Coordination Coefficient Research Articles

Construction of a competency framework of dental hygienists: A Delphi study

AimTo explore the basic and core competencies of dental hygienists, construct a systematic and scientific competency framework for dental hygienists taking into account China’s national conditions and provide a theoretical basis for the future training in China and other countries that have not yet established the competencies of dental hygienists. BackgroundThe establishment of dental hygienists role is essential for the public to improve the dental health level. Currently, more than 50 countries around the world have established the role of dental hygienists and defined the core competencies needed by dental hygienists. However, studies on developing a standardized and unified consensus of competencies of dental hygienists are lacking in China. MethodsBased on the literature review and theoretical research, this study explored the theoretical basis and fundamental principle of constructing the competency framework for dental hygienists. Moreover, a correspondence questionnaire on dental hygienists’ competency framework was initially constructed to clarify the specific content of each competency. Finally, the Delphi method was adopted to establish the indicators of the dental hygienists’ competency framework according to the principle of expert selection and inclusion criteria. ResultsThe three rounds of Delphi consultation experts were from nursing, stomatology and management and other fields. Three rounds of Delphi results showed that the expert authority, enthusiasm and coordination coefficients were high. Thereafter, a competency framework of dental hygienists with 4 primary indicators, 15 secondary indicators and 50 tertiary indicators was constructed, which included theoretical knowledge, professional skills, professional abilities and occupational qualities. ConclusionLiterature and theoretical research methods along with Delphi expert consultation were used to construct the competency framework of dental hygienists based on the onion model. The competency framework of dental hygienists was scientific, reasonable and practical, which is consistent with the current health situation in China and has distinct Chinese characteristics. Some of our findings, offer ideas for other developing countries that have not yet set up the role of dental hygienists or are in an initial stage.

Community-aware empathetic social choice for social network group decision making

To study how interdependent and self-interested decision makers collectively make a choice in highly complex social environments, this paper presents a novel and powerful Community-Aware Empathetic Social Choice (CAESC) model, which considers decision makers in social networks as autonomy-oriented agents, who derive utility based on both their own intrinsic preferences, and empathetic preferences determined by the satisfaction of their intra-community neighbors. We devise optimization approaches for identifying community structures with local (global) social welfare maximizing under two varieties of CAESC models: The local CAESC model first identifies the non-cooperative behaviors by calculating the structure-preference coordination coefficients between pairwise decision makers, then employs the Logit response like dynamics process in a carefully defined potential game to find the optimal community structure that maximizes the local social welfare. To find the optimal community structure that maximizes the global social welfare, the global CAESC model is composed of three coupled phases during each stage: (i) opinion evolution within each community using the classic Jacobi method; (ii) structure-preference coordination matrix updating based on the current opinion vector; and (iii) local optimal community structure updating based on the local CAESC model. Extensive experiments on both randomly generated and real-world social networks with synthetic and real-world preferences confirm that neglecting the empathetic effect and community structure usually yields sub-optimal group decisions which degrade the social welfare of network members. Our experiments also show that, the higher societal empathy, the rougher preference distribution and the denser network structure will facilitate the maximal social welfare reaching in both local and global CAESC models; meanwhile, by comparing with the typical empathetic decision making models and some recent proposed consensus reaching methods, our proposed approaches show relatively significant advantages in terms of candidate ranking and decision efficiency.

Determining the core competencies for international postgraduate nursing students in internship programs: A delphi study

AimTo determine the core competencies of clinical internships for international postgraduate nursing students undertaking a two-year professional program in China. BackgroundClinical internship is an important part of nursing education and is the cornerstone for the future training of nursing professionals. However, in terms of providing a basis for the training and assessment of international postgraduate nursing students undertaking a two-year professional program in China, their core competencies of clinical internships have not yet been sufficiently determined. MethodsFocus group interviews and a two-round Delphi method were conducted. The preliminary list of core competencies was determined based on a scoping review and focus group interviews. Subsequently, experts provided suggestions for modifications to the core competencies in two rounds of the Delphi survey. The response rate (RR), composite reliability (Cr), coefficient of variation and Kendall coefficient of indices were calculated. ResultsTwenty experts completed two rounds of Delphi expert consultation and reached consensus on five first-level indices and 13 s-level indices with 27 connotations. The RR values for the two rounds of consultation were 100 %, the Cr values were 0.853 and 0.873 and the Kendall coordination coefficients were 0.134–0.250 (p < 0.05). ConclusionThe core competencies identified in this research can provide a basis for further training international postgraduate nursing students undertaking a two-year professional program in China through internship programs. This research also provides a reference for effectively evaluating and improving clinical programs.

Theoretical calculation method for critical buckling load of locally stiffened U-shaped steel sheet pile using the dynamic coordination coefficient method

In order to solve the problem that U-shaped steel sheet piles (USSSPs) are prone to buckling when inserted, we propose a local stiffened U-shaped steel sheet pile destabilization critical load calculation method, namely ‘dynamic alignment coefficient method’, and analyze the influence of stiffening area, stiffening position and number of stiffening plates on the stiffening effect.The study shows that when the total stiffening area is certain, there is a scheme of stiffening plate arrangement to maximize the critical load value of USSSPs with determined length,and reveals the law of local instability caused by the small width of single stiffening plate when the number of blocks is too large. The critical load value of the member can be increased by 13.55% with the variation of the single stiffener plate arrangement position for 10 m long USSSPs, and the optimized theoretical scheme of stiffener plate arrangement for 10 m and 30 m long USSSPs with different total stiffener area is obtained.

Is Balance Training Using Biofeedback Effective in the Prophylaxis of Falls in Women over the Age of 65?

The paper aims to investigate the usefulness of training in improving mobility and reducing the risk of falls of patients with osteoarthritis by using a force plate and virtual reality as rehabilitation tools. The study involved 72 women randomly divided into two equal groups: the force plate training group, which underwent virtual balance training with visual motor feedback, and the gym training group, which received conventional balance training only. The functional balance assessment was performed before and after the rehabilitation by computerized posturography in a relaxed upright position with open and closed eyes, with visual motor feedback. In the FPT group in the feedback measurement, the mean radius of sways was 30% smaller after rehabilitation (p < 0.00002); the feedback coordination coefficient was more than 10% bigger after rehabilitation (p < 0.001) and reached 92%, which is excellent for elderly people. Total stagnation and stumbling reported by patients decreased after rehabilitation compared to the first examination. Both tested forms of training can contribute to reducing the risk of falls. However, a more significant improvement was obtained in the force plate training group perhaps because the physical effort on a force plate trains the precise movements needed to reposition the centre of gravity without generating excessive inertia forces responsible for loss of balance and falls. Perhaps the most desirable method of intervention is to train a person's ability to perform slow but definite body movements.

Development of the peer-supported open dialogue attitude and competence inventory for practitioners: A Delphi study.

Peer-supported Open Dialogue (POD) is a novel approach to mental health care that is currently being practiced and researched in the United Kingdom. For POD to be successfully implemented, effective training must be provided to make sure trainees are prepared to deliver the approach as intended. Therefore, a specific instrument that can assess the development and competence of POD trainees, as well as the effectiveness of POD training is crucial. Therefore, the current study aimed to establish an inventory named the Peer-supported Open Dialogue Attitude and Competence Inventory (PODACI), measuring the changes in attributes and attitudes of trainees before and after training. To generate the inventory, a four-round modified Delphi approach was used. We first identified the dimensions that are essential and specific to POD through an extensive literature review and individual interviews with practitioners (n = 8). After generating the items, we further refined the items through two rounds of questionnaires, asking practitioners to rate the relevance of each item from 1 (not essential) to 4 (highly essential; n = 21 and n = 10), and finalized the inventory via a focus group interview with POD trainers (n = 4). In total, 76 items were included in the PODACI. A good consensus on the items was reached: the median score of the items was all above 3.00 (essential) and achieved an agreement level greater than 85%. The Kendall coordination coefficient W was 0.36 and 0.28 in the two questionnaires employed, indicating a fair level of agreement between participants. The PODACI provides a way to measure attitudinal and competency factors related to the treatment integrity of POD as well as the efficacy of the training courses being offered. This highly enriched instrument opens up a wide range of possibilities for POD research and application, facilitating the development of Open Dialogue services. The next step is to assess the psychometric properties of the inventory.

Spatial correlation network of pollution and carbon emission reductions coupled with high-quality economic development in three Chinese urban agglomerations

China's objective to achieve peak carbon by 2030 and carbon neutrality by 2060 and the strategy of realising high-quality economic flows are vital to the transition towards ecological, green, and low-carbon development. We calculated the coupling coordination between pollution and carbon reductions and economic quality in three of the largest urban agglomerations in China the Beijing-Tianjin-Hebei (BTH), Yangtze River Delta (YRD), and Pearl River Delta (PRD) between 2010 and 2019. We used a modified gravity model and social network analysis the overall correlation and network structure and its influence on individual cities. The coupling coordination coefficient in the three urban agglomerations displayed a fluctuating upward trend, whereas the spatial distribution changed from dispersed to centralised and uniform. The intensity of spatial coupling connections had a complex interweaved, multi-directional network structure, with intensifying inter-urban connections. The direction of coupling spatial connections remained stable, with marked geographical proximity and central city features. In terms of individual network structure, most of the spatial associations are dominated by central cities or developed cities. In the process of coupling and coordination and improvement, central cities lead, sub-level cities pass, and marginal cities lag behind.Based on the results, some policy recommendations are finally made for pollution and carbon emission reductions coupled with high-quality economic development.

Construction of the Upper Limb Vocational Ability Assessment System: Based on ICF

<i>Objective</i>: To initially construct a comprehensive assessment system for upper extremity occupational competence based on the International Classification of Functioning, Disability and Health (ICF), and to provide a reference for the development of comprehensive intervention programs covering physiology, psychology, function and social participation for patients with upper extremity injuries. <i>Methods</i>: Taking the comprehensive ICF core set for vocational rehabilitation as the basic framework, using the Delphi expert correspondence method, after a two-round email-based survey with experts who are experience in clinical, vocational rehabilitation, rehabilitation, nursing. Combined with the statistical results and expert opinions, the index of the ICF upper limb vocational ability evaluation system was finally established. <i>Results</i>: The effective recovery rates of the two rounds of expert correspondence were 95% and 100%; the expert authority coefficients (Cr) were 0.807 and 0.805, and the Kendall coordination coefficients were 0.290 and 0.374 (P<0.001). The average importance value ranged from 3.52-4.48. The variation coefficients ranged from 0.103-0.222, The ICF upper limb vocational ability assessment system include 4 first-level indicators and 41 second-level indicators. <i>Conclusion</i>: The construction process of the ICF upper limb vocational ability assessment system is scientific and reliable, which promotes the clinical application and promotion of the brief version of the ICF core combination, and provides reference for the formulation of the ICF assessment combination for other diseases.

Construction of a Quality Evaluation system for Emergency Pre-examination and Triage under the Normalization of the COVID-19 Epidemic based on the SERVQUAL Model

Background: The effect of emergency epidemic prevention and control and the quality of emergency pre-testing and triage under the normalization of COVID-19 epidemics was evaluated by quality evaluation system based on the SERVQUAL model. Objectives: This study aimed to develop a quality evaluation system for emergency pre-test and triage under a normal COVID-19 epidemic, based on the SERVQUAL model. Methods: Based on the SERVQUAL model, a quality evaluation system of emergency pre-examination and triage under the normalization of the COVID-19 epidemic was developed. Two rounds of expert consultation were conducted by the Delphi method, involving 15 experts. Results: The recovery rates for the two rounds of expert consultation were 100 %, the expert authority coefficient was 0.954, and the Kendall coordination coefficients were 0.273 and 0.182. The coefficients of variation of the three-level indicators of the two rounds of expert consultation were 0.003-0.275 and 0.052-0.125, respectively. An evaluation system including 5 first-level indicators, 14 second-level indicators, and 42 third-level indicators of 5 dimensions (tangibility, reliability, responsiveness, assurance, and empathy) of the SERVQUAL model was established. Conclusion: Based on the SERVQUAL model, a quality evaluation system for emergency pre-examination and triage under the normalization of the COVID-19 epidemic situation was completed. It reflected the medical services, triage, and epidemic prevention and control required to provide the requisite quality of emergency pre-examination and triage under the normalization of the COVID-19 epidemic situation. It provided a reference for the quality supervision of emergency pre-examination and triage under the normalization of the COVID-19 epidemic situation.

Coordination evaluation of urban tourism and urban development based on TOPSIS method—a case of Xiamen city

Facing the current situation of tourism and urban prosperity and development, whether there is a contradiction between urban tourism and urban development, and whether they can always coordinate with each other will affect the sustainable development of both. In this context, the coordination of urban tourism and urban development has become an urgent research object. Based on the statistics of twenty indicators of urban tourism and urban development in Xiamen from 2014 to 2018, the article uses the TOPSIS analysis method to develop the number of tourists. Research results show that (1) the selected indicators all showed significant growth characteristics, and over time the coordination coefficient increases year by year and gradually approaches the ideal optimal value. (2) Among them, 2018 has the highest coordination coefficient, 0.9534. (3) The occurrence of "big events" has a double-sided effect on urban tourism and development coordination.

Construction and verification of a quantitative index system to evaluate the medical and nursing care for the elderly service needs.

To construct a quantitative index system with the integrated medical and nursing care assessment for the elderly service needs, this system can assess the cost of medical and care services accurately and objectively, so as to provide scientific basis for the allocation of old-age service resources in China. Based on the survival needs of the Existence, Relation and Growth theory, an index system is constructed through literature analysis, group discussion, and expert correspondence. Analytic hierarchy process was used to determine the weights of indicators at all levels. The 3-grades service items corresponding to each index were quantified through the measurement of working hours, and the medical and nursing care needs of 624 disabled/demented elderly people over 60 years old in Changsha were investigated to evaluate their reliability and validity. The authoritative coefficients of the 2 rounds of expert correspondence were 88.5% and 88.6%, respectively, and the opinion coordination coefficients were 0.159 and 0.167, respectively. The final quantitative evaluation index system included 4 first-level indicators, 17 second-level indicators, and 105 third-level indicators. The service time of doctor ranged from 6.01 to 22.64 min, the service time of nurses ranged from 0.77 to 24.79 min, and the service time of caregiver ranged from 0.12 to 51.88 min. The Cronbach's αcoefficient was 0.73, the split-half reliability was 0.74, the content validity was 0.93, and the calibration validity was 0.781. The quantitative evaluation index system of medical and nursing service need for the elderly can be used to accurately evaluate the medical and nursing service need.

Establishment of infection prevention and control strategy in nursing managements during surgical operations in COVID-19 patients based on Delphi method.

The aim of this study was to establish an infection prevention and control strategy for nursing managements during surgical operations in coronavirus disease 2019 (COVID-19) patients. A Delphi method. Between November 2021 and March 2022, we first formulated a preliminary infection prevention and control strategy based on the literature review and institutional experience. Then, we applied Delphi method and performed expert surveys to reach a final strategy for nursing managements during surgical operations in COVID-19 patients. The strategy included seven dimensions with 34 items. The positive coefficients of Delphi experts in both surveys were 100%, indicating a high coordination among experts. The degree of authority and expert coordination coefficient were 0.91 and 0.097-0.213. After the second expert survey, value assignments for importance of each dimension and item were 4.21-5.00 and 4.21-4.76 points, respectively. The coefficients of variation for dimension and item were 0.09-0.19 and 0.05-0.19, respectively. Except the medical experts and research personnel, there was no other patient or public contribution involved in the study.

Development and validation of the regarding infection prevention and control among environmental service workers on knowledge, attitudes, practise, and experience questionnaire.

This study aimed to develop and test the validity and reliability of the Knowledge, Attitudes, Practise, and Experience regarding Infection Prevention and Control-associated Questionnaire for environmental service workers. This study was a development and validation study of a questionnaire using multiple methods, including literature review, questionnaire survey, and Delphi technique. Phase I of the study entailed the development of items through an extensive literature review and two round Delphi process with 15 experts specialised in infection prevention and control, environmental service worker management, or scale construction to examine the content validity of the questionnaire. Phase II involved administering the questionnaire to a convenience sample of 1,176 environmental service workers from the public hospital from 13 provinces in China to evaluate its construct validity and reliability. In the two rounds of Delphi consultation, the recovery rate were 93.75 and 100%. Moreover, the expert authority coefficient was 0.93, and the coordination coefficients of expert opinions in the first round were as follows: correlation of 0.204 and importance of 0.249 for the first-level index; correlation of 0.128 and importance of 0.142 for the secondary index. In round two, the coordination coefficients of expert opinions were as follows: correlation of 0.221 and importance of 0.221 for the first-level indicators; correlation of 0.096 and importance of 0.101 for the secondary index. The results for the index were P < 0.05 for the two rounds. The pilot survey shows the instrument was excellent content validity (S-CVI/Ave = 0.989). The overall internal consistency was excellent (Cronbach's α = 0.967). The questionnaire ultimately comprised four first-level indices (knowledge, attitudes, practise, and experience) and 49 second-level indices. The Questionnaire demonstrated good reliability and validity and is effective in measuring levels of infection prevention and control-related knowledge, attitudes, practise, and experience among environmental service workers. It will provide a tool for future national investigations of the current infection prevention and control situation among environmental service workers. Future research should explore determinants of environmental service workers' knowledge, attitudes, practise, and experience and associations between infection prevention and control knowledge, attitudes, practises, and experience.

Establishment of early warning indicators of SARS-CoV-2 Omicron variant in Tianjin

In this study, Delphi method was used to conduct a questionnaire survey on 12 experts to determine the indicators system and the corresponding weight for early warning features of SARS-CoV-2 Omicron in Tianjin.The positive indexes of experts in three rounds of consultations were both 100%. The experts' authority coefficient was 0.79. The Kendall's W coordination coefficients were 0.375, 0.356 and 0.385 respectively (all P<0.05). The indicators system for early warning features of 2019-nCoV Omicron variant had 5 first-level indicators, 10 second-level indicators and 52 third-level indicators. The weight of each indicator was also determined.

Construction of a sport-specific strength and conditioning evaluation index system for elite male wheelchair badminton athletes by the Delphi method

In this study, the Delphi method was used to construct the evaluation index system of the specific physical fitness of Chinese wheelchair badminton players. The Delphi method was used in the first two rounds to determine sport-specific strength and conditioning evaluation indexes for wheelchair badminton athletes. The Analytic Hierarchy Process was used in the third round to determine the weighting of each index. The results indicate that the recovery rate of questionnaires in the first two rounds was higher than 90%, the degree of expert authority was &gt;80%, the degree of expert coordination in the second round was 0.350 and was greater than that in the first round (0.298), and significance testing of the coordination coefficient was significant (p &lt; 0.001), thus indicating that expert opinions were consistent. Results during construction of the evaluation system were credible. Ultimately, we identified four primary indicators, 12 secondary indicators, and 30 tertiary indicators. The order of the four primary indices in terms of weighting was as follows: sport-specific skills (0.4406), sports qualities (0.2928), cardiorespiratory function (0.1828), and body shape (0.0838). We used the Delphi method to construct an evaluation index system for the sport-specific physical ability of elite male wheelchair badminton athletes. The index system exhibited high credibility and specificity for wheelchair badminton.

Spatiotemporal Characteristics of Coupling and Coordination of Cultural Tourism and Objective Well-Being in Western China

A supply of high-quality cultural tourism products effectively promotes people's happiness. This study takes the coupling and coordination relationship between cultural tourism (CT) and objective well-being (OWB) in western China as the research object and constructs an index evaluation system for the development levels of cultural tourism and objective welfare, which are divided into three development stages of dysfunctional, transitional, and coordinated development and 10 coordination levels, including high-quality coordination. The entropy weight method, coupled coordination model, Thiel index, standard deviation, and coefficient of variation were used to calculate the comprehensive development index and coupling coordination degree of the CT and OWB systems in western China from 2007 to 2020, and then their evolution characteristics were analyzed from the perspectives of time and space. The results show the following: (1) The comprehensive development capacity of the CT and OWB systems in the western region shows a relatively consistent growth trend except for 2020, the overall development capacity of objective welfare was relatively high, and the development capacity of cultural tourism was relatively low. (2) The CT and OWB systems were in a state of transition from high coupling and low coordination to high coupling and high coordination, which were divided into three development stages: imbalanced stage (2007-2008), transitional stage (2009-2011), and coordinated development (2012-2020). The coordination degree has developed steadily from moderate misalignment to good coordination over time, and the diversified characteristics of coupling coordination levels are obvious. (3) The spatial equilibrium of the CT and OWB systems is obvious, and the spatial difference in the western region is getting smaller, but the relative gap is widening significantly. (4) The comprehensive development capacity of the cultural tourism system should be enhanced, the spiritual needs of residents based on objective well-being should be met, and the sustainable development of the CT and OWB systems.

Development of the health literacy assessment instrument for chronic pain patients: A Delphi study.

To develop health literacy assessment instrument for patients with chronic pain. Qualitative methods based on Delphi technique, assessed against the CREDES checklist. A 2-round Delphi method was adopted in this study. The panel consisted of 19 experts. The health literacy assessment instrument for chronic pain patients was constructed, which contained 3 dimensions (functional health literacy, interactive health literacy and critical health literacy) and 41 items. The positive coefficients of two rounds Delphi were 100.00% and 89.5%, respectively. The authority coefficient of experts was 0.848 and 0.858, respectively. The coordination coefficients of dimension and items were 0.222 and 0.364, respectively. The health literacy assessment instrument dimensions and items for patients with chronic pain based on a Delphi method are valid. This instrument is suitable for investigating the health literacy level of patients with chronic pain.

Construction of early warning indicators of in-hospital cardiac arrest in adult inpatients

To establish early warning indicators for Chinese nurses to recognize in-hospital cardiac arrest (IHCA) of adult inpatients. Computer retrieval of Chinese and English databases such as CNKI, Wanfang Database, VIP, National Medical Library of the United States PubMed Database, Web of Science, Embase Database of the Netherlands Medical Abstracts, Cochrane Library Database and other international guidelines collaboration network (GIN), National Institute for Health and Clinical Optimization (NICE), Scottish Intercollegiate Guidelines Network (SIGN), BMJ best clinical practice and other guidelines was performed. The retrieval time limit for respiratory and cardiac arrest early warning indicators or risk identification related content of the adult inpatient in the professional website was until June 30, 2020. After literature research and expert group analysis, the research group drew up an expert correspondence questionnaire, and selected 32 medical and nursing experts from Beijing, Tianjin, Jilin, Shandong, Shaanxi, Sichuan, Zhejiang and other grade three first-class general hospitals from July to September 2022. The Delphi method was used to conduct two rounds of expert correspondence, forming the final version of the early warning index of cardiac arrest in adult inpatients. Five first-level indicators, 23 second-level indicators and 41 third-level indicators including vital signs, consciousness and pupils, postoperative blood drainage volume, lab results and other five aspects were initially formed. The effective response rates of the two rounds of expert correspondence were 100% (32/32) and 93.75% (30/32), respectively, the Kendall coordination coefficients W of the first round and the second round were 0.340 and 0.462, respectively, the expert authority coefficients Cr were 0.88 and 0.89, respectively, the mean value of importance assignment was 3.94-5.00, 4.07-5.00, and the coefficient of variation was 0-0.16, 0-0.14, with statistically significant differences (all P < 0.05). Finally, 5 primary indicators, 23 secondary indicators and 43 tertiary indicators were formed, including five aspects of vital signs, consciousness and pupils, postoperative blood drainage, lab results, symptoms and chief complaints. The expert consultation on the early warning indicators of IHCA for adult patients tends to be consistent and scientific, which is applicable to help nurses detect the changes of patients' condition as early as possible.

Construction of a nurses' interpersonal communication knowledge system: A Delphi study

BackgroundEffective communication is essential for nursing students to provide safe patient care. Many communication consensuses focus on physician-associated communication rather than nurses' interpersonal communication. However, studies on developing a systematic and comprehensive communication knowledge system for nursing students are scarce. ObjectivesTo explore the teaching content and teaching framework of nurses' interpersonal communication, construct a systematic and scientific knowledge system for interpersonal communication among nursing students and provide a theoretical basis for the training of nurses on interpersonal communication. MethodsBased on the literature review and comparative research, this study explored the theoretical basis and basic principles of constructing an interpersonal communication knowledge system for nurses. Moreover, a correspondence questionnaire on nurses' interpersonal communication knowledge systems was initially constructed to clarify the related teaching content and structure. Finally, the Delphi method was used to establish the index of the nurses' interpersonal communication knowledge system according to the principle of expert selection and inclusion criteria. ResultsThe Delphi method included 26 experts from nursing education, clinical nursing, nursing management and other fields for consultation. The effective response rate of the letter inquiry was 96.3 % in the first round and 100 % in the second round. The judgment basis, familiarity and authority coefficient of expert consultation were 0.907, 0.862 and 0.884, respectively. In the two rounds of inquiry, the coordination coefficients of the total questionnaire were 0.228 and 0.302, which was statistically significant (P < 0.001). Thereafter, a wheeled model of nurses' interpersonal communication knowledge system with 3 primary indicators, 13 secondary indicators and 58 tertiary indicators was constructed, which included professional ethics and attitude, communication knowledge and communication skills. ConclusionLiterature and comparative research methods along with Delphi expert consultation were used to construct a scientific and systematic knowledge system of nurses' interpersonal communication. The research methods were feasible, and the results were scientific and reliable, thereby providing a basis for the education of nurses' interpersonal communication among nurses and the compilation of related teaching materials in China and globally. Furthermore, special attention should be paid to the comprehensive cultivation of nursing students' professional ethics and attitude, communication knowledge and communication skills.

Evaluation and Prediction of Ecological Sustainability in the Upper Reaches of the Yellow River Based on Improved Three-Dimensional Ecological Footprint Model.

Ecological footprint is an important method for regional sustainable assessment. Scientific assessment of the ecological sustainability of the upper reaches of the Yellow River is of great significance to the realization of a win–win situation for the ecological environment protection and economic development of the entire Yellow River basin. Based on the improved three-dimensional ecological footprint model, this paper measures and spatially portrays the ecological footprint per capita depth (EFdepth), ecological footprint per capita size (EFsize), and ecological footprint per capita 3D (per capita EF3D) of the upper Yellow River region from 2011 to 2020. Then, the ecological footprint diversity index (EFDI), integrated land stress index (Icomprehensive), ecological stress index (ETI), and ecological coordination coefficient (ECC) are used to evaluate its ecological safety and sustainability. The results of the study indicate that: (1) From 2011 to 2020, the three-dimensional ecological footprint of all provinces and regions in the upper reaches of the Yellow River was in a fluctuating upward trend as a whole, and NMG had the highest growth, from 2.6256 hm2/person to 3.3163 hm2/person, with an average annual growth rate of 2.36%. (2) In the past 10 years, the ETI index of the upper reaches of the Yellow River increased from 2.13 in 2011 to 3.28 in 2020, which is a serious insecurity. The EFDI index fluctuates slightly, but increases year by year. (3) The capital flow occupancy rate of the upper reaches of the Yellow River has been above 86.67%, and fluctuated during the study period, reaching a peak of 88.61% in 2020. (4) In the four periods, the number of land comprehensive pressure states and ecological security pressure states of the provinces and regions in the upper reaches of the Yellow River show a distribution pattern that the northeast region is better than the southwest region. This study is expected to provide scientific reference for land use in the upper reaches of the Yellow River, building the ecological security barrier of the Qinghai Tibet Plateau, and promoting sustainable socio-economic development.