Methodological exploration on the construction of a traditional Chinese medicine nursing expert consensus based on evidence--taking stroke as an example

Objective: To explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine(TCM) nursing taking stroke as an example.Methods: First, preliminary and comprehensive presentation of all stroke-related symptoms and corresponding TCM nursing techniques involved were revealed through bibliometric analysis. Then, selection of stroke symptoms and TCM nursing techniques for inclusion in the consensus was performed using an expert consultation method. Next, we determined the search strategy for a precise evidence search;conducted an evaluation of evidence quality and the grade of the evidence;and completed evidence extraction, evidence analysis, and evidence synthesis based on the included symptoms and TCM nursing techniques. The Delphi method was then applied to determine the strength of each recommendation and the choice of nursing care points by referring to the Grading of Recommendations, Assessment, Development, and Evaluations grid. Finally, we conducted an external expert validation of the Delphi results to form an expert consensus guideline.Results: Through the bibliometric analysis, 22 stroke symptoms and 18 TCM nursing techniques were identified in the literature. Then, after expert consultation, 22 symptoms and 111 pairs of symptoms combined with TCM nursing techniques were selected for the evidence search. Evidence integration yielded 10 stroke symptoms corresponding to 29 bodies of evidence;these 10 symptoms were retained through the Delphi consultation, and recommendation strength results for 26 recommendations were obtained. A total of 9 symptoms were further retained for expert external validation to form 24 recommendations, with a recommendation process score range of 7.64-9.99 points and a more scientific and standardized recommendation-formation process.Conclusion: Owing to the current limited conditions of evidence-based resources for TCM nursing, the present consensus-building process represents only a preliminary exploration of an evidence-based expert consensus for TCM nursing to provide a reference for a more scientific and standardized methodology.

中医理念对护理教育的启示

中医学作为中国文化的重要组成部分,在整体观念与辨证论治理论的指导下,经历数千年的临床实.践,逐渐发展成为以“道”“术”“技”三位一体的防病治病医学模式。现代护理学中“以病人为中心”的整体护理观与中医学整体观念不谋而合,且中医学诸多传统技术在慢病管理、治未病及养生康复等临床护理实践中发挥着巨大的优势。因此,为了更好地发展护理事业,应加强护理专业学生中医学素养与中医护理实践能.力的培养,并将现代护理研究方法引人到中医护理的研究中。

Posthumous organ donation beliefs of college students:A qualitative study

Objective:To explore the perspectives and beliefs of college students toward posthumous organ donation,and the factors influencing their beliefs.Methods:This was a descriptive phenomenology study conducted with semi-structured indepth interviews.Nine college students attending three universities in Beijing who agreed to participate in this study were interviewed.Data were analyzed following the guideline suggested by Colaizzi(1978).Briefly,statements identified as noteworthy were coded and organized.A description was then written to formalize their meaning and returned to the participants for validation of the description.Results:In general,the participants exhibited positive attitudes toward posthumous organ donation.However,not all subjects indicated that they would become an organ donor.Based on the provided responses,four main themes emerged:(1)knowledge about organ donation,participants reported a general lack of education or understanding of organ transplantation and donation;(2)core beliefs on organ donation,despite believing it is valuable public service,participants were unwilling to go against the cultural beliefs held by parents and elders;(3)factors influencing beliefs on organ donation,including cultural and peer opinion,posthumous care of the body,legal registration,and publicity;(4)institutional and policy context,lack of guarantee for proper use of organs after donation was a concern.Conclusion:Despite positive attitudes towards posthumous organ donation,college students are hesitant to become donors because of lack of knowledge/publicity;cultural disdain;and lack of governmental assurance.

Differentiation between two healthcare concepts:Person-centered and patient-centered care

1.Background Engel's biopsychosocial model,which was constructed in 1977,was considered a momentous breakthrough from the traditional biomedical model of medicine that regards the person as a disease-carrier requiring diagnosis and treatment[1]towards recognition of the whole person and furnish customized care.This model argues that health should not be considered solely on biological factors but on a combination of biological,psychological,and social factors[2].This idea of considering individuals as a whole and respecting their rights to self-determination has led to a shift in the care model from disease-centered care to patient-centered or person-centered care.The latter two care models are both abbreviated as PCC.Ensuring that people are involved in and central to the healthcare process is now recognized as a key component in developing high-quality care.Studies have revealed that both concepts of care can help improve people's health condition and lower health service burdens.Thus,countries and healthcare organizations have been paying close attention to the patients'concerns.The National Health Service in England has made person-centered care as one of its seven core principles[3].