The objective of this study was to prove if certain variables related to labour affect the traditional signs of perinatal asphyxia (cardiotocography records, Apgar score and the umbilical artery pH). This is an observational, multicentric, longitudinal, analytical, cohort study in pregnant women at term admitted to the delivery room of Hospital Infanta Cristina, Hospital de Fuenlabrada and Hospital Puerta de Hierro Majadahonda. Of all the variables under scrutiny, the onset of labour, parity, clamping the umbilical cord, gestational age, type of delivery, newborn weight and neonatal resuscitation have a significant relationship with the three signs of perinatal asphyxia. This study showed a relationship between the three signs and some of the studied variables, therefore recommending assessing them in the perinatal asphyxia diagnosis. Key words: Cardiotocography records, umbilical pH, Apgar score, perinatal asphyxia.

Objectives:  Patient safety is one of the principles of the health system that requires several matrices. Nurses, on the other hand, are the most influential group in the care of patients, which due to safety in nursing care will reduce accidents and injuries. Therefore, care methods can be a good way to implement patient safety guidelines. One of these methods is the Case-care Method that is utilized by the Ministry of Health. On the other hand, it is necessary to implement Nine patient safety solutions in health care centers. The purpose of this study was to determine the relationship between the case-care method and the implementation of Nine patient safety solutions. Methods: This study evaluated the relationship between the case-care method and the implementation of Nine patient safety solutions in Farhikhtegan, Bu Alim, Amir al Momenin Hospitals’ wards by using the standard checklists and data analyzed using correlation test and linear regression. Results: There was a significant correlation between the two variables and 31.4% of patient safety solutions were covered by Case-care Method. There was also a relationship between these two variables in the internal and intensive wards, but in the surgical ward, there was no significant relationship. Conclusion: The case-care method provides a foundation for nursing services such as patient safety and improving their quality. Therefore, to improve the patient's safety, it is necessary to use proper care methods base on the conditions of each ward.

Childbirth is perhaps, the most painful experience encountered by most women and just like other forms of pain, the experience of labour pain is unique to individual women, so it is only the woman in labour who can describe the extent of pain she is going through. This study assessed the perceptions, attitude, intention to use, also predict factors that influence intention to use epidural analgesia among pregnant women attending antenatal clinic. The study adopted a cross-sectional design and was conducted among 200 randomly selected pregnant women attending Ante-natal Clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Data were obtained using a structured questionnaire and were analyzed descriptively and inferentially. Statistical significance was determined at p < 0.05. The study revealed that majority (85%) of the respondents had good perception of epidural analgesia but majority (86%) displayed negative attitude toward epidural analgesia. More than half (56%) of the respondents got their information on epidural analgesia from nurses and midwives and 72.5% expressed their intention to use epidural analgesia (EA). Furthermore, there was significant relationship between ethnicity and attitude towards epidural analgesia (p= 0.001). Factors predicting intention to use EA include religion (B=0.99, p=0.016), perception of EA (B=-2.47, p=0.001), appropriate pain control (B=1.75, p=0.02), fear of pain procedure (B=-0.2, p=0.01). The study concluded that pregnant women in this setting have a desire to use EA for child birth. Factors that predict the use include perception, religion, and desire for pain control. Efforts should be intensity to improve on the negative attitude of the respondents as this will ensure prompt intervention which may result in positive birth outcome. Key words: Perception, attitude, epidural, analgesia, pregnant women.

Learning of management skills is necessary for the training of nursing middle managers in the next generation. However, in perinatal medical care, there have been few studies on management skills for midwives as middle managers. The aim of this study was to determine whether advanced midwives have an awareness of probable future changes in perinatal nursing and what management skills they consider will be required for nursing middle managers in the next generation. This study was a qualitative descriptive design conducted for 761 advanced midwives who work in hospitals having 300 beds or more and having an independent department of nursing during the period from November 2018 to May 2019 in Japan. Self-reported questionnaires were sent after receiving acceptance from directors of nursing and questionnaire forms from 501 midwives in 91 hospitals were analyzed. The proportion of midwives who responded that perinatal care and nursing will change in the next 10 to 20 years was 86.8%, and the items of the top three were increase in the number of pregnant women with a high risk, development of reproductive medicine and development of prenatal diagnosis. According to the responses to the questionnaires, management skills that are required for nursing middle managers in the next generation include the ability to deal with different values of midwives, the ability to train midwives with high ethical values and the ability to cooperate with the community. Midwives recognize the need for systematic training for nursing middle managers in the next generation having a high level of management skill. Key words: Advanced midwives, nursing middle managers in the next generation, management skill, predicted change.

The Coronavirus (COVID–19) pandemic has had devastating effects throughout the United States and the world. Recent numbers indicate that approximately 250,000 people in the United States have died from COVID-19, while over 150,000 new cases are announced each day. The numbers of people affected, and the latest Covid research findings have been reported several times a day. Despite the reports, directions, mandates, and recommendations of public health officials, the number of people with COVID-19 continues to climb. Medical information has been reported by the media, medical officials, press briefings, social media, and through social interactions, but that information has often been confusing, conflicting, misleading, and fear inducing for many. Individuals with low health literacy may be impacted by COVID–19 more heavily and more frequently than individuals with proficient health literacy levels due to their inability to understand and carry out health safety recommendations.

Objective To explore the effects of nursing intervention on the Biobanks of patients with nasopharyngeal carcinoma. Methods A total of 560 patients were selected to be screened for nasopharyngeal cancer in the outpatient department of the First Affiliated Hospital of Guangxi Medical University from May 2016 to May 2017, including 352 males and 208 females, 482 confirmed cases and 78 high-risk suspected cases.The confirmed patients were randomly divided into control group and experimental group with 241 cases each.High-risk suspected patients were also divided into control group and experimental group by random number table method, with 39 cases in each group.Nasopharyngeal carcinoma patients and high-risk patients were divided into experimental group and control group.Patients in the control group received routine care and patients in the experimental group received comprehensive care.To evaluate the management effect of nasopharyngeal carcinoma sample base, the patients in the experimental group and the control group were assessed with the following methods: file pass rate, patient satisfaction, revisit rate, complication rate, smoking cessation rate, etc. Results During the 1-year follow-up, the archival qualification rate, patient satisfaction, revisit rate and complication rate of the experimental group were significantly better than the control group, and the archival qualification rate, patient satisfaction, revisit rate and smoking cessation rate of the experimental group were significantly higher than the control group in the high-risk patients, with statistically significant differences (P<0.05). Conclusions Comprehensive nursing plays an important role in improving the management of biological sample bank in patients with nasopharyngeal carcinoma. Key words: Nasopharyngeal carcinoma; Biobank; Comprehensive care; Psychological intervention

Objective To explore the application effect of flipped classroom in palliative care training of nursing staff in oncology department and expand clinical nursing training methods. Methods A total of 60 clinical nurses in oncology department of the Second Hospital of Nanjing City were selected and were diveided into the control group and the experimental group according to the random number table method, 30 cases of each group.The two groups of nurses were given special training in palliative care, the control group adopted the training method of traditional theory teaching, and the experimental group adopted the teaching and training method of flipped classroom.Nursing knowledge questionnaire and teaching training satisfaction scale were used to evaluate the training effect of the two groups of nurses. Results The average score of nursing staffs' palliative knowledge in the experimental group was (17.19±2.85) points, and that in the control group was (14.25±3.92) points.The teaching mode of the experimental group stimulated the active learning interest, the learning content contributed to the understanding and mastery of knowledge, the classroom interaction and communication improved the ability to analyze and solve problems, and the overall evaluation satisfaction of the teaching and training methods was significantly higher than that of the control group, the differences were statistically significant (P<0.05). Conclusions The teaching and training method of flipped classroom can help improve the initiative and critical thinking ability of nursing staff in learning, deepen the understanding and solidification of the knowledge of palliative care training, and improve teaching satisfaction. Key words: Flipped classroom; Palliative care; Training

Objective To explore the effect of hierarchical management on the early activity of severe pneumonia patients in intensive care unit (ICU). Methods A total of 100 patients with severe pneumonia in ICU admitted to Guangdong Agricultural Cultivation Central Hospital from June 2017 to May 2018 were selected. The patients were divided into observation group and control group with 50 patients in each group according to the odd and even number of inpatient beds.The control group used routine methods to judge the patients' activity ability and perform routine activities on a daily basis.The observation group divided the activity ability of ICU patients into levels A, B, C, and D according to the factors affecting the early activities of ICU patients with severe pneumonia, and developed the corresponding level of activity programs. By daily assessment of the level of patients, the corresponding activity programs were adopted for activities.The Barthel index was used to judge the activity ability of daily life, and the differences between the two groups were compared.Meanwhile, the use time of ventilator, blood oxygen saturation at the time of discharge, average length of stay in ICU, and patients' satisfaction with nursing work were compared between the two groups. Results There was no significant difference in Barthel index score between the two groups(P>0.05). There was a statistically significant difference between the Barthel index score at the time of discharge and that at the time of admission(P<0.05). The duration of ventilator use and average length of stay in ICU in the observation group were significantly shorter than those in the control group, blood oxygen saturation was significantly better than that in the control group, and nursing work satisfaction was significantly higher than that in the control group, with statistically significant differences(P<0.05). Conclusions The implementation of hierarchical management can further improve the daily living ability of ICU patients with severe pneumonia, accelerate the recovery process of patients, and improve the treatment effect and nursing satisfaction of patients. Key words: Hierarchical management; Severe pneumonia in ICU; Average length of stay in ICU; Nursing

Objective To understand the current situation and influencing factors of humanistic care ability of newly upgraded undergraduate nursing students. Methods A survey of 184 nursing undergraduates was conducted by means of humanistic care ability scale and college students' professional commitment scale. Results The score of humanistic care ability of nursing students was (171.01±12.96)points, which was lower than the domestic norm and positively correlated with professional commitment.As an important influencing factor, professional commitment could explain 16.60% variation in humanistic care ability. Conclusions The newly upgraded undergraduate universities are in a special transition period, and the humanistic care ability of nursing students is generally low. Therefore, the investment in humanistic care education should be increased, the guidance of professional attitude and the improvement of professional commitment should be emphasized, and the improvement of humanistic care ability should be promoted. Key words: Undergraduate nursing students; Humanistic caring ability

Stigma is common in women with breast cancer, and with current medical advances, the survival rate for breast cancer is increasing year by year.Stigma can be a problem after breast cancer surgery.The article outlines the sources of stigma and interventions including cognitive behavioral therapy, peer education, and family support. Key words: Breast cancer patients; Stigma