To investigate the status of health behavior and its influencing factors in stroke among young adults. Previous research on young stroke patients has focused mainly on clinical risk factors, with limited attention paid to health behavior. Factors associated with health behavior in younger adults is unclear. A cross-sectional survey of 220 Chinese younger adults was conducted. A structural equation model(SEM) identified factors associated with health behavior and their effect magnitude. The young adult participants had a mean age of 39.62 ± 4.85 years(18 to 44 years), with male accounting for the majority (74.5

Background Multidisciplinary stroke teams, especially those including a dedicated stroke nurse, play a crucial role in optimizing the management and timely administration of intravenous thrombolysis. Studies have explored in-hospital, nurse-driven service models where nurses assume full responsibility or provide continuous accompaniment throughout the care process, which can reduce the time to intravenous thrombolysis for patients with acute ischemic stroke(AIS). Objective This review systematically evaluates the efficacy of the in-hospital, nurse-driven service model in shortening the time to intravenous thrombolysis. It also aims to define the roles and responsibilities of nurses within the stroke emergency green channel process. Methods A search of six electronic databases was conducted to identify eligible trials published up to september 30, 2025. Quasi-experimental studies comparing nurse-driven models for reducing intravenous thrombolysis time in AIS patients were included. The primary outcome was door-to-needle time(DNT). Secondary outcomes included Door-to-physician time, Door-to-imaging time, Registration to Check Time, and image completion-to-needle time. Data extraction and quality assessment were performed. Results are presented as risk ratios or mean differences, analyzed using fixed- or random-effects models as appropriate. Heterogeneity was assessed using the I² statistic. Results A total of 27 trials and 5725 participants were included. The meta-analysis results indicate that nurse-driven service models significantly reduces the following time intervals: Door-to-needle time [MD=-16.72, 95%CI(-21.42, -12.02), P<0.001]; onset to treatment time [MD=-9.80, 95%CI(-15.04, -4.56), P=0.37]; Door-to-physician time[MD=-1.68, 95%CI(-2.36, -1.00), P<0.001]; Door-to-imaging time[MD=-8.96, 95%CI(-13.15, -4.77), P<0.001]; Registration to Check Time[MD=-1.76, 95%CI(-3.23, -0.30), P<0.001]; and image completion-to-needle time[MD=-13.73, 95%CI(-21.12, -6.34), P<0.001]. Conclusion Adopting the nurse-driven intravenous thrombolysis care model can significantly reduce the total time from hospital arrival to thrombolysis for AIS patients. Nurses' involvement in every stage of stroke treatment can effectively address the lack of unified coordination and seamles, when personnel from different disciplines are only responsible for one or a few specific tasks. Additionally, nurses' participation helps resolve treatment delays caused by patients' cumbersome medical procedures.

BACKGROUND:What kind of feeding should be provided during therapeutic hypothermia (TH) in patients with large hemispheric infarction (LHI) is not clear. Therefore, we conducted a retrospective observational study to determine whether providing early postpyloric feeding (PPF) (<24 h after admission) is beneficial or harmful for patients with this condition.METHODS:This study retrospectively screened 78 patients with LHI who were treated with TH from one neurological intensive care unit (ICU). The patients were receiving either early PPF (n = 52) or early parenteral nutrition (PN) (n = 26). Data regarding 30-day mortality, neurological outcome, nutrition-related laboratory indicators, ICU hospitalization time, mechanical ventilation (MV) duration, and complications were collected.RESULTS:A greater number of patients who received early PPF had favorable neurologic outcome than those who received early PN (57.7% vs 30.7%, P = 0.025). The early PPF group had a lower severity of pulmonary infection than the early PN group, as measured by the Clinical Pulmonary Infection Score (7.33 ± 0.96 vs 9.42 ± 2.11, P = 0.006). The total protein and hemoglobin levels in the early PPF group were higher than those in the early PN group (59.56 ± 5.09 vs 56.52 ± 7.94 g/L, P = 0.046; 131.06 ± 19.58 vs 122.07 ± 17.72 g/L, P = 0.045). The MV duration and ICU hospitalization time were shorter in the early PPF group (13 [9;21] vs 21 [14;30] days, P = 0.006; 28 [22;36] vs 34 [33;51] days, P = 0.014). There were no significant differences in the incidence of catheter-related bloodstream infections, 30-day mortality, or nutrition intolerance between the two groups.CONCLUSION:Early PPF is an effective and safe enteral nutrition method for patients with LHI receiving TH.

The use of machine learning (ML) in predicting disease prognosis has increased, and researchers have adopted different methods for variable selection to optimize early screening for AIS to determine its prognosis as soon as possible. We aimed to improve the understanding of the predictors of poor functional outcome at three months after discharge in AIS patients treated with intravenous thrombolysis and to construct a highly effective prognostic model to improve prediction accuracy. And four ML methods (random forest, support vector machine, naive Bayesian, and logistic regression) were used to screen and recombine the features for construction of an ML prognostic model. A total of 352 patients that had experienced AIS and had been treated with intravenous thrombolysis were recruited. The variables included in the model were NIHSS on admission, age, white blood cell count, percentage of neutrophils and triglyceride after thrombolysis, tirofiban, early neurological deterioration, early neurological improvement, and BP at each time point or period. The model's area under the curve for predicting 30‐day modified Rankin scale was 0.790 with random forest, 0.542 with support vector machine, 0.411 with naive Bayesian, and 0.661 with logistic regression. The random forest model was shown to accurately evaluate the prognosis of AIS patients treated with intravenous thrombolysis, and therefore they may be helpful for accurate and personalized secondary prevention. The model offers improved prediction accuracy that may reduce rates of misdiagnosis and missed diagnosis in patients with AIS.

Fatigue is a common symptom in patients with multiple sclerosis,characterized by subjective exhausted and insufficient physical and/or mental energy.It is an important cause of disability and unemployment,seriously affecting the quality of life of patients with multiple sclerosis.Psychological disorders are one of the important reasons for the persistence and deterioration of fatigue in patients with multiple sclerosis.Previous studies have explored psychological interventions for multiple sclerosis fatigue,such as cognitive-behavioral therapy,mindfulness therapy,relaxation therapy,self-management projects,and guiding imagination,which have shown certain effects in improving fatigue in multiple sclerosis patients.This paper reviews the psychological intervention methods and effects on fatigue in multiple sclerosis patients both domestically and internationally,aiming to provide theoretical basis for future research on psychological intervention for fatigue in patients with multiple sclerosis.

目的:设计高龄模拟体验教学的老年护理课程共情教育,并探讨其实施效果.方法:采用类实验研究设计,选取某高校护理学院2015级40名学生、2016级31名学生为对照组,2017级36名学生为干预组,对照组在"老年人认知与感知的护理"章节采用2个学时传统理论授课的教学方法及2个学时老年病房的临床见习活动,干预组将原"老年人认知与感知的护理"2个学时理论授课及2个学时临床见习调整为4个学时的高龄模拟体验教学,比较3个年级学生干预前后老年态度(KAOP)评分、杰弗逊共情量表(JSE-HPS)得分,并分析学生的反思日记.结果:干预后,对照组2015级、2016学生KAOP得分分别为(147.13±17.00)分、(137.61±18.01)分,干预组2017级学生KAOP得分为(160.75±18.17)分,3个年级比较差异有统计学意义(P<0.05);2015级与2016级学生干预后JSE-HPS得分分别为(102.85±9.31)分、(102.90±7.54)分,2017级学生干预后JSE-HPS得分为(115.36±11.05)分,3个年级比较差异有统计学意义(P<0.05).学生反思日记提取的主题为:高龄模拟体验教学使学生对老年护理兴趣增加;切身体会老化感受,加深对老年人的共情;敬老、爱老理念和老年护理意愿增强.结论:基于高龄模拟体验教学的老年护理课程共情教育的设计与实施能影响护生对老年人的态度,对学生的共情能力产生积极的影响.

Objective:Based on the core competence of stroke certified registered nurses, this study construct the theoretical raining curriculum system for stroke certified registered nurses and made a preliminary evaluation.Methods:Using Delphi expert consultation method and based on literature research, the first draft of training course for stroke certified registered nurses was formed. In the form of Email, 14 experts in the field of stroke care who met the selection criteria were sent a questionnaire, and two rounds of consultation were conducted. The theoretical raining curriculum system for the training of stroke specialist nurses was constructed; the purpose sampling method was used to evaluate the application effect of the stroke specialist nursing theoretical training curriculum system through the theoretical performance and satisfaction evaluation of 127 trainees who participated in the first phase of the stroke specialist nursing theoretical training curriculum.Results:The recovery rate and effective rate of the two rounds of expert consultation questionnaire were 14/14, the authority coefficient of the second round of expert consultation was 0.94, and the expert Kandall coordination coefficients of the first, second and third-level indexes were 0.356, 0.216, 0.207 respectively ( P<0.05). The training curriculum of stroke specialist nurses finally formed included 5 primary indicators (Professional practice concept, general nursing knowledge, stroke diagnosis and treatment, acute stroke nursing management, secondary prevention of cerebrovascular disease), 21 secondary indicators and 63 tertiary indicators. The Analytic hierarchy process was used to determine the weight coefficients of all levels of indicators, and the consistency Ratio <0.1. Based on the curriculum system as the content framework, theoretical courses were set up to train stroke specialist nurses. 109 trainees completed the post-training assessment. Before training, the qualified rate of theoretical performance of stroke certified registered nurses was 77.95% (99/127), and after training, the qualified rate of theoretical performance of stroke certified registered nurses was 100% (109/109). The difference was statistically significant ( χ 2=27.60, P<0.01). The excellent rate of theoretical performance of stroke certified registered nurses before training was 35.43% (45/127), and 100% (109/109) after training, the difference was statistically significant ( χ 2=24.17, P<0.01).The average score of the trainees′ satisfaction was (38.90±2.55) points. Conclusions:The theoretical raining curriculum system for stroke certified registered nurses setting constructed in this study standardizes the training system of stroke nurses to a certain extent, and provides a basis for the construction of homogeneous training courses in China in the future.

目的 评价卒中吞咽障碍患者以国际吞咽困难饮食标准倡议(the International Dysphagia Diet Standardisation Initiative,IDDSI)量化稠度后的匀浆膳经口进食干预后改善营养状况的效果.方法 选取2019年1月至2020年8月首都医科大学宣武医院收治的198例急性缺血性卒中患者,以病区为单位抽签确定干预方法,分为试验组和对照组,每组99例.试验组采用IDDSI制定的液体稠度测量方法量化匀浆膳稠度后进行摄食训练;对照组采用布丁状、蛋羹状和糖浆状3类所对应的具体食谱进行经口进食干预.观察两组营养状况变化和摄食训练的安全性.结果 试验组与对照组的误吸[1例(1.0％)比9例(9.1％)]、腹泻[1例(1.0％)比8例(8.1％)]、出院洼田饮水试验[85例(85.9％)比69例(69.7％)]、出院ALB[39.4(36.2,45.3)g/L比38.3(35.4,40.5)g/L]和住院时间[8.5(7.0,11.5)d比9.0(7.0,14.0)d]比较,差异均有统计学意义(P＜0.05);两组吸入性肺炎、消化道出血、出院BMI比较,差异均无统计学意义(P＞0.05).结论 以IDDSI量化匀浆膳稠度后进行摄食训练,可以有效改善卒中吞咽障碍患者进食的安全性和营养情况.

目的 分析急性缺血性脑卒中静脉溶栓患者发生早期神经功能改善的影响因素.方法 采用连续入组方便取样的方法纳入2018年11月1日—2019年9月30日在北京市某三甲医院神经内科住院的所有满足纳入和排除标准的患者共353例,根据静脉溶栓后是否出现早期神经功能改善分为改善组和未改善组.分别对两组患者的基线临床特征、溶栓前后病情状况、溶栓后实验室指标、溶栓后血压等相关指标进行组间比较.将单因素分析中P<0.1的参数作为自变量,使用多因素Logistic回归分析进一步探究早期神经功能改善发生的独立影响因素.结果 使用替罗非班(OR=0.305,95％CI=0.131～0.709,P=0.006)、静脉使用降压药物(OR=0.395,95％CI=0.175～0.894,P=0.026)、小脑梗死(OR=3.460,95％CI=1.314～9.106,P=0.012)、夜间收缩压最大值(OR=0.984,95％CI=0.969～0.998,P=0.026)是早期神经功能改善的独立影响因素.结论 在使用溶栓药物后脑卒中症状不缓解或加重、梗死的部位以及夜间血压异常会影响早期神经功能改善的发生.

高致残率和高死亡率是急性卒中发作的主要特点,卒中后的超早期活动也一直被认为是高级卒中中心治疗和护理的一个重要组成部分.现就指南中关于卒中后超早期活动的推荐意见、相关干预研究的安全性和有效性、实施现状以及静脉溶栓治疗患者超早期活动的现状进行综述,旨在为急性缺血性脑卒中患者进行超早期活动提供证据支持.

目的 对9条目简版老年患者护理态度量表(perspectives on caring for older patients scale,PCOP)进行汉化及修订,并对其信效度进行初步评定.方法 采用Brislin双人翻译-回译法,经5名专家咨询,对简版PCOP进行翻译、回译和修订.将形成的中文简版PCOP用于206名护理学生及197名临床护士进行调查,对量表的信度和结构效度进行检验.结果 中文简版PCOP包括老年护理的积极态度(4个条目)和消极态度(5个条目)2个维度,在护理学生及护士群体中验证的内部一致性信度Cronbach'sα系数分别为0.838和0.849,重测信度分别为0.945和0.938.探索性因子分析提取的两个因子与源量表结构一致,护理学生及护士总体累计贡献率分别为69.576％和66.989％,具有良好的结构效度.9个条目的专家评分均≥3分,全体一致量表水平的内容效度指数(universal agreement S-CVI,S-CVI/UA)为1.000,量表的内容效度好.结论 中文简版PCOP具有良好的信效度,可用于衡量我国护士及护理学生对老年护理的态度,量表的进一步发展和应用可为改进老年护理服务及教学提供依据.

从脑卒中后认知障碍主观及客观评估工具的来源、应用进展、优势及局限性等方面进行综述,以期为脑卒中后认知障碍评估提供依据.

Stroke-related sleep disorder is a common clinical manifestation after stroke, which has a greater impact on the prognosis and recovery of patients, but it is often overlooked in actual clinical work. Therefore, it is necessary to quantitatively evaluate the severity of stroke-related sleep disorders through relevant assessment scales in order to facilitate clinical intervention and improve patient prognosis. This article reviews the subjective and objective assessment tools of stroke-related sleep disorders, so as to provide certain theoretical support and a reference basis for the diagnosis, intervention and effect evaluation of stroke-related sleep disorders.

Blood pressure (BP) monitored within 24 h from the beginning of intravenous thrombolysis (IVT) with alteplase, is one of the important factors affecting the prognosis of patients with acute ischemic stroke (AIS). This study aimed to explore longitudinal BP trajectory patterns and determine their association with stroke prognosis after thrombolysis. From November 2018 to September 2019, a total of 391 patients were enrolled consecutively during the study period, and 353 patients were ultimately analyzed. Five systolic (SBP) and four diastolic blood pressure (DBP) trajectory subgroups were identified. The regression analysis showed that when compared with the rapidly moderate stable group, the continuous fluctuation-very high level SBP group (odds ratio [OR]: 2.743, 95% confidence interval [CI]: 1.008-7.467) was associated with early neurological deterioration (END). Both the rapid drop-high level SBP (OR: 0.448, 95% CI: 0.219-0.919) and DBP groups (OR: 0.399, 95% CI: 0.219-0.727) were associated with early neurological improvement (ENI). Moreover, there was a U-shaped correlation between the OR value of SBP trajectory group and favorable outcome (the modified Rankin Scale [mRS] score 0-2) at 3 months: the slow drop-low level SBP group represent a well-established unfavorable outcome risk factor (OR:5.239, 95% CI: 1.271-21.595), and extremely high SBP-the continuous fluctuation-very high level SBP group, are equally associated with elevated unfavorable outcome risk (OR:3.797, 95% CI: 1.486-9.697). The continuous fluctuation-very high level DBP group was statistically significant in mRS (OR: 3.387, CI: 1.185-9.683). The BP trajectory groups show varying clinical features and risk of neurological dysfunction. The findings may help identify potential candidates for clinical BP monitoring, control, and specialized care.

[目的]构建精准的护理绩效独立考核指标体系.[方法]采用德尔菲专家咨询法,通过两轮共18名专家咨询建立精准化的护理绩效独立考核指标.[结果]两轮专家函询表的回收率均为100％,第二轮专家咨询的权威系数为0.899,一级和二级指标专家意见的协调系数分别为0.54、0.36 (P ＜0.001).最终确立护理绩效的考核指标体系:一级指标4项,二级指标23项;一级、二级指标的变异系数(CV)范围在0.106～0250.[结论]该研究构建的护理绩效考核体系具有较高的科学性和可靠性,从内容上体现了"精准"的考核,为推进护理人员薪酬制度的公平合理以及护理岗位的管理提供了依据.

目的 探讨急性缺血性脑卒中患者静脉溶栓后24 h血压与早期神经功能恶化的相关性.方法 采用连续入组方便取样的方法纳入2018年11月1日至2019年9月30日在首都医科大学宣武医院住院的353例急性缺血性脑卒中患者.采用Logistic回归分析控制混杂因素后对入院、溶栓完成即刻、24 h、日间、夜间血压与早期神经功能恶化的关系进行分析.结果 调整混杂因素后,入院收缩压(OR=5.018,95％CI:1.183～21.282,P=0.029)、入院舒张压(OR=4.691,95％CI:1.106～19.886,P=0.036)、溶栓完成即刻收缩压(OR=4.851,95％CI:1.137～20.695,P=0.033)、溶栓完成即刻舒张压(OR=4.918,95％CI:1.158～20.885,P=0.031)、24 h平均收缩压(OR=1.021,95％CI:1.002～1.040,P=0.033)为早期神经功能恶化发生的独立影响因素.结论 急性缺血性脑卒中患者静脉溶栓期间的血压与神经功能恶化的发生独立相关.

Objectives: To investigate the treatment compliance of patients with ischemic stroke to remote ischemic conditioning (RIC) and to determine the factors that influence compliance. Methods: We conducted a retrospective study of patients with ischemic stroke who were treated with RIC. Treatment compliance was determined and analyzed in patients who had received 1 year of RIC training. Factors that influenced patient compliance were also determined using univariate and multivariate regression analyses. Results: Between March 2017 and February 2018, 91 patients were recruited into this study. The mean (±SD) age was 57.98 ± 10.76 years, and 78 (85.7%) patients were male. The baseline Kolcaba comfort scale of patients with good compliance scores were higher than those with poor compliance. The scores of the four dimensions in the scale and the total score are as follows: physiological dimensions, 15.0 (12.0,17.0) vs 17.0 (13.0,19.0); psychological dimensions, 30.0 (25.0,34.0) vs 31.0 (27.0,35.0); sociological dimensions, 20.0 (18.0,24.0) vs 21.0 (18.0,23.0); environmental dimensions, 19.0 (12.0,24.0) vs 20.0 (17.0,22.0); and total points, 82.0 (69.0,94.0) vs 91.0 (78.0,98.0). the differences between the groups were significant (p < 0.05), except for the sociological dimensions. A history of hypertension, number of follow-ups, and the physiological, psychological, and environmental dimensions of the comfort scale were related to patient compliance, out of which the number of follow-ups (Adjusted OR = 2.498, 95% confidence interval (CI) 1.257–4.964) and the physiological discomfort (Adjusted OR = 1.128, 95% CI 1.029–1.236) independently influenced compliance (p < 0.05). Conclusion: In patients with ischemic cerebrovascular disease who were treated with RIC, the number of follow-up visits and physiological discomfort associated with RIC treatment independently influenced patient compliance. Further studies are needed to investigate the RIC protocols and their corresponding nursing models.

目的 构建首次发生急性缺血性脑卒中的患者发生深静脉血栓的预测模型,并探究模型的预测效果.方法 2019年9月-2020年2月,选取某三级甲等医院神经内科收治的急性缺血性脑卒中患者,收集患者的一般资料、疾患相关信息及相关实验室指标等,通过二分类Logistic回归模型分析相关数据,应用ROC曲线下面积检验模型的预测效果,并选取35例患者进行模型预测效果的验证.结果 纳入的239例首次发病的急性缺血性脑卒中患者中,36例发生深静脉血栓.多因素分析的结果显示,入院NIHSS评分(OR=1.130;95％CI=1.057～1.209)、总卧床时间(OR=1.020;95％CI=1.001～1.039)、血浆D二聚体(OR=1.054;95％CI=1.019～1.090)、甘油三酯(OR=1.497;95％CI=1.033～2.169)及高密度脂蛋白(OR=0.500;95％CI=0.264,0.948)是深静脉血栓发生的独立影响因素,并依此构建了首次发作的急性缺血性脑卒中患者深静脉血栓的风险预测模型,为a=-3.296±0.122×入院NIHSS+0.02×总卧床时间+0.052×血浆D二聚体+0.693×甘油三酯-0.403×高密度脂蛋白.本模型的ROC曲线下面积为0.876,灵敏度为0.889,特异度为0.793.将35例急性缺血性脑卒中患者代入模型进行风险预测,ROC曲线下面积为0.798(95％CI=0.687～0.901;P<0.001).结论 DVT是急性缺血性脑卒中患者院内常见的严重并发症之一,本研究构建的首发急性缺血性脑卒中的患者发生深静脉血栓的预测模型预测效果良好,是针对脑卒中人群深静脉血栓预警的特异性模型,可为临床医护人员及时对高危患者采取预防性治疗和护理提供参考.