目的 对乳腺癌首次手术患者需求的研究现状及需求内容进行总结.方法 计算机检索PubMed、Cochrane Library、Web of Science、Embase、中国知网、万方数据库、维普网、中国生物医学文献数据库中有关乳腺癌首次手术患者需求的文献,检索时限均为2013年1月1日-2022年12月31日.结果 共纳入17篇文献,研究设计以质性研究和观察性研究为主.乳腺癌首次手术患者的需求程度高,需求内容呈现多样性,主要包括信息需求、健康指导需求、情感需求和社会支持需求;不同年龄段、不同治疗阶段的乳腺癌手术患者的需求不同.结论 建议制订个性化需求干预计划,满足乳腺癌患者的多样化需求.

BackgroundThe inconsistencies between randomized clinical trials (RCTs) registrations and peer-reviewed publications may distort trial results and threaten the validity of evidence-based medicine. Previous studies have found many inconsistencies between RCTs registrations and peer-reviewed publications, and outcome reporting bias is prevalent. AimsThe aims of this review were to assess whether the primary outcomes and other data reported in publications and registered records in RCTs of nursing journals were consistent and whether discrepancies in the reporting of primary outcomes favored statistically significant results. Moreover, we reviewed the proportion of RCTs for prospective registration. MethodsWe systematically searched PubMed for RCTs published in the top 10 nursing journals between March 5, 2020, and March 5, 2022. Registration numbers were extracted from the publications, and registered records were identified from the registration platforms. The publications and registered records were compared to identify consistency. Inconsistencies were subdivided into discrepancies and omissions. ResultsA total of 70 RCTs published in seven journals were included. The inconsistencies involved sample size estimation (71.4%), random sequence generation (75.7%), allocation concealment (97.1%), blinding (82.9%), primary outcomes (60.0%) and secondary outcomes (84.3%). Among the inconsistencies in the primary outcomes, 21.4% were due to discrepancies and 38.6% resulted from omissions. Fifty-three percent (8/15) presented discrepancies in the primary outcomes that favored statistically significant results. Additionally, although only 40.0% of the studies were prospective registrations, the number of prospectively registered trials has trended upward over time. Linking Evidence to ActionWhile not including all RCTs in the nursing field, our sample reflected a general trend: inconsistencies between publications and trial registrations were prevalent in the included nursing journals. Our research helps to provide a way to improve the transparency of research reports. Ensuring that clinical practice has access to transparent and reliable research results are essential to achieve the best possible evidence-based medicine.

Objective:To systematic review the efficacy and safety of external application of traditional Chinese medicine on treatment of breast cancer related lymphedema.Methods:CNKI, Wanfang Data, VIP, Sino-Med, The Cochrane Library, PubMed, Web of Science were searched for related randomized controlled trials, the retrieval time was from inception to May 25, 2020. Two researchers independently screened and evaluated the included studies. Meta-analysis was performed by RevMan 5.4 software.Results:A total of 16 studies involving 1 315 patients with breast cancer related lymphedema were included, and the methodological quality of the included studies was not high. Compared with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment had advantages in improving the total efficiency( P<0.01) and quality of life( P<0.01), reducing pain( P<0.01) and improving upper limb function( P<0.01), without obvious adverse reactions( P>0.05), but there was no improvement in depression( P>0.05). Compared with conventional treatment, external application of traditional Chinese medicine could improve the total efficiency( P<0.01). Compared with placebo sticker combined with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment can reduce circumference( P<0.05) and reduce pain( P<0.01), without obvious adverse reactions( P>0.05). Conclusions:Available evidence suggests that external application of traditional Chinese medicine may be a potential treatment method for breast cancer related lymphedema. Due to the poor methodological quality of the included studies, high-quality randomized controlled trials are still needed.

本文对6个国内外早产儿疼痛特异性评估量表进行综述,并对疼痛评估量表的应用情况、量表比较分析和应用启示进行论述.旨在为早产儿疼痛管理提供参考,并为早产儿疼痛特异性量表的本土化发展提供借鉴.

目的 了解中医药院校护理专业学生对护理学基础实验项目课后开放的满意度和需求情况.方法 采用整群抽样的方法,对完成护理学基础课程相关实验室开放的2018级全体护理本科生进行问卷调查.结果 98.2％的学生认为实验室开放对护理专业的学生来说很必要,而且学生课后开放练习的意愿较强;96.9％的学生对实验室课后开放满意;50％以上的学生认为实验开放提高了自己的实践操作能力、团队协作能力和自我学习自我管理能力;学生建议"抽吸药液""头皮静脉输液法""留置导尿术"3个实验项目开放时的小组人数分别设置为(3.87±1.25)人、(3.19±1.02)人、(3.07±0.98)人更合适;此外24人次希望进一步完善开放安排和管理制度,10人次提出希望开放更多时间和机会,10人次希望增加教师或助管的现场指导,学生还有其他方面的需求.结论 学生对护理学基础实验开放整体满意度较高,实验室开放得到了学生的认可.但需要进一步关注学生的需求,合理安排实验项目的开放时长和小组人数,完善开放管理制度,提高实验室开放管理水平,为学生提供更多练习机会、环境、条件,为培养高素质护理人才提供有力保障.

目的 对涉及胃癌术后化疗自我管理的相关指南进行质量评价和内容分析,为制订我国胃癌术后化疗患者自我管理方案提供参考.方法 检索国内外临床实践指南网站、胃癌专业协会网站及部分中英文数据库,搜集胃癌术后化疗患者自我管理相关指南,检索期限为2015年7月至2020年6月.采用AGREE Ⅱ评价指南质量,并对各指南推荐意见进行汇总分析.结果 共纳入8部指南,总体质量评价为A级2部,B级3部,C级3部.胃癌术后化疗患者自我管理相关推荐意见涉及解决自身健康问题、如何进行决策、获取资源、建立医患合作关系、制订行动计划、自我监测6个方面35条.结论 纳入的指南部分质量较高,但指南开发的应用性、严谨性、参与人员等领域亟待加强.未来可借鉴国外质量较高指南进行本土化实践,并遵循国际标准尽快构建适应我国国情的胃癌术后化疗患者自我管理指南.

目的 对乳腺癌相关淋巴水肿评估与管理的相关指南进行质量评价和内容分析,为我国本土化乳腺癌相关淋巴水肿评估与管理指南的制定提供参考.方法 计算机检索国内外指南网站、相关专业协会网站及中英文数据库,搜集乳腺癌相关淋巴水肿评估与管理相关指南.采用AGREE Ⅱ评价纳入指南的质量,并对各指南推荐意见进行汇总分析.结果 最终纳入4部指南,2部A级,2部B级.推荐意见涉及评估、治疗与健康指导3个方面.结论 纳入的指南质量较高,纳入的指南涵盖了较为全面的乳腺癌相关淋巴水肿评估方法,对我国临床实践有一定的指导意义,但治疗方法不全,可进一步补充中医护理等方面内容,开发本土化乳腺癌相关淋巴水肿评估与管理指南.

目的 系统评价俯卧位对早产儿喂养的有效性和安全性.方法 计算机检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Cochrane图书馆、Embase数据库中有关不同体位对早产儿胃潴留影响的随机对照试验.检索时限从建库至2020年3月18日.由2名经过培训的研究员独立筛选文献、提取资料并评价文献质量,采用RevMan5.3软件、StataMP16软件进行Meta分析.结果 共纳入28项随机对照试验和3项随机交叉试验,包括3178例研究对象.与仰卧位相比,俯卧位能够降低早产儿胃潴留量、发生率[RR =0.34,95％CI(0.17,0.70),P=0.003];呕吐次数和发生率[RR=0.30,95％CI(0.19,0.46),P=0.000];腹胀次数、发生率[RR =0.28,95％CI(0.17,0.44),P=0.000];呼吸暂停次数和发生率[RR=0.36,95％CI(0.25,0.52),P=0.000].与侧卧位相比,俯卧位能够降低早产儿胃潴留量.结论 俯卧位可有效减少早产儿胃潴留、呕吐、腹胀及呼吸暂停的发生,但受纳入研究数量和质量的影响,上述结论尚需开展更多高质量研究予以进一步证实.

目的 通过检索国内外胃癌移动医疗应用程序的相关文献,了解该领域的研究现状和发展动态,并对可用性评价进行重点分析,以期为今后相关研究提供参考.方法 检索2010年1月至2020年4月发表的胃癌移动医疗应用程序相关的中、英文文献,检索的中文数据库包括中国知网、万方、重庆维普数据库和中国生物医学文献数据库,英文数据库包括Web of Science、PubMed、Embase、Medline、Science Direct、Springer Link及Cochrane Library等.结果 经过文献筛选,本研究共纳入15篇英文文献.胃癌移动医疗应用程序的功能以自我监测、疼痛管理、健康教育、营养咨询和监测以及加强体育锻炼为主.应用程序的可用性评价以量性评价为主,评价方法多采用问卷调查的方式进行,评价对象大多针对目标患者用户,评价持续时间差异较大,可用性评价要素以可用性、可行性、有效性和满意度为主.结论 胃癌移动医疗应用程序相关研究呈持续性增加趋势,仅适用于胃癌患者的移动医疗应用程序相对不足.应用程序设计时应在尽可能考虑胃癌患者全面需求的同时注重个性化服务,应用程序的可用性评价应贯穿应用程序研发的全过程,且如何规范实施移动医疗应用程序可用性评价应受到相关研究人员的重视.

This report introduced and summarized the nursing care experience for a senior patient with lung cancer and developed programmed cell death protein 1 (PD-1) immunotherapy-related myocarditis combined with coronary heart disease (CHD) after receiving said treatment. In this case, immune myocarditis with CHD occurred shortly after implementing the PD-1 immunotherapy, yet the patient presented no clinical symptoms. Frequent nursing attention and close observation are so required for monitoring the patient's status and updating the physicians for a swift control of the myocarditis. For this case, nursing care procedures vital for the successful recovery of the patient included condition observation, position management, pre- and postcoronary angiography care, infection prevention, hemorrhage prevention, venous access port maintenance, pain care, trachea care, psychological care, diet care, environment management, and health education. After receiving effective, successful treatment and care, the patient was discharged after 13 days of treatment with generally satisfying overall conditions.