Objective: To identify the role development process and role responsibilities of clinical nurse specialists in pulmonary hypertension. Methods: Drawing on the participatory, evidence-based, patient-focus process（PEPPA） framework,we used a scoping review methodology to identify the responsibilities of pulmonary hypertension specialist nurses in multidisciplinary collaboration. Results: Totally 16 articles were identified based on the eligibility criteria, including two practice guidelines, one expert consensus, one standard, one data audit, three cross-sectional studies, one qualitative study,and seven reviews. We explained the role development of pulmonary hypertension specialist nurses from five aspects:identifying the target population, identifying the stakeholders, determining the need for a new model of care, identifying priority problems, and defining the nurse practitioner’s role. Conclusion: Clinical nurse specialists play an important role in the multidisciplinary management of pulmonary hypertension. The advancement of pulmonary hypertension centers require the development of new nursing roles in a systematic way.

心脏康复是冠心病的一种重要治疗手段.功能评估是康复治疗的基础,冠心病心脏康复评估内容包括对心功能、运动功能、社会功能和生活质量等的评定.当对患者进行身体功能评估时,不应仅局限于心肺功能的评估,还应考虑患者的功能状态、活动水平等.此外,冠心病患者心脏康复身体结构的评定主要包括影像学检查和体格检查.评估生活质量的量表很多,其中西雅图心绞痛量表是目前最适合的评估冠心病心脏康复患者生活质量的量表.未来还需进一步研究并推广适用于冠心病心脏康复的评估工具.

目的:旨在基于Rasch模型分析冠心病心脏康复护理相关《国际功能、残疾和健康分类》(Inter-national Classification of Functioning,Disability and Health,ICF)类目的测量学特征.方法:通过便利抽样选取100例冠心病心脏康复患者,对其采用冠心病心脏康复护理相关ICF类目和简明生活质量量表(the MOS 36-Item Short-Form Health Survey,SF-36)进行调查,运用 Winsteps 3.66.0软件对每一类目进行测量学检验,统计指标包括单维性检验、类目拟合度、个人和项目分离信度.结果:共58个心脏康复护理评估类目,包括"身体功能"(23个类目)、"身体结构"(2个类目)、"活动与参与"(17个类目)、"环境因素"(16个类目)4个维度.总类目的Cronbach's α系数为0.879,各类目拟合度较高,各维度项目分离信度分别为0.95、0.96、0.91、0.94,与SF-36具有较高的同时效度.结论:冠心病心脏康复护理评估类目具有较好的心理测量学属性,可有效评价心脏康复患者的健康状况.

BackgroundChronic heart failure (CHF) is a common cardiovascular disease. Improving the self-management ability of CHF patients will contribute to quality of life improvement and reduction of rehospitalization and mortality rates. The Partners in Health (PIH) Scale is a measure designed by Flinders University, Australia, to assess the generic knowledge, attitudes, behaviors, and impacts of self-management in chronic disease patients, and is mainly used to assess the implementation effect of self-management projects in chronic disease patients.ObjectiveTo translate the PIH Scale into Chinese, then test the reliability and validity of the Chinese version in CHF patients, providing CHF patients with a tool for precisely assessing their self-management abilities.MethodsThe PIH was translated into Chinese with the guidance of the Brislin's translation model, then was revised according to the results of the review of a panel of experts, and a pre-test, and then the Chinese version of PIH (C-PIH) was developed. The demographic questionnaire, C-PIH, and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used in two surveys (one was conducted between April and June 2010, and another between April and June 2011) with 410 CHF patients selected from two grade A tertiary hospitals in Beijing using convenience sampling. Measurement of ceiling and floor effects, and item-total correlation were used for item analysis. Expert evaluation was used to evaluate the content validity analysis. Spearman's rank correlation coefficient was used to measure the criterion-related validity. KMO test, Bartlett's test of sphericity, exploratory factor analysis and confirmatory factor analysis were used for construct validity analysis. Monofactor analysis was used for validity analysis of known-groups. Reliability analysis was estimated by using the Cronbach's α.ResultsItem analysis indicated that only item 3 (level of adhering to medication) of the C-PIH showed ceiling effect. Item-total correlation coefficients of the scale ranged from 0.424 to 0.761 (P<0.001) . The scale-level content validity index of the scale was 0.966. Item-level content validity indices ranged from 0.800 to 1.000. C-PIH was positively correlated with MLHFQ in terms of total score (rs=0.200, P<0.05) . The KMO value was 0.872 and Bartlett's test of sphericity was χ2=1 139.142 (P<0.001) , indicating that the sample size was appropriate for factor analysis. By exploratory factor analysis, 3 factors with an eigenvalue greater than 1.000 were extracted, including knowledge (7 items) , coping (3 items) and adherence (2 items) , explaining 66.514% of the total variance. The loadings of items on each factor ranged from 0.571 to 0.869. The original model fit indices did not reach the critical value. After adding the suggested covariance correlation between errors-in-variables e1 and e2, e6 and e7, the fitting indices of the modified model were acceptable (χ2/df=2.393, RMSEA=0.0851, CFI=0.968, NFI=0.953, NNFI=0.963, GFI=0.905, AGFI=0.854, RFI=0.932, IFI=0.966) . Known-groups analysis demonstrated that the C-PIH total score varied significantly by level of education, economic income, NYHA class, and treatment (inpatient or outpatient) in CHF patients (P<0.001) . Good internal consistency was indicated with a scale Cronbach's α of 0.890, and three factors' (knowledge, coping and adherence) Cronbach's α of 0.894, 0.807, and 0.511.ConclusionThe C-PIH exhibited good reliability and validity, which may be used as a general self-management assessment tool in patients with CHF.

目的 探究国外营养素养研究现状及趋势,揭示相关主题的内涵、相关性及发展脉络.方法 选取Web of Science数据库(1998-2019年)收录的以"营养素养"为主题的475篇文献,应用CiteSpace 5.5对文献的国家分布、期刊或文献共被引和关键词进行计量学分析,了解该领域研究热点和发展趋势.结果 "营养""健康素养""教育"是节点最大的关键词;营养素养概念、营养素养与健康素养关系、营养素养量表研制、营养素养水平在营养摄入和饮食行为上的影响及如何有效提高人群营养素养的水平等是营养素养的研究热点.结论 营养素养教育干预的理论和实践体系还有待深入开展.

目的 探讨经外周静脉输注血管活性药物的风险因素及安全输注方案.方法 系统检索5个指南网站、7个中英文数据库,检索时限为建库至2021年3月7日,定性描述经外周静脉输注血管活性药物并发症的基本特征、风险因素及安全输注方案.结果 纳入14篇文献,其中指南2篇、系统评价4篇、原始研究8篇.经外周静脉输注血管活性药物的安全性受药物因素、患者因素、输注方案影响.1篇指南和8篇原始研究提供了经外周静脉血管活性药物安全输注方案,内容涉及输注速度、输注部位、输注技术、输注时长、监测频率、并发症处理等.结论 实施全程风险评估和安全输注方案,短期经外周静脉输注血管活性药物是安全可行的.