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Objective:To analyze the influential factors of hypothermia in congenital heart disease (CHD) after cardiopulmonary bypass (CPB) rewarming using the decision tree model, thus providing theoretical basis for medical staff.Methods:A total of 711 CHD children who underwent surgery in the Shanghai Children′s Medical Center from January 1, 2019 to April 30, 2019 were retrospectively analyzed.A decision tree model was established to predict the risk factors for hypothermia in CHD children following CPB.Results:The decision tree model showed that CPB program, preoperative nutrition score and body surface area were the high-risk factors for hypothermia in CHD children after CPB rewarming.The accuracy, sensitivity, specificity of the decision tree model were 86.45%, 77.14% and 90.97%, respectively, and the area under the receiver operating characteristic curve was 0.851(95% CI: 0.798-0.904). Conclusions:Decision tree model has a high application value in predicting hypothermia in CHD children following CPB.It contributes to identify the influential factors of hypothermia, and provides references for performing preventive treatment and nursing measures to control the risk of hypothermia.
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Objective:To analyze the clinical applicability of the sixth edition of nursing measures classification in children's general surgery, to provide a basis for standardizing clinical nursing terms and to promote the clinical use of standardized terminology of nursing measures.Methods:The research method of this study was mapping method. The electronic nursing records of the general surgery of Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from October 1st to December 31st, 2018, including the records of care records for free entry and the records of nursing measures related to medical orders were selected. The degree of matching between electronic care records and classification of nursing measures (sixth edition of nursing measures classification) was compared with conceptual consistency. Difficulties and time-consuming analysis of the characteristics of the standardized care measures obtained by matching.Results:A total of 4 560 independent electronic care records mapped 86 treatments in seven areas. Among them, 98.84% (4 507/4 560) of the nursing records were completely matched with the nursing measures, 0.83% (38/4 560) of the nursing records were partially matched with the nursing measures, and 0.33% (15/4 560) of the nursing records did not match the nursing measures. Difficulty and time-consuming were expressed as standard deviation, which were 2.20±0.45 and 2.03±1.25 respectively.Conclusions:The classification of nursing measures can be used to describe the daily behavioral activities of the children's general surgery nurses, and can also solve the standardization problem of the nursing records in the presentation, and is suitable as a standardized nursing language for the nursing records of children's general surgery.
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Objective@#To translate the Children′s International Mucositis Evaluation Scale (ChIMES) into Chinese and evaluate its psychometric charateristics in pediatric patients with acute leukemia.@*Methods@#After translation and cognitive debriefing interviews, convenience sampling was used to recruit 105 pediatric patients with acute leukemia in a Shanghai AAA pediatric hospital.@*Results@#The known-group validity was great, and criterion validity was 0.947. Through EFA, the Chinese version of ChIMES included two dimensions which accounted for 75.270% of the accumulated variance, and each item had high factor loading quantity (>0.5). Cronbach alpha was 0.826 and the split-half reliability was 0.590. Relevance between each item and total score was good, with Pearson correlation coefficient 0.424-0.900.@*Conclusion@#The Chinese version of ChIMES has been proved valid and reliable and can be practically and feasibly used in the future.
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Objective:To translate the Children ′s International Mucositis Evaluation Scale (ChIMES) into Chinese and evaluate its psychometric charateristics in pediatric patients with acute leukemia. Methods:After translation and cognitive debriefing interviews, convenience sampling was used to recruit 105 pediatric patients with acute leukemia in a Shanghai AAA pediatric hospital.Results:The known-group validity was great, and criterion validity was 0.947. Through EFA, the Chinese version of ChIMES included two dimensions which accounted for 75.270% of the accumulated variance, and each item had high factor loading quantity (>0.5). Cronbach alpha was 0.826 and the split-half reliability was 0.590. Relevance between each item and total score was good, with Pearson correlation coefficient 0.424-0.900.Conclusion:The Chinese version of ChIMES has been proved valid and reliable and can be practically and feasibly used in the future.
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Objective To investigate the use of smartphone applications in the adherence with inhaled glucocortiocoids (ICS) therapy in asthma children. Methods Sixty-six asthma children and their caregivers in Shanghai Childrren's Medical center from July 2016 to February 2017 were recruited in this study using convenience sampling . All participants were randomly allocated to intervention and control groups. All participants were given routine education and technical guidance on inhalation. In addition all participants had the same chips attached to their regular nebulizers. The APP was installed on each caregivers' smartphone in the intervention group. Key modules of mobile applications include real-time monitoring of medication and health education. The ICS adherence rates were recorded by the chips and were monitored monthly by researcher. The frequency of asthma exacerbations, emergency department visits and hospital admissions in intervention group was collected by smartphone APP every 3 months. the frequency of asthma exacerbations, emergency department visits and hospital admissions in control group was investigated by researcher every 3 month. Results After 6 months follow up, although ICS compliance decreased in both groups. The first month's adherence in the intervention group was 98(97.0, 100.0)％, in the sixth month's was 96(92.0, 100.0)％. The first month's adherence in the control group was 93(68.5,100.0)％, in the sixth month's was 28(0, 55.5)％. The difference in adherence between the two groups was significant (Z=2.664, 4.318, P<0.01). The decline trend of the control group was significantly greater than that of the intervention group (F=25.097, P<0.01). The compliance of the control group was less than 60％from the third month and below 30％by the sixth month, below the average ICS compliance of 30％ to 60％ in China. Though the ICS compliance of intervention group was declining, the ICS compliance was more than 90％ and higher than the mean compliance in our country. No significant differences were found in the frequency of asthma exacerbations, emergency department visits and hospital admissions between the intervention and control group (χ2=3.043, 1.065, 1.015, P>0.05). But the frequency of asthma exacerbations, emergency department visits and hospital admissions of two times or more intervention group was lower than that in the control group. Conclusions Smartphone APP significantly improved the compliance of children with asthma aged 0 month to 3years old.
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Objective To identify the core interventions preliminarily performed by pediatric nurses for hospitalized children. Methods Based on Nursing Interventions Classification (NIC), the data of survey related to the factors of representation and frequency derived from the definition of Core Nursing Interventions were collected from 59 pediatric senior nurses above the 3rd clinical ladder, working in one of Shanghai university affiliated and tertiary children hospitals. The data was analyzed by L type of Metric Diagram. The intervention with product of two factors above 12 was selected as the core intervention. Results A total of 109 interventions were selected as core interventions on pediatric nursing from 497 interventions of NIC. The top 3 domains in quantity of interventions were physiological complex domain (36 items), physiological basic domain (26 items) and health system domain (19 items). The domain with the highest score (16.79 ± 3.42) was safety domain, followed by physiological complex domain (16.19 ± 2.98), while domain with the lowest score (13.62±2.05) was family domain. Conclusions The initial and systematic pediatric nursing core interventions were identified based on NIC and definition of core intervention. Part of core interventions reflects the characteristics of pediatric nursing practice, but more is requested to reflect the pediatric-specific care related to family-center and age-appropriated concepts. Some of inefficient interventions remind nursing administers further reflect thinking, especially on human resource management.
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Levels of adenosine, inosine and hypoxanthine in rabbit brain tissue du-ring acute cerebral hypoxia induced by hypotonic hypoxemia were increased much morethan that of the normal controls from 53.3?2.9, 115.6?11.8 and 186.5?10.3 to 816.4?59.0, 1049.7?37.5 and 704.4?55.3 ?M/g (X?SD) respectively (P