Self-disclosure is a simple and effective intervention to improve the health outcomes of patients. Foreign scholars have paid attention to it and applied it in the self-management of patients with chronic diseases widely. However, there are few domestic related studies in China. This article reviewed the definition, significance, assessment tools, and summarized the influencing factors and intervention studies of self-disclosure in patients with chronic diseases. It would provide references for research of self-disclosure, further improving the self-management and mental health of patients with chronic diseases.

目的 评价国内外炎症性肠病患者饮食管理软件,探究其基本功能设置及性能.方法 在Android、IOS应用商店中搜索截至2020年3月发布的与炎症性肠病患者饮食管理相关软件,下载并安装后对软件基本功能设置及性能进行评价.结果 共纳入18个炎症性肠病患者饮食管理相关软件,Android系统2个,IOS系统14个,IOS及Android兼容系统2个;版本1.X 7个,2.X 6个,3.X及以上4个,1个版本不详;纳入的均为英文软件.功能数2～15(6.8±3.9)个,软件功能主要涉及饮食记录(14/18)个,食谱参考(4/18)个,饮食咨询(3/18)个,饮食查询(5/18)个,饮食不良反应记录反馈(4/18)个,食物消化情况(2/18)个,个性化饮食管理设置(7/18)个,饮食教育(8/18)个.另有其他辅助功能如症状管理、情绪管理、药物管理、厕所定位、信息发送等.在纳入的软件中,50％有使用指导,33.3％提供了参考资料来源,44.4％有专业医护人员参与软件开发.结论 市面上正在运营的炎症性肠病患者饮食管理软件均来自国外且质量良莠不齐,多数软件功能不全面,如缺少炎症性肠病患者营养摄入需求的评估模块,缺乏对患者饮食不良反应的关注,饮食推荐不符合我国人群饮食习惯等软件对患者实验室检查结果 的关注度较低,难以判断饮食管理效果.另外,大部分软件的信息设计未循证相关指南,缺乏专业医疗人员参与,科学性较差,建议改良或开发适合我国国情的炎症性肠病患者饮食管理软件.

Objective:To explore the research hotspots and development trends of male nurses in China from 2009 to 2019 by bibliometric analysis, and provide references for related research.Methods:Relevant literature on male nurses in my country from 2009 to 2019 were retrieved through Wanfang Data, China National Knowledge Infrastructure (CNKI) , VIP, China Biology Medicine and other databases. The content of the included literature was analyzed, and word frequency analysis as well as two-way cluster analysis on keywords were performed by bicomb 2.0 software and gCLUTO 1.0 software.Results:A total of 931 journal articles were included, and 25 high-frequency keywords were obtained. Three research hotspots were obtained through cluster analysis, namely, male nurses' work advantages and management, male nurses' mental health, and male nursing students' nursing education.Conclusions:Male nurses are receiving increasing attention, and core journal forums have begun to take shape, but the overall research quality is not good. In the future, it is necessary to strengthen the scientificity and rigor of scientific research design and research implementation, so as to enhance the guiding value of literature for clinical practice.

This prospective parallel-group controlled trial explored the effects of a written expression-based positive psychological intervention on the psychological status of patients with inflammatory bowel disease. Primary outcomes were anxiety, depression, hope, optimism, and subjective well-being, assessed at 8 weeks. Secondary outcomes were coping mode, quality of life at 8 weeks, and patient feedback. Sixty-eight volunteer patients meeting inclusion criteria were recruited from a hospital in China and randomized into the intervention group (positive psychological intervention+care as usual = 33) and the control group (care as usual = 35). The intervention group showed significantly greater improvements in anxiety, depression, hope, and quality of life (p > .05). The intervention group scored the feasibility, simplicity, and applicability of the positive psychological intervention themes at more than 6.5 for all measures. The study concludes that written expression-based positive psychological interventions alleviate negative emotions in inflammatory bowel disease patients and enhance their positive psychological characteristics. This approach also promotes a positive coping mode in inflammatory bowel disease patients, and the intervention measures devised are convenient, feasible, and well-accepted by patients.

目的:评价持续声门下吸引与间断声门下吸引对呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)预防及对气管黏膜损伤的影响.方法:计算机检索PubMed、Cochrane library、Web of Science、Science Direct、EMBASE、中国知网、万方数据库、维普数据库中机械通气患者持续声门下吸引与间断声门下吸引比较的随机对照试验,检索时限均从建库至2019年3月31日.由2位评价员独立筛选文献提取资料并评价纳入研究的偏倚风险后,采用Review Manager 5.3及Stata 15.1软件进行meta分析.结果:共纳入9项研究,865例患者.meta分析结果显示,与间断声门下吸引相比,持续声门下吸引VAP发生率[RR=1.06,95％CI(0.88～1.28),P=0.53]、早发VAP发生率[RR=1.09,95％CI(0.66～1.79),P=0.74]、机械通气时间[MD=0.12,95％CI(-0.49～0.72),P=0.70]、ICU住院时间[MD=-0.16,95％CI(-0.88～0.56),P=0.66]和病死率[RR=0.92,95％CI(0.69～1.23),P=0.58]方面,差异均无统计学意义;持续声门下吸引隐血试验阳性率[RR=2.74,95％CI(1.72～4.37),P＜0.000 1]高于间断声门下吸引,差异有统计学意义.结论:持续与间断声门下吸引在预防VAP效果方面无差异,但持续声门下吸引较易致气管黏膜损伤.

Objective:To understand the research status of positive psychology in the world, analyze its development trend and provide reference for the research of positive psychology in China.Methods:The research literatures on positive psychology from 2000 to 2019 were retrieved in Web of Science Core Collection database.Its built-in analytical function was used for bibliographic analysis of annual distribution, country distribution, fund supporting institutions, journal distribution, and research direction. CiteSpace 5.1.R6 software was used to draw high-frequency keywords maps to analyze research hotspots, and HistCite Pro 2.1 software was used to draw citation chronicle chart to analyze highly cited literatures.Results:A total of 4 536 literatures related to positive psychology were included, and the number of literatures showed an increasing trend year by year. The United States had the most publications, with 1 793 papers. And the number of published papers in China was 241, ranking 6th. Funding agencies and journals were scattered, but mostly from the United States. Research focused on psychology (52.491%, 2 381/4 536) , and nursing ranked 10th (1.984%, 90/4 536) . Adolescents, subjective positive experiences and personal positive traits were research hotspots.The 10 most frequently cited studies focused on positive emotions and experiences, positive psychological interventions and validation of their effectiveness.Conclusions:Positive psychology research is in a stage of continuous development and growth, and the core journal forum has not yet formed.The United States occupies a leading position in this field of research, and there is still a great room for improvement in the quantity and quality of research in this field in China.In the future, researchers can conduct in-depth studies on children, the elderly and the positive social environment, and at the same time, combine with local characteristics to explore the theoretical system and intervention mode of positive psychology suitable for China.

Objective:To evaluate the effects of telemedicine on the quality of life in patients with inflammatory bowel disease (IBD) and provide effective evidence for the implementation of telemedicine in patients with IBD.Methods:Randomized controlled trails (RCT) involving telemedicine on improving the quality of life in patients with IBD which were published since the databases were established to September 23, 2018 were retrieved from PubMed, Web of Science, Embase, the Cochrane Library, Cumulative Index of Nursing & Allied Health Literature (CINAHL) , China Biology Medicine (CBM) , VIP, Wanfang Data and China National Knowledge Internet (CNKI) . Meta-analysis was performed by two researchers using RevMan 5.3 after independent selection of literature, extraction of data, and quality evaluation according to the inclusion and exclusion criteria of the literature.Results:Among the 741 articles identified in the initial search, totally 8 RCT were included, involving a total of 1 966 patients, including 1 067 patients in the intervention group and 899 patients in the control group. One study was of high quality and the remaining seven were of medium quality. Meta-analysis showed that the quality of life scores of patients in the telemedicine group were higher than those in the control group after intervention [ SMD=0.26, 95% CI (0.06, 0.46) , P=0.01]. Subgroup analysis of the follow-up evaluation time revealed that within 3 months of intervention, telemedicine could better improve the quality of life of patients compared with the control group [ SMD=0.56, 95% CI (0.02, 1.10) , P=0.04]. Subgroup analysis of age showed that telemedicine could better improve the quality of life of adult patients compared with the control group [ SMD=0.29, 95% CI (0.06, 0.52) , P=0.01]. Conclusions:The effects of telemedicine on the quality of life in patients with IBD are better than that of routine/standard care, but high-quality research is still needed to verify it. Telemedicine can be an effective alternative for the long-term disease monitoring, management and education of patients, and may also provide a reference for the formation of a scientific and effective community-family management model for patients with IBD.

目的 编制科学、规范的炎症性肠病患者症状群评估量表,并进行信效度检验.方法 以症状经历模型为指导,通过文献回顾、德尔菲专家函询形成量表初稿;对条目进行描述性定义后进行小样本预调查,根据患者反馈完善量表.便利选取2019年6月-9月在江苏省4所三级甲等综合医院消化科门诊就诊或住院的150例炎症性肠病患者进行问卷调查.运用SPSS 20.0对数据进行项目分析,测定量表的信效度.结果 最终形成的炎症性肠病患者症状群评估量表包括18个条目,量表的内容效度指数为0.850,各条目的内容效度指数为0.941～1.000.探索性因子分析提取出5个公因子,累计方差贡献率为77.390％.各因子与总量表间呈正相关,相关系数为0.580～0.857,总量表与炎症性肠病生活质量问卷的相关系数为0.925.总量表的Cronbach's α系数为0.900,重测信度为0.856.结论 炎症性肠病患者症状群评估量表具有良好的信效度,可引导医护人员精准、针对性地评估患者,为患者制订个性化的症状管理措施提供依据.

Objective To analyze the studies on self-management in patients with inflammatory bowel disease (IBD) in China and its development status, and provide a direction and idea for the further development of studies in this regard. MethodsRelevant literatures on self-management in IBD patients published since the database was established to May 2018 were retrieved from CNKI, WanFang Data, VIP and CBM. NoteExpress 3.2.0 and Excel 2016 were used to establish a database. External characteristics such as the year, journal and author as well as internal characteristics such as the research type, research subject and intervention measures were extracted from the literatures, and methodological quality assessment was conducted over the randomized controlled trails (RCT). ResultsTotally 87 articles about self-management in IBD patients were included in this study. The number of publications rose perpendicularly from 2014 to 2018. Totally 52 articles (65.82%) were published on the top 5 journals in terms of the total number of articles. The top 3 areas in terms of the total number of articles were Jiangsu (42), Zhejiang (10) and Guangdong (7). There were 64 (73.56%) co-authored articles in total, and 29 articles (36.71%) were supported by a grant. There were various types of intervention studies, but there was huge difference between them in intervention time and frequency and there was no complete assessment tool for outcome indicators yet. The blind method and random distribution were not stated in any RCT, and their quality needed to be improved. ConclusionsCurrently, China's studies on self-management in IBD patients are still in a rapid development stage. Both core journals, forums and authors have taken form, but researchers still need to develop a complete specificity assessment tool, apply complete outcome assessment indicators, and enhance the scientific and preciseness of research design and implementation,thus improving the quality of literatures.

目的 探讨腹式深呼吸训练对胃食管反流病患者消化道症状群和心理症状群的影响.方法 便利选取2017年7月-2018年2月某三级甲等医院消化科门诊的胃食管反流病患者80例,随机分为试验组和对照组,每组各40例.试验组在常规药物治疗和护理基础上,进行腹式深呼吸训练,每日2次,每次15～20 min;对照组接受常规药物治疗和护理,在干预前及干预8周后比较两组结局指标,包括症状积分、抑郁、焦虑、睡眠质量.结果 干预后两组的症状积分、焦虑抑郁评分、匹兹堡睡眠质量指数总分和各维度得分(除催眠药物维度)均显著低于干预前(P＜0.01).干预后试验组的症状积分显著低于对照组(P＜0.01),焦虑抑郁评分、匹兹堡睡眠质量指数总分和各维度得分(除睡眠质量、催眠药物维度)均显著低于对照组(P＜0.05).结论 腹式深呼吸训练能够有效改善胃食管反流病患者消化道症状群和心理症状群.

This article reviewed the concept,origin and development,theoretical basis,implementation process standards,application in chronic diseases management,and existing problems of structured education in China and abroad.It was suggested that the foreign structured education has been mature and used widely.However,domestic structured education mostly has still stayed in the education of children with autism or social disabilities,and diabetes patients.While drawing lessons from foreign experiences,we needs to explore a structured education model that suits Chinese national conditions.By introducing foreign mature theories,implementation plans,and evaluation standards,and taking a localization reform,finally,a complete system framework would be formed and be applied into different diseases.

目的 了解目前临床护理实习带教老师人文关怀品质的现状,并探讨其影响因素.方法 以一般资料问卷、人文关怀品质量表、职业获益感量表调查本院的122名临床护理实习带教老师并进行分析.结果 临床护理实习带教老师人文关怀品质总体得分为(127.14 ± 12.63)分,得分率为87.68%;单因素分析显示,不同的年龄(r=0.243,P<0.05)、职业获益感程度(r=0.646,P<0.05)、同事关心程度(F=4.466,P<0.05),人文关怀品质得分不同,差异有统计学意义;不同科室在人文关怀能力维度得分不同(F=2.259,P<0.05),不同婚姻状况在人文关怀感知维度得分不同(F=3.092,P<0.05),不同的初始学历在人文关怀理念维度得分不同(F=3.236,P<0.05),差异有统计学意义;多元线性回归显示,年龄、职业获益感是临床带教老师人文关怀品质的独立预测因素.结论 临床护理实习带教老师人文关怀品质良好,不同的年龄、职业获益感程度,人文关怀品质不同.