Table of Content

15 December 2022, Volume 19 Issue 12 Previous Issue    Next Issue

Research Paper

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Design and implementation of Health Informatics Course from the perspective of international interprofessional collaboration YANG Yang, REN Yuanpeng, XU Qin, YANG Rumei 2022, 19 (12):  1061-1666.  doi: 10.3761/j.issn.1672-9234.2022.12.001 Abstract ( 542 )   HTML ( 0 )   PDF (1028KB) ( 16 )   Save Figures and Tables | References | Related Articles | Metrics Guided by constructivism and cognitive load theory，an international teaching team consisted of teachers with multidisciplinary backgrounds was developed to design and implement Health Informatics Course with the aim of advancing medical students’ interdisciplinary thinking and informatics knowledge. Health Informatics Course is based on multi-disciplinary integrated course curriculum，multi-dimensional curriculum operation，and formative evaluation，all of which make the course high-order，innovative，and challenging. After 3 semesters of implementation，a total of 147 undergraduates from 21 different majors，including medicine，nursing，preventive medicine，medical informatics etc.，took the course. The pass rate（≥60 points） was 97%. Students recognized that the course could stimulate their interests in learning，deepen their understanding of the frontiers of health informatics，and expand their international vision. Interprofessional collaborative learning is helpful to cultivate students’ higher-order thinking. The course has been shown to have promising results，but further exploration is needed to better explore how to break through the boundaries of disciplines while retaining the original discipline characteristics.

Building and Application of Intelligent Nursing Platform

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The current status and usability evaluation of the ehealth applications in older patients with breast cancer WANG Suxing, ZHANG Enming, CUI Jiasong, DAI Zhengyue, SHEN Yixiao, FANG Qiong 2022, 19 (12):  1067-1072.  doi: 10.3761/j.issn.1672-9234.2022.12.002 Abstract ( 257 )   HTML ( 0 )   PDF (961KB) ( 11 )   Save Figures and Tables | References | Related Articles | Metrics Objective To investigate the current status and to evaluate the usability of the ehealth applications in older patients with breast cancer. Methods A mixed method was used in the study. We investigated the usage of mobile programs among 236 older patients with breast cancer and the System Usability Scale was further used. In addition，semi-structured interviews were conducted with 13 older patients with breast cancer who used mobile medical programs. Results A total of 122 patients（51.69%） did not use the ehealth application，64 patients（27.12%） were assisted by family members，and only 50 patients（21.19%） reported that they used it. The reasons that older adults did not use mobile programs included having no knowledge of these medical programs applications （n=88） and being not able to use（n=76）. Logistic regression analysis showed that the education level，type of caregiver，and stage of treatment were independent factors of the use of the ehealth applications in older patients with breast cancer（P<0.05）. The total score of the App System Usability Scale was（58.05±13.97）. Two themes and five sub-themes emerged from the interview data：positive experience of App use（comprehensive platform functions，convenience and practicality，targeted and credible scientific contents）；limitations of the App and suggestions for improvement（operation methods need to be improved，more interactive design，the program interface needs to be improved for aging，and the integration of emotional support）. Conclusion Older patients with breast cancer do not pay much attention to the existing applications，and the system usability of the mobile medical application among them is low. The operation level and interface of the applications are low. The application needs to be improved according to the characteristics of the older adults.

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Research on construction and application of intelligent cloud inpatient health education platform in diabetes patients SUN Yujiao, ZHANG Ning, ZHANG Hongmei, LU Yi, CHEN Yanqin, DING Miao, ZHANG Hui 2022, 19 (12):  1073-1076.  doi: 10.3761/j.issn.1672-9234.2022.12.003 Abstract ( 363 )   HTML ( 0 )   PDF (1073KB) ( 19 )   Save Figures and Tables | References | Related Articles | Metrics Objective To build an intelligent cloud inpatient health education platform and explore the application effect with diabetes patients preliminary. Methods The public cloud and private cloud computing technology were integrated to build an intelligent cloud inpatient health education platform. The platform has three ports：clinical nursing，patient management and nursing management. It has the functions of sending diabetes multimedia education content，receiving health education evaluation feedback，and grading health education management. A diabetes health education resource library was built，taking diabetic patients as a pilot and classified them based on types. In addition to in-person education，nurses sent health education information to patients via the platform according to patients’ needs and path-based forms and make sure patients read it. The head nurse checked nurses’ implementation and health education feedback through the platform. The study compared the nurses’ time spent on patient health education and patients’ satisfaction before（30 patients from September to November 2018 as the control group） and after（30 patients from September to November 2020 as the test group） the application of the platform. Also，25 nurses were surveyed with a questionnaire about their satisfaction with the platform. Results After application of the platform，time of nursing health education was（12.25±7.38） min，which was significantly lower compared to（26.36±8.07） min before using the platform（t=6.933，P<0.001）. No significant difference was founded in patients’ satisfaction of health education（43.13±4.63 vs 41.50±6.28，t=2.406，P=0.257）. The average satisfaction score from nurses of the platform was ≥4. Conclusion The intelligent cloud inpatient health education platform is helpful in reducing the time spent on health education and improving the patients’ satisfaction. Besides，nurses were satisfied with the intelligent cloud inpatient health education platform.

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A study on the development and application of distance training courses on health management of chronic heart failure for community health workers TAN Yaru, XU Cuirong, XU Xiaolu, HAO Tiantian 2022, 19 (12):  1077-1080.  doi: 10.3761/j.issn.1672-9234.2022.12.004 Abstract ( 231 )   HTML ( 1 )   PDF (671KB) ( 10 )   Save Figures and Tables | References | Related Articles | Metrics Objective To develop and explore the application effect of the distance training courses on health management of chronic heart failure for community health workers. Methods A training and teaching group for chronic heart failure health management of community medical staff was set up to develop training courses. Then，the distance training for community health workers was conducted in a medical alliance with a remote training platform. Finally，course assessment and questionnaires survey among 333 community health workers were used to collect feedback on the distance training courses and evaluate the application effect. Results All of the community health workers completed the course and passed the assessment examinations. Their satisfactions with the training was≥97.00%. Conclusion Under the epidemic environment，the training program designed and developed according to the characteristics of the community， can provide convenient training method for community health workers with chronic heart failure health management. All the trainees could complete the training as required and were satisfied with the training.

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Development and application of an intelligent platform for homogenous comprehensive assessment of the older adults CAO Ziwei, YUE Liqing, PENG Hua, HUANG Weihong, HU Jianzhong, LI Jing, LUO Aihong 2022, 19 (12):  1081-1085.  doi: 10.3761/j.issn.1672-9234.2022.12.005 Abstract ( 292 )   HTML ( 0 )   PDF (1820KB) ( 11 )   Save Figures and Tables | References | Related Articles | Metrics The expert consultation was adopted to identify the homogenous comprehensive assessment items and tools for the older adults，to determine the homogenous assessment criteria，and to form a health promotion suggestions pool. A scientific，professional，practical and convenient intelligent platform for the homogenous comprehensive assessment of the older adults was finally established and applied. A total of 7 institutions signed up to use the platform from June to December 2021. A total of 144 registered appraisers completed 1，284 evaluations，with a high user satisfaction. The platform unified assessment tools，standardized the assessment process，and ensured assessment quality. This platform is conducive to further promote the comprehensive geriatric assessment in China. The platform is worthy of promotion.

Nursing Education

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A qualitative study of nursing faculty’s resistance to clinical practice from a perspective of stakeholder theory FU Hongqiong, LU Jin, YAO Hui, BAI Ru, ZHU Meiyu 2022, 19 (12):  1086-1090.  doi: 10.3761/j.issn.1672-9234.2022.12.006 Abstract ( 121 )   HTML ( 0 )   PDF (680KB) ( 10 )   Save Figures and Tables | References | Related Articles | Metrics Objective To gain insight into the resistance to clinical practice of nursing teachers through the lens of stakeholder theory. Methods Using the purposive sampling method，a total of 20 interviewees，including teachers participating in clinical practice，school teaching administrators，hospital nursing department heads and clinical instructors，were interviewed by semi-structured questions in two health care schools in Shihezi，Xinjiang. The thematic analysis method was applied to analyze the data. Results The total length of all interviews was 723 min and more than 60，000 words were transcribed. Three themes emerged from the data：conflict of interests within the school（engineering conflict，work-relax conflict，insufficient incentive policy），conflict of interests between the school and the hospital（unclear responsibilities，conflicting practice goals，conflicting practice needs） and lack of shared interests between the school and the hospital（lack of communication and cooperation，lack of hospital main body position）. Conclusion The resistance arising from the conflict of interests in the clinical practice of nursing instructors requires the administrative education department，schools，and hospitals to give incentive policies，strengthen communication and cooperation between schools and hospitals，pay attention to the interests of teachers，schools and hospitals. By these ways，the conflict of interests will be resolved，the shared interests will be realized，and teachers can play greater roles in the clinical practice system.

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A Ricoeur-inspired phenomenological-hermeneutic study of baccalaureate nursing students’ online learning experience ZHANG Heng, CHEN Lixia, DU Shizheng 2022, 19 (12):  1091-1095.  doi: 10.3761/j.issn.1672-9234.2022.12.007 Abstract ( 121 )   HTML ( 0 )   PDF (740KB) ( 10 )   Save Figures and Tables | References | Related Articles | Metrics Objective To investigate and interpret the online learning experience of baccalaureate nursing students for further improvement of educational efficiency. Methods Purposive sampling method was utilized，and 13 baccalaureate nursing students who participated in online learning were individually interviewed. A Ricoeur-inspired phenomenological hermeneutic approach including naive reading，structural analyses，and critical interpretation was adopted to analyze and interpret the narrative text. Results Four themes with seven subthemes were formulated from the data，including：the need to adapt to the new learning environment （being overwhelmed by learning resources；being tired of the increased burden of schoolwork；being forced to change the learning style）；enjoying the online interaction（being more active and freer in participating in interaction）；the need for self-control and heteronomy（low learning efficiency；harm to eyesight and physical health） and expecting necessary offline training （being unsatisfied with practical training）. Conclusion The shift to an online learning environment poses challenges for both teachers and students. For students，it is necessary to cultivate the spirit of independent learning and develop self-discipline. For teachers，it is necessary to constantly reflect on and adjust online teaching strategies and encourage effective student participation to achieve desired teaching results.

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Development and preliminary application of a formative evaluation program based on the PBL teaching GAO Huanling, ZHANG Hong, LI Hongmei, ZHOU Xue, LIU Aimei, SONG Ge 2022, 19 (12):  1096-1099.  doi: 10.3761/j.issn.1672-9234.2022.12.008 Abstract ( 154 )   HTML ( 0 )   PDF (731KB) ( 9 )   Save Figures and Tables | References | Related Articles | Metrics Objective To develop a formative evaluation program based on PBL teaching and to apply it initially. Methods A course team was established，and a formative evaluation program based on PBL teaching was developed through the evaluation of the current situation of PBL teaching，literature review and expert meetings. This evaluation program covered the main stages of PBL teaching（scenario creation，self-directed learning，group cooperation，and achievements exchange）. The program included 4 first-level indicators and 15 second-level indicators and the corresponding evaluation standards. The evaluation program was initially applied in the PBL teaching of Geriatric Nursing in 60 nursing undergraduates. After the course teaching，students’ formative evaluation scores were recorded and their satisfaction level was surveyed. Results The total score of the PBL teaching formative evaluation was（78.42±2.58），and the overall satisfaction with the course evaluation plan after the course was 83.33%. Conclusion The evaluation program is in line with the professional training objectives and PBL teaching objectives，and is operable. Students are satisfied with the program.

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Design and practice of the Ideological and Political Education by the integrated cases in Medical Nursing HU Rong, SHEN Ling, ZHUANG Jiayuan, CHEN Yimin, CHEN Meijing 2022, 19 (12):  1100-1105.  doi: 10.3761/j.issn.1672-9234.2022.12.009 Abstract ( 164 )   HTML ( 0 )   PDF (868KB) ( 13 )   Save Figures and Tables | References | Related Articles | Metrics Objective To design and explore the effectiveness of the Ideological and Political Education in Medical Nursing. Methods Medical Nursing was designed in four areas，including political literacy，professional literacy，scientific literacy，and humanistic literacy，which were embedded into teaching cases. After teaching practice，semi-structured interviews with 19 nursing students who were randomly selected from the Grade 2019 were conducted to evaluate the effectiveness. Results Students expressed 5 beneficial themes about the ideological and political，including enhancing the professionalism，strengthening the professional beliefs，improving the interest，transforming the way of thinking，and experiencing the spirit of teamwork. In addition，students reported 4 weakness，including lack of in-depth discussion，difficulty in answering question，the existence of ideological and political points similarities，several cases were not practical. The students showed a tendency for real-life examples，videos and pictures materials，and the preferred teaching methods were classroom interaction and role-play in ideological and political education. Conclusion The case-integrated ideological and political education in Medical Nursing turned out to be effective. The students expressed their validation of the teaching method. In the future，we would further improve the quality of the ideological and political education by enriching the elements and integration methods.

Continuing Education

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Training in risk assessment of pressure injury for junior nurses HU Yan, HU Qingxia, CHEN Weiqin, LIU Suyun, CHEN Min, LIU Haijia 2022, 19 (12):  1106-1108.  doi: 10.3761/j.issn.1672-9234.2022.12.010 Abstract ( 163 )   HTML ( 0 )   PDF (593KB) ( 9 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the effects of training in pressure injury assessment for junior nurses. Methods A total of 100 junior nurses from 31 clinical departments in a tertiary hospital in Nanchang city were recruited by convenience sampling. Problems regarding the risk assessment of pressure injury were identified through preliminary investigation. Training was carried out by theory teaching，standardized video production，clinical practice guidance and competition. The scores of quality control of pressure injury risk assessment and the accuracy of risk assessment were compared before and after the training. Results After the training，the scores of quality control of stress injury assessment in junior nurses were higher than those before the training（t=6.674，P<0.001）. The assessment accuracy of the items of sensation，dampness，mobility and nutrition and total accuracy in the assessment of stress injury among junior nurses were higher than those before the training （all P<0.05）. Conclusion The training of risk assessment of pressure injury can standardize the assessment of pressure injury and improve the accuracy of assessment.

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Nurses’ Hospice Knowledge Scale：development，reliability and validity SHEN Yang, LI Xiaohan 2022, 19 (12):  1109-1113.  doi: 10.3761/j.issn.1672-9234.2022.12.011 Abstract ( 158 )   HTML ( 0 )   PDF (705KB) ( 11 )   Save Figures and Tables | References | Related Articles | Metrics Objective To develop the Nurses’ Hospice Knowledge Scale and to test its reliability and validity. Methods The scale was developed through literature review，experts consultation and Delphi method. The cluster sampling was adopted to recruit 335 nurses in tumor ward，ICU and hospice care specialized ward of Shenyang hospital. Eight experts were invited to evaluate the content validity of the scale. Results The Nurses’ Hospice Knowledge Scale had 7 dimensions and 34 items. The Cronbach’s α of the total table was 0.947，and the content validity index was 0.92. A total of 7 common factors were extracted by exploratory factor analysis，and the cumulative variance contribution rate was 85.04%. Conclusion The Nurses’ Hospice Knowledge Scale has good reliability and validity and can be used to measure nurses’ hospice knowledge level.

Health Education

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The experience of participating the preoperative visit in patients undergoing percutaneous coronary intervention：a qualitative study YANG Zengzhen, LIU bin, WEI Qing, BAI Xiaoling, CHENG Zhongsha, LOU Ting 2022, 19 (12):  1114-1118.  doi: 10.3761/j.issn.1672-9234.2022.12.012 Abstract ( 76 )   HTML ( 0 )   PDF (736KB) ( 10 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the experience of participating the preoperative visit in patients undergoing percutaneous coronary intervention（PCI）. Methods Semi-structured interviews were carried out from July to August 2021. Ten patients who participated in the preoperative visit were recruited. Data were analyzed by Colaizzi’s method. Results The interviews lasted for about 330 minutes and approximately 18，000 words were transcribed. Four themes emerged from the data：negative emotions were relieved（less fear，less nervousness），knowledge and attitude were changed（understanding the PCI process，understanding environmental information，actively cooperate in PCI process），access to humane nursing services（patience and carefulness，thoroughness），unmet needs （communication methods need to be improved，being eager for positive support and care，multiple forms of visits）. Conclusion Patients could relieve negative emotions，correctly understand and actively confront the PCI through preoperative visit，and make them feel care and warmth. However，there are still difficulties in language communication and positive support. Nursing managers should strengthen the training of nurses in cardiac catheterization room，improve the preoperative visit，to meet patients’ physiological and psychological demands，improve the satisfaction level with the preoperative visit.

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Mediating effect of exercise self-efficacy between kinesiophobia and amount of physical activity in patients with coronary heart disease HUANG Rong, DING Mei, HUANG Huahua, ZHANG Huawei 2022, 19 (12):  1119-1123.  doi: 10.3761/j.issn.1672-9234.2022.12.013 Abstract ( 108 )   HTML ( 0 )   PDF (602KB) ( 10 )   Save Figures and Tables | References | Related Articles | Metrics Objective To investigate the current status of amount of physical activity，kinesiophobia and exercise self-efficacy in patients with coronary heart disease，and to analyze the mediating role of exercise self-efficacy between kinesiophobia and amount of physical activity. Methods Convenience sampling was conducted with a total of 276 outpatient review patients with coronary heart disease admitted to the department of cardiology in a Grade Ⅲ level A hospital in Ganzhou city，Jiangxi Province from December 2020 to March 2021. General data questionnaire，Physical Activity Rank Scale，Tampa Scale for Kinesiophobia Heart，Exercise Self-efficacy Scale were employed. Results The total score of physical activity，kinesiophobia and exercise self-efficacy in patients with coronary heart disease was（17.58±14.09），（36.32±5.04），and（54.10±26.03），respectively. Exercise self-efficacy played a part of mediating effect between kinesiophobia and physical activity（β=-0.263，P<0.01），and effect ratio was 49.94%. Conclusion Patients with coronary heart disease hold a low level of physical activity. Kinetophobia can directly affect the physical activity of patients with coronary heart disease，and can indirectly affect the physical activity through exercise self-efficacy.

Clinical Practice

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Application of navigation nursing model in postoperative chemotherapy patients with lung cancer XU Yulin, LI Hao, WANG Xiaodong, YUAN Yuan, JIANG Qiuling, HAO Xianfang 2022, 19 (12):  1124-1129.  doi: 10.3761/j.issn.1672-9234.2022.12.014 Abstract ( 128 )   HTML ( 0 )   PDF (769KB) ( 10 )   Save Figures and Tables | References | Related Articles | Metrics Objective To evaluate the effects of navigation nursing model in postoperative chemotherapy patients with lung cancer. Methods From July to November 2020，postoperative chemotherapy patients with lung cancer who were hospitalized were selected into an experimental group（n=39） and a control group（n=41） according to the ward of the hospital. The patients in the control group received routine care and health education. The experimental group was given the navigation nursing mode，and the nurse acted as the navigator to carry out nursing intervention based on the patient’s needs assessment during outpatient treatment，hospitalization and discharge. The self-management ability was compared between the two groups at admission，at the end of and one month after the intervention. The unplanned readmission was compared at one-month and three-month after the intervention. Results Interactive effect in time and grouping（Finteraction=57.439，P<0.00l） was founded in the scores of cancer patients’ self-management evaluation scale between the two groups. Besides，simple effect analysis showed that the scores of the cancer patients’ self-management evaluation scale in the experimental group were higher than that in the control group（P<0.001） at the end of the intervention and one month after the intervention. Also，the experimental group was better than the control group（P<0.05） with regard to the unplanned readmission rates at three-month after the intervention. Conclusion The navigation nursing model can improve the disease management ability of postoperative chemotherapy patients with lung cancer，as well as reduce the frequency of unplanned hospitalizations.

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The effects of resistance exercises on the metabolism-related indicators of menopausal women：a systematic review WU Lili, YANG Na, ZHAO Hui 2022, 19 (12):  1130-1135.  doi: 10.3761/j.issn.1672-9234.2022.12.015 Abstract ( 102 )   HTML ( 0 )   PDF (729KB) ( 9 )   Save Figures and Tables | References | Related Articles | Metrics Objective To systematically evaluate the effects of resistance exercises on the metabolism-related indicators of menopausal women using meta-analysis. Methods We searched databases including Cochrane Library，PubMed，Embase，CNKI，Wanfang etc. to collect studies about the effects of resistance exercises on the metabolism-related indicators of menopausal women published from their inception to August 2021. Meta-analysis was performed using RevMan 5.2 software after two reviewers independently screened the studies，extracted data，and evaluated paper quality. Results Eleven studies were recruited，including 289 participants. The results of meta-analysis showed that resistance exercises could significantly improve the systolic blood pressure[SMD=-0.46，95%CI（-0.92，-0.01），P=0.04]，body mass[MD=-2.20，95%CI（-4.25，-0.16），P=0.03]，and BMI[MD=-0.82，95%CI（-1.61，-0.03），P=0.04]. The results of sensitivity analysis on body mass and BMI showed that there was no statistically significant differences between the two groups，and the meta-analysis results were unstable. However，resistance exercises could not significantly improve diastolic blood pressure[SMD=-0.21，95%CI（-0.66，0.23），P=0.35]，TC[SMD=-0.10，95%CI（-0.54，0.34），P=0.65]，HDL-C[SMD=0.31，95%CI（-0.06，0.68），P=0.10]，LDL-C[SMD=-0.08，95%CI（-0.47，0.32），P=0.69]，TG[SMD=-0.19，95%CI（-0.75，0.37），P=0.51] and blood glucose[SMD=-0.42，95%CI（-1.19， 0.35），P=0.28]. Conclusion Resistance exercises can improve the systolic blood pressure of menopausal women. However，a larger sample size is still needed to provide evidence regarding the effectiveness of resistance exercises on diastolic blood pressure，blood lipids，blood glucose，body mass and BMI of menopausal women.

Review

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Current status of the certification and re-certification conditions of nurse anesthetists FENG Chun, ZHANG Anping, WANG Jing, YANG Jianyang, CHEN Benzhen, LING Tao 2022, 19 (12):  1136-1140.  doi: 10.3761/j.issn.1672-9234.2022.12.016 Abstract ( 139 )   HTML ( 0 )   PDF (608KB) ( 12 )   Save References | Related Articles | Metrics This paper reviewed the certification and re-certification conditions of anesthesia specialist nurses. Besides，the paper discussed the role of the development of international anesthesia specialist nurse certification and re-certification conditions on the certification work of anesthesia specialist nurses internationally through comparative analysis. The establishment of anesthesia specialist nurse certification and re-certification is proposed.

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Research progress of pre-rehabilitation for patients with colorectal cancer ZHANG Huipin, ZHANG Hailin, ZHOU Xiaomin, CHEN Guanjie 2022, 19 (12):  1141-1146.  doi: 10.3761/j.issn.1672-9234.2022.12.017 Abstract ( 133 )   HTML ( 0 )   PDF (728KB) ( 11 )   Save References | Related Articles | Metrics Surgery is one of the main treatment methods for patients with colorectal cancer. Pre-rehabilitation can effectively improve the postoperative functional ability of patients and reduce postoperative complications. This article reviewed the definition of pre-rehabilitation，the implementation personnel of pre-rehabilitation for patients with colorectal cancer，eligible subjects，interventional contents and methods，effects and mechanisms. The article is hoped to provide reference for the implementation of pre-rehabilitation for patients with colorectal cancer.