Objective:To understand the symptom perception and coping experience of postoperative delirium in patients with Stanford type A aortic dissection (TAAD) .Methods:Using the purposive sampling method, a total of 13 patients with delirium after Stanford type A aortic dissection who were admitted to Department of Cardiovascular Surgery of Henan Provincial Chest Hospital from July 2020 to July 2021 were selected as the research objects. Semi-structured interviews were conducted with patients using the phenomenological research method and the interview data were analyzed using the Colaizzi 7-step analysis method.Results:Postoperative delirium in patients with TAAD was classified into four sub-themes, such as confusion, physical and mental discomfort, cognitive disturbance and death perception. The coping experience was classified into three sub-themes, such as communication barriers, lack of encouragement and support and need for safe companionship.Conclusions:Patient with delirium after TAAD have many uncomfortable symptoms and long for support and help.

Objective:To evaluate the rehabilitation efficacy of early mobilization based on collaboration care model for patients with laparoscopic colorectal surgery.Methods:Cluster sampling method was used in the department to recruit colorectal cancer patients with laparoscopic surgery. The control group (49 cases) received routine perioperative care and exercise, and the intervention group (47 cases) received the coordinated early mobilization combined with routine perioperative care and exercise, from January to March 2019. Primary outcome were health status and the proportion of patients returning to preoperative functional walking capacity (6-min walk test) at 4 weeks after surgery. The in-hospital mobilization (time out-of-bed), time to achieve discharge criteria, time to recover gastrointestinal function and complication rate were explored.Results:In intervention group,89.4%(42/47) of patients achieved mobilization target on 4 days after surgery compared with 42.6%(20/47) on the day of surgery. Time out of bed were greater in the intervention group compared with the control group, and there were differences between the two groups( Z values were -8.437--7.381, P<0.01). Time to recover gastrointestinal function and the recovery of energy on 3 days after surgery were (58.74±17.41) h, (59.02±9.46) points in the observation group, and (71.82±21.53) h, (62.61±7.68) points in the control group, and there were significant differences between the two groups ( t values were -3.263, -2.046, P<0.05). But other outcome measures were not different between the two groups ( P>0.05). Conclusions:For colorectal laparoscopic surgery patients, the coordinated early mobilization improved the adherence to ambulation, in-hospital mobilization, time to recover gastrointestinal function and recovery of energy to promote rehabilitation.

目的 制订腹腔镜结直肠癌手术患者出院准备服务干预方案并探讨其临床应用效果.方法 在文献回顾及现状调查的基础上,结合个人与家庭自我管理理论和过渡期理论构建干预方案.采用整群抽样选取腹腔镜结直肠癌手术患者,按科室分对照组56例与研究组60例.对照组接受普外科围手术期护理及常规出院指导,研究组在此基础上,采用自行制订的出院准备服务干预方案进行干预.结果 两组出院前出院准备度得分、出院指导质量得分、术后4周并发症级别及非计划性再入院率比较,差异有统计学意义(P＜0.05,P＜0.01).结论 腹腔镜结直肠癌手术患者出院准备服务方案的制订和实施可改善护士出院指导质量,提高患者出院准备度水平,降低术后并发症发生率及非计划性再入院率.

目的 探讨加强临床表现和医疗安全的团队策略与工具(TeamSTEPPS)在腹腔镜结直肠癌手术患者出院准备沟通中的应用效果.方法 选取2019年3～6月48例腹腔镜结直肠癌手术患者为对照组,给予常规出院准备服务;选取2019年7～10月49例患者为研究组,实施基于加强临床表现和医疗安全的团队策略与工具改进的出院准备服务.结果 改进后两组床边交班感知得分及医护合作得分比较,差异有统计学意义(P＜0.05,P＜0.01).结论 基于加强临床表现和医疗安全的团队策略与工具改进的出院准备服务,可改善出院准备服务团队的沟通效率,提高腹腔镜结直肠癌手术患者的满意度.

对国内外关于癌症患者心理困扰相关的普适性、特异性测评工具进行综述,包括测评工具的条目、信效度及适用人群等方面,以期为临床应用提供参考,并为今后编制癌症患者心理困扰特异性测量工具提供依据.

多阶段优化策略(multiphase optimization strategy,MOST)是由Collins等[1]在工程学原理的基础上提出的方法学理论框架,旨在实现多因素行为干预方案优化及方案评估的双重目标,可应用于健康行为干预发展的多个方面,包括构建新的干预方案、修正现有干预项目及明确干预项目实施机制等.MOST自提出以来,在国外得到了很好的推广,被广泛应用于公共卫生实践及与健康相关政策等领域[2];而我国有关MOST指导构建多因素干预的研究尚未见报道.本文通过对MOST在戒烟、饮食管理、运动促进、心理调节、规范用药等多种健康行为干预领域的国外应用情况进行介绍,以期为采用MOST构建我国护理相关多因素行为干预方案提供借鉴.

出院准备服务（discharge preparation services）,又称出院计划（discharge planning,DP）,其是由美国教育发展中心为急症老年患者高级护理的继续教育项目设计、发展而来,是明确患者从一个医疗机构顺利转介到另一环境中需求的过程 [1] 。研究显示 [2-3] ,出院准备服务的科学制订及成功实施有助

综述了时间观疗法的概念、内容、评估工具、实施策略及对精神障碍患者的心理康复作用.通过阐述近年来时间观疗法在精神障碍患者中的应用研究现况,分析该疗法对精神障碍患者心理康复的应用价值,为制订国内精神障碍患者的干预方案提供依据.