是心脏病发作(40.55％),参与现场救护的方式主要是拨打120(62.76％)和送往医院(46.06％),而心肺复苏(14.62％)、电除颤(5.22％)等专业急救方式使用极少.(3)多因素非条件Logistic回归分析结果显示,与家庭月收入＜5 000元相比,公众家庭月收入＞10 000 元(OR=1.889,95％CI 1.065～3.351,P=0.030)、公众既往被救的经历(OR=2.431,95％CI 1.669～3.541,P＜0.001)、既往接受过现场救护培训(OR=8.832,95％CI 5.355～14.569,P＜0.001)是促进参与现场救护行为的有利因素.结论:对经济收入水平低的地区加强现场救护相关培训,普及现场救护技能有助于促进公众现场救护的参与行为,同时可以积极探索既往获救人员参与现场救护行为的机制和途径,促进公众参与现场救护的行为.

综述可穿戴设备在急性心肌梗死病人院前急救中的应用现状，包括心电监测、风险预测、紧急救护、呼救定位、信息交互等方面，并提出了可穿戴设备在院前急救中需要克服的挑战及发展方向，以期提高急性心肌梗死病人急救效率，助力院前急救服务体系建设。

目的 深入了解T管带管患者对居家护理平台服务的体验及效果评价,明确居家护理平台进一步改善的方向,为各医疗机构居家护理相关制度的制定提供参考依据.方法 根据目的抽样法和信息饱和原则选取居家护理平台T管带管患者,对其进行半结构式访谈,对访谈过程进行录音,使用NVivo 11.0软件将访谈资料转录为文字,经双人核对后,按顺序进行编码、归纳,最终形成主题并进行验证,得出结论.结果 共提炼出2个主题:①T管带管患者对居家护理平台服务满意;②T管带管患者对居家护理平台服务改进的具体期待.结论 居家护理平台的优势明显,专业的团队和科学的流程规范满足了社会需要和患者的多元化、多层次需求,未来健康、有序的居家护理环境还需广大医护人员共同建设.

Introduction Health education, as a crucial strategic measure of disease prevention and control in the 21st century, has become an important part of healthcare. As the main deliverers of patient health education, nursing personnel’s patient health education competence (PHEC) has received much attention. Instruments for assessing the PHEC of nursing personnel have been developed internationally, but there is a lack of systematic reviews and evaluations of the psychometric properties of these instruments. To effectively select appropriate PHEC assessment instruments in specific contexts, a systematic and comprehensive review and evaluation of these measurement instruments are needed. The goal of this systematic review is to systematically evaluate the psychometric properties of existing PHEC instruments.Methods and analysis In this study, eight databases will be searched between 1 March 2023 and 31 2023 to retrieve studies that include instrument(s) measuring the PHEC of nursing personnel. Two researchers will independently perform literature screening, data extraction and literature evaluation. In case of disagreement, a third researcher will be involved in the resolution. The measurement properties of PHEC assessment instruments will be systematically reviewed based on the consensus-based standards for the selection of health measurement instruments (COMSIN) methodology and guideline.Ethics and dissemination Ethical approval is not applicable for this study. We will share the findings from the study at national and/or international conferences and in a peer-reviewed journal in the fields of health education and/or patient education.PROSPERO registration number CRD42023393293.

ObjectiveTo examine the participation in on-the-spot first aid among inpatients in Hunan province and the outcome and influencing factors of the participation for providing a reference to improve pre-hospital emergency and field rescue.MethodsUsing stratified random sampling and a self-designed questionnaire, an online survey was conducted among 6 004 inpatients in 109 medical institutions in Hunan province during January – February 2022. The information on the inpatients′ participation in on-the-spot first aid, the outcomes and influencing factors of their participations were collected and analyzed. Unconditional multivariate logistic regression model was used to explore influencing factors for outcomes of the on-the-spot first aid actions.ResultsFor the 5 964 inpatients finally included in the analysis, 1136 (19.05%) reported ever encountering on-site rescue events. Among the 1136 inpatients ever encountering on-site rescue events, 440 (38.73%) had participated in on-site rescue. Of the 440 participants taking on-site rescue, 71.86% called emergency services; 24.42% sent the first aid recipients to hospital; 12.79% performed cardiopulmonary resuscitation; and 2.56% conducted electric defibrillation. For all the first aid recipients in the on-the-spot first aids being involved by the inpatient participants, 213 (48.41%) were cured, 127 (28.86%) were improved, 75 (17.05%) died, and 25 (5.68%) had an unknown outcome. The results of unconditional multivariate logistic regression analysis showed that emergency personnel not arriving at the first aid site within 10 minutes was a hindering factor for the outcomes of the latest on-the-spot first aid; ever participating in on-the-spot first aid more than 3 times and emergency personnel arriving at the first aid site within 30 minutes were promoting factors for the outcomes of the latest on-the-spot first aid.ConclusionThe participation of on-the-spot first aid was low among inpatients in Hunan province. The outcome of the resued persons for the latest on-the-spot first aid being involved by the inpatient participants was mainly influenced by the time of emergency personnel arriving at the first aid site and the frequency of inpatients′ ever participating in on-the-spot first aid.

目的 通过检索、分析和总结危重症成人患者失禁相关性皮炎资料,为其预防和管理提供最佳证据.方法 在循证护理的基础上,提出相关问题,系统检索近 10 年国内外数据库及相关网站关于危重症成人患者失禁相关性皮炎相关的临床实践、指南、最佳证据、系统评价、专家共识,检索文献时间范围为 2012 年 2 月—2022 年 2 月.由 2 名研究人员独立进行文献的质量评价,并结合主题和专业判断对证据进行提取和总结.结果 根据文献纳入标准,共纳入 11 篇文献,其中有 1 篇指南、1 篇系统评价、7 篇证据总结和 2 篇专家共识,总结出 20 条最佳证据,包括IAD的评估和预防、失禁护理、IAD的皮肤护理方法和IAD护理人员培训与管理 4 个方面.结论 该研究总结的最佳证据为医护人员提供证据,建议医护人员应用证据时,充分考虑患者实际情况,结合个体化差异制订干预方案,促进循证实践.

AIM:To explore the experiences of healthcare workers (HCWs) following occupational exposure to coronavirus disease 2019 (COVID-19) during the early stage of the pandemic. DESIGN:A Husserl descriptive phenomenological study design was employed. METHODS:Convenient and snowball sampling was used. In-depth semi-structured telephone interviews were conducted from February to March 2020 with the frontline HCWs who were exposed to COVID-19 during work. Data analysis was conducted following the 7-step analysis method developed by Colaizzi. RESULTS:Fifteen HCWs participated in the study. Four themes were identified, including (1) traumatic experiences since the occupational exposure; (2) getting through the hard time; (3) struggling to return to work; (4) reflections on occupational exposures. CONCLUSION:The HCWs had traumatic and painful experiences after the occupational exposure. But they returned to work with strong resilience, professional obligation and social support. Training and supervision, and adequate supply of personal protective equipment are suggested to prevent professional exposure. Social and organizational support should be provided for the exposed HCWs.

With the vigorous development of emerging technologies such as artificial intelligence, 5G, and mobile Internet, wearable devices provide ideas for active health management of cardiovascular diseases. This paper introduces the application status of wearable devices in active health management of patients with cardiovascular diseases, including diet, weight, exercise, medication, behavior, psychology and risk warning management, and puts forward the main challenges and development directions that wearable devices need to overcome, in order to make better use of wearable devices to improve the health literacy of patients with cardiovascular diseases and promote the formation of active health management system for patients with cardiovascular diseases.

目的 通过应用前期研究制定的体外循环心脏手术中体温管理证据,以规范术中体温管理操作行为保障患者安全.方法 采用JBI循证实践证据应用程序,按照基线审查、临床实践变革、证据应用后质量审查3个阶段实施循证实践.根据前期研究获得的证据制订临床审查指标进行基线审查,分析障碍因素,制订行动策略将证据在临床应用,然后实施证据应用后审查.结果 证据应用前后,术中鼻咽温、氧合器动脉出口温度、氧合器静脉入口温度比较,差异无统计学意义(P>0.05),术中膀胱温比较差异有统计学意义(P<0.05);不同时间点的鼻咽温、氧合器动脉出口温度、氧合器静脉入口温度比较,差异有统计学意义(P<0.05),膀胱温比较差异无统计学意义(P>0.05);不同时间点的鼻咽温、膀胱温、氧合器动脉出口温度、氧合器静脉入口温度与证据应用前后交互无统计学意义(P>0.05).证据应用后低体温、寒颤、躁动发生率分别为16.7％、6.7％、13.3％,对比基线审查时分别为36.7％、26.7％、40.0％,差异具有统计学意义(P<0.05).培训前后心脏专科小组护士及体外循环师相关知识考核成绩分别为(76.25±9.62)分,(91.25±6.35)分,差异具有统计学意义(P<0.001).基线审查时手术室护士对审查指标1、2、3的执行率分别为63％、27％、100％,其余审查指标执行率均在20％以下,证据应用后,审查指标2、4-15的执行率均有明显提高,差异具有统计学意义(P<0.05).结论 基于证据的体温管理策略在体外循环心脏手术中应用,可规范临床操作行为,提高护士术中体温管理的科学性与执行依从性,有效保护术中心肌、大脑细胞及神经组织,降低相关并发症,确保体外循环手术患者术中安全.