The Development of Doctor-nurse-patient Co-construction through Evidence-based Narrative Exploration of Traditional Chinese Medicine

Traditional Chinese medicine(TCM)is the wisdom crystallization and cultural treasure of the Chinese nation.Establishing a positive relationship among doctors,nurses,and patients is essential for promoting the sustainable development of TCM culture.As an important branch of evidence-based narrative medicine,evidence-based narrative of TCM significantly contributes to the co-construction of doctors,nurses and patients.This paper discusses the necessity and clinical practice value of promoting co-construction of doctors,nurses and patients based on the principles of evidence-based narrative TCM.By working together to select optimal diagnosis and treatment options,we aim to enhance patient compliance,alleviate tensions among the parties involved,and establish equitable collaborative relationships.Creating a harmonious medical environment is crucial for promoting the continuous development of this collaborative model in clinical practice,thereby improving patients'overall health,increasing public recognition of TCM,and supporting its sustainable growth.

Narrative nursing for negative emotions in patients with acute pancreatitis:Based on model construction and application

BACKGROUND Acute pancreatitis(AP),as a common acute abdomen disease,has a high incidence rate worldwide and is often accompanied by severe complications.Negative emotions lead to increased secretion of stress hormones,elevated blood sugar levels,and enhanced insulin resistance,which in turn increases the risk of AP and significantly affects the patient's quality of life.Therefore,exploring the intervention effects of narrative nursing programs on the negative emotions of patients with AP is not only helpful in alleviating psychological stress and improving quality of life but also has significant implications for improving disease outcomes and prognosis.AIM To construct a narrative nursing model for negative emotions in patients with AP and verify its efficacy in application.METHODS Through Delphi expert consultation,a narrative nursing model for negative emotions in patients with AP was constructed.A non-randomized quasi-experimental study design was used in this study.A total of 92 patients with AP with negative emotions admitted to a tertiary hospital in Nantong City of Jiangsu Province,China from September 2022 to August 2023 were recruited by convenience sampling,among whom 46 patients admitted from September 2022 to February 2023 were included in the observation group,and 46 patients from March to August 2023 were selected as control group.The observation group received narrative nursing plan,while the control group was given with routine nursing.Self-rating anxiety scale(SAS),self-rating depression scale(SDS),positive and negative affect scale(PANAS),caring behavior scale,patient satisfaction scale and 36-item short form health survey questionnaire(SF-36)were used to evaluate their emotions,satisfaction and caring behaviors in the two groups on the day of discharge,1-and 3-month following discharge.RESULTS According to the inclusion and exclusion criteria,a total of 45 cases in the intervention group and 44 cases in the control group eventually recruited and completed in the study.On the day of discharge,the intervention group showed significantly lower scores of SAS,SDS and negative emotion(28.57±4.52 vs 17.4±4.44,P<0.001),whereas evidently higher outcomes in the positive emotion score,Caring behavior scale score and satisfaction score compared to the control group(P<0.05).Repeated measurement analysis of variance showed that significant between-group differences were found in time effect,inter-group effect and interaction effect of SAS and PANAS scores as well as in time effect and inter-group effect of SF-36 scores(P<0.05);the SF-36 scores of two groups at 3 months after discharge were higher than those at 1 month after discharge(P<0.05).CONCLUSION The application of narrative nursing protocols has demonstrated significant effectiveness in alleviating anxiety,ameliorating negative emotions,and enhancing satisfaction among patients with AP.

Research Progress on the Combination of Rehabilitation Therapy and Evidence-Based Nursing in Restless Legs Syndrome Among Hemodialysis Patients

Restless legs syndrome(RLS)is a common neurological disorder in clinical practice,particularly prominent among hemodialysis patients.RLS severely impacts patients’sleep quality and mental state,exacerbating their pre-existing physical discomfort and life burden.Current pharmacological treatments often yield suboptimal results and carry numerous adverse effects.Consequently,combining evidence-based nursing with rehabilitation therapy has emerged as a promising intervention strategy.Rehabilitation therapy,a multimodal non-pharmacological treatment,aims to enhance patients’physical and psychological health,while evidence-based nursing emphasizes individualized,scientifically grounded nursing interventions.The integration of these two approaches not only alleviates RLS symptoms but also improves patients’quality of life and self-management abilities.Based on this,the paper conducts an in-depth study of the pathogenesis and clinical characteristics of RLS in hemodialysis patients and provides a detailed analysis of the combined application of rehabilitation therapy and evidence-based nursing for this condition.

The Application of Narrative Education of Wisdom Classroom Model in Nursing Teaching

Objective:To evaluate the effect of narrative education in nursing teaching of wisdom classroom model.Methods:60 general surgery nursing students were divided into groups,30 nursing students in control class were taught in traditional teaching mode,and 30 nursing students in research class were taught in wisdom classroom mode.Compare the nursing teaching effect of two classes.Results:There was no significant difference in the scores of clinical nursing ability between the two classes before teaching,and the improvement was more obvious after different teaching modes,with statistical significance between the two groups(p<0.05).After different teaching modes,the assessment results of nursing students in the research class were better in all aspects,and the difference between groups was obvious(p<0.05).There was no significant difference in clinical thinking between the groups before teaching(p>0.05),and the clinical thinking ability of the study group was improved after different teaching modes,and the difference between the groups was significant(p<0.05).Compared with the two classes of nursing students’satisfaction with different teaching modes,the satisfaction of the research class was higher,with statistical significance(p<0.05).Conclusion:The use of narrative education in wisdom classroom mode in nursing teaching can significantly improve the clinical nursing ability of nursing interns,exercise their clinical thinking,improve their assessment scores and teaching quality satisfaction,and is beneficial to the cultivation of excellent quality of humanistic care of nursing interns,and has a prospect of popularization and application.

A Study on the Application of Evidence-Based Nursing in The Care of Patients with Severe Acute Pancreatitis

Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis. Patients with severe acute pancreatitis who received treatment in our hospital were selected, from which 80 cases were chosen for detailed analysis. The patients were randomly grouped into a control group (conventional nursing care) and a study group (evidence-based nursing care), with 40 patients each. Relevant research data were recorded during the nursing process, analyzed, and used as research indicators. Results: The hospitalization time and morbidity and mortality rate of the research group were shorter than those of the control group, and the recovery rate was higher than that of the control group (P < 0.05). Patient satisfaction with nursing care in the observation group was higher than in the control group (P < 0.05). Conclusion: For patients with severe acute pancreatitis, the use of evidence-based nursing methods effectively reduced the patient’s mortality rate, improved its curative effect, and also shortened the patient’s hospitalization time.

Exploring the Impact of Narrative Nursing on Anxiety, Depression, and Quality of Life in Middle-aged and Young Dialysis Patients

Objective:To explore the impact of narrative nursing on anxiety,depression,and quality of life in middle-aged and young dialysis patients.Method:Eighty-six middle-aged and young dialysis patients admitted from January 2023 to December 2023 were selected and divided into a control group and a study group,with 43 patients in each group.The control group received general nursing interventions,while the study group received narrative nursing in addition to the general interventions.The levels of anxiety and depression before and after the intervention were compared,and the quality-of-life scores of the two groups were analyzed.Results:After comprehensive intervention,the scores of both groups significantly decreased(P<0.05).After intervention,the scores of the study group were more significant compared to the control group(P<0.05).Compared with the control group,the quality-of-life score of the study group showed a significant upward trend,and this difference was statistically significant(P<0.05).Conclusion:Comprehensive narrative nursing can effectively reduce anxiety in middle-aged and young dialysis patients,further enhance their quality of life,and is worth promoting in clinical practice.

Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Improve nursing in evidence-based practice:How Chinese nurses'read and comprehend scientific literature

Objectives:To examine Chinese nurses'practice of reading and understanding scientific literature and elucidate the motivating and deterring factors.Methods:This is a cross-sectional study conducted between March and June 2015.A random sample of 853 full-time registered nurses from three tertiary and two secondary hospitals in China filled out a set of self-administered questionnaires,including literature habit questionnaire(41 items),the situational motivation scale and the socio-demographic and professional characteristics questionnaire(15 items).Results:Significant majority(89.2%)of the respondents reported perception of barriers to keeping up to date with literature.The language barrier was the most prominent,followed by poor presentation and readability of articles.Using simpler language when writing articles,improving ones'foreign language proficiency and getting education or training on nursing research were raised as the top facilitators.Additionally,reading and understanding literature was significantly associated with the nurses'educational background,motivation,genders and work settings.Conclusions:The survey of the current status of literature education among Chinese nurses suggests that providing protected time,training for critical thinking,and incentive mechanisms will help improve nurses'engagement in literature and create a culture of academic inquiry.

The power of story:Narrative inquiry as a methodology in nursing research

The aim of this paper is to explore the essential elements and value of narrative inquiry in nursing research.We propose that understanding a previous experience allows the nurse researcher an“insider view”and hence a deeper understanding of the issues that arise in the relationship between participant and researcher.We suggest that narrative inquiry in nursing research offers a particular way of caring about how knowledge is produced.Nursing science would benefit from the understanding that health and nursing practices are dynamic processes characterized by the continuous interaction of human thought and behaviour that continuously‘pumps’into personal,social and material environments.Narrative inquiry as a methodology in nursing research is exceptionally useful to uncover nuance and detail of previous experiences.

Application of narrative nursing in the families of children with biliary atresia:A retrospective study

BACKGROUND Narrative nursing is an important clinical nursing intervention model.It is the practice of patient storytelling to share the essence of nursing.The current clinical intervention for biliary atresia(BA)mainly focuses on disease treatment and does not pay enough attention to the psychological state of family members.AIM To explore the application value of narrative nursing in the families of children with BA.METHODS Sixty-four family members of children with BA in our hospital from December 2017 to October 2020 were retrospectively included and were divided into a study group(n=32)and a control group(n=32).The control group was provided with routine nursing,while the study group was given narrative nursing on the basis of the control group.The scores of mood state(depression and anxiety),family members’nursing ability,perceived stress,and nursing job satisfaction of the children’s families were calculated before and after the intervention.RESULTS Before intervention,there was no significant difference in the self-rating anxiety scale and self-rating depression scale scores between groups(P>0.05).After intervention,the self-rating anxiety scale and self-rating depression scale scores in the study group were lower than those in the control group(both P=0.000).Before intervention,the study group adjusted life to meet care needs,evaluated family members and social resources,dealt with personal emotions,responded to needs,and provided assistance,and the adaptive care role scores were not significantly different from those in the control group(P=0.802,0.819,0.694,0.796,and 0.686,respectively).After intervention,all scores were significantly lower in the study group than in the control group(all P<0.0001).Before intervention,there was no significant difference in the child post-traumatic stress disorder symptom score(CPSS)score between groups(P=0.615).After intervention,the CPSS scores were significantly lower than those before intervention in both groups and lower in the study group than in the control group(P<0.0001).Nursing job satisfaction of the family members of the study group(93.75%)was higher than that of the control group(75.00%)(P=0.039).CONCLUSION Narrative nursing with family members of children with BA can effectively alleviate negative emotions,reduce perceptual pressure,and improve nursing ability.Additionally,family members are more satisfied with nursing work.

Under the narrative medicine theory to establish the evidence-based medical record written by doctors and patients through integrated therapy of traditional Chinese and western on digestive system diseases

Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record following the concept of narrative evidence-based medicine.Methods:The information was searched from Pubmed,Embase,CBMdisc,CNKI.A preliminary agreement was reached by referring to the principles of narrative medicine and advises given by experts of digestive system and evidence-based medicine in both Traditional Chinese Medicine and Western Medicine.Result:This research is a useful attempt to discuss the establishment of doctor-patient co-operated evidence-based medical record guided by the direction of narrative evidence-based medicine.Reflection and outlook:Doctor-patient co-operated medical record can be a key factor of the curative effect evaluation methodology system of integrated therapy of Tradition Chinese Medicine and Western Medicine on spleen and stomach diseases.

Narrative nursing for cancer patients:a meta-analysis

Objective:To systematically review the effect of narrative nursing for cancer patients.Methods:Systematic searches in PubMed,EMBASE,The Cochrane Library,Web of Science,Chinese biomedical literature database,China National Knowledge Infrastructure,Wanfang medical and VIP database were performed for randomized controlled trials(RCTs)or quasi-RCTs which explored the effects of narrative nursing mode for cancer patients.Then,meta-analysis was performed by RevMan 5.3 after two independent investigators screened the literature,extracted the data and evaluated the risk of bias of all included studies.Results:A total of 15 studies were included,including 1778 cancer patients.The meta-analysis showed that narrative nursing could effectively relieve patients'anxiety and depression compared with the conventional nursing model(WMD=-9.04,95%CI=-11.82,-6.27;P<0.001),reduce the the inner shame(WMD=-2.28,95%CI=-3.76,-0.88;P=0.001),improved the mental resilience(WMD=18.20,95%CI=3.30,33.11;P<0.001)and the quality of life.Conclusion:This study has been systematically evaluated to show that narrative care can effectively improve the negative mood of patients with cancer and improve their quality of life.However,subject to the quality limitations of the included studies,the appeal conclusions are yet to be tested in more high-quality studies.

The concept of narrative evidence-based medicine and shared decision-making in traditional Chinese medical practice

For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making and promote the transformation of clinical research evidence in TCM. Paying attention to patients＇ narrative needs and strengthening medical humanistic concerns could improve clinical outcome and patient satisfaction. We described the origins and development of evidence-based medicine, narrative medicine and shared decision-making, and analyzed the existing problems in TCM clinical decision-making. Further, we put forward the model of shared decision-making between clinicians and patients under the guidance of narrative evidence-based medicine concepts and methods.

Enhancing Evidence-Based Practice and Critical Thinking Skills of Nursing Students: Lessons from the Review of the Bachelor of Science in Nursing Curriculum of the University of Zambia

Background: Making changes in the existing curriculum aims, objectives, course contents learning outcomes and assessment strategies have become a fact of life for nurse educators. Purpose: To enhance the existing Bachelor of Science (BSc) in nursing curriculum through integration of evidence-based practice (EBP) and teaching of critical thinking skills. Materials and Methods: A needs analysis was conducted using a five-phased approach to review the BSc in nursing Curriculum. Kern’s six-step model was adapted and introduced through a series of workshop exercises that highlighted the application of each step: 1) Desk review of the BSc curriculum offered globally;2) Administration of the needs assessment questionnaire to key informants;3) Strengths, weakness, opportunities and threat analysis;4) Consultative meeting with major stakeholders;5) Curriculum review. Results: The five-phased approach established some gaps in existing curricula, and identified critical core competences and best practices in integrating EPB and critical thinking in the BSc undergraduate curriculum and some “A” level content that was not in tandem with the practice of nurses. New courses were developed to support students in academic writing and enhance professionalism and duration of training was reduced from 5 to 4 years. Conclusion: The process demonstrated that BSc curriculum review, in fact, should be thoroughly scrutinized to encourage positive changes to the curriculum, provide opportunities for team building and the development of leadership skills and a whole-of course perspective on the curriculum.

Research progress on narrative education in clinical nursing education

This article introduces the concept and mode of narrative education in addition to the application of narrative education in clinical nursing education. A summary is presented of the application of narrative education in this clinical nursing context from several aspects, including providing a display platform and various other teaching forms for the teachers＇ use, promoting the professional quality of teachers and students, and facilitating the teaching of abstract concepts.

Application of evidence-based nursing intervention in patients with congenital heart diseases treated by transcatheter interventional therapy

Objective To explore the application of evidence-based nursing intervention in patients with congenital heart diseases treated by transcatheter interventional therapy.Methods A total of 64 patients with congenital heart diseases who were administered in our hospital from June 2011 to July 2013 were recruited in our research.

Thoughts on the Construction of Evidence-based Nursing Standard Plan for Dominant Diseases in Traditional Chinese Medicine

The evidence-based Traditional Chinese Medicine(TCM) nursing in standard plan is to be constructed by a combination of evidence-based thinking and expert consensus.(1) The symptoms of diseases with better curative effect in TCM and the nursing techniques of TCM based on scientific evidence can be preliminarily presented through bibliometric analysis.(2) Expert consultation letters can be developed based on bibliometric results, and symptoms of dominant diseases in TCM and TCM nursing techniques can be selected through those letters.(3) Based on the selected symptoms and TCM nursing techniques, the PICO can be determined, and then evidence search, evidence extraction, evidence analysis can be conducted and synthesized, and recommendations would be chosen.(4) The recommendation grade of each recommendation can be determined by applying the Delphi method and referring to GRADE.(5) The plan will be determined through discussions of experts. The construction of TCM nursing plan would make sure that TCM nursing is scientific, and internationalize TCM nursing.

Evidence-based Care for Rehabilitation Nursing Effect of Patients with Patellar Fracture

Objective.To analyze the effect of applying evidence-based care in rehabilitation nursing effect of patients with patellar fractures.Methods.A total of 54 patients with patellar fractures were randomly selected from the hospital.The diagnosis and treatment time were from the beginning of July 2018 to end of June 2019.The digital table grouping was adopted to divide patients into two groups with each group consists of 27 patients with this disease.Both groups underwent routine nursing and the experimental group with increased evidence-based care.Results.Compared with the control group,the knee function evaluation,complications and nursing satisfaction of the experimental group were more ideal,and the difference was statistically significant(P<0.05).Conclusion.Evidence-based care in rehabilitation nursing of patients with patellar fracture can obtain ideal nursing effect.

Application of Evidence-based Nursing in Elderly Patients with Arrhythmia after Acute Myocardial Infarction

Objective: To investigate the effect of evidence-based nursing intervention in elderly patients with arrhythmia after acute myocardial infarction. Methods: 146 elderly patients with arrhythmia after acute myocardial infarction treated in our hospital from February 2016 to March 2017 were selected as research objects. According to the random number method, patients were divided into control group (73 cases, traditional nursing) and observation group (73 cases, evidence-based nursing intervention). The clinical effects and nursing satisfaction of the two groups were compared. Results: The hospital stay, average bed rest time, hospitalization cost, and incidence of arrhythmia complications in the observation group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). After nursing, the four grades of heart function and satisfaction of nursing in the observation group were significantly higher than those in the control group. The difference was statistically significant (P<0.05). Conclusions: In elderly patients with arrhythmia after acute myocardial infarction, evidence-based nursing intervention was adopted. The patient's health has been greatly improved and the doctor-patient relationship has been significantly improved. This method is worth promoting.

Application effect of narrative nursing teaching method in nursing teaching:A systematic evaluation

Objective:To analyze and summarize the application effect of narrative teaching method in nursing teaching,so as to provide empirical support for the application of narrative teaching method in nursing education.Methods:In this study,Meta analysis was used to search the databases of CNKI,Wanfang,VIP,Cochrane Library,PubMed,Web of Science and Science Direct.The retrieval time was from October 2019.Results:A total of 14 randomized controlled trial conclusions were included.The results showed that the application of narrative nursing teaching method could improve the theoretical knowledge[SMD=1.34,95%CI 0.70-1.97,P<0.01],the mastery of operational skills[SMD=1.30,95%CI 0.65-1.96,P<0.01],the humanistic care ability[SMD=0.98,95%CI 0.26-1.69,P<0.01],and the empathy level[SMD=6.13,95%CI 5.15-7.11,P<0.01].Conclusion:The application of narrative nursing teaching method can improve the required ability of nursing students and has a good application effect.More high-quality RCT studies are needed in the future for further research.