ABSTRACT
Objective:To explore the status of occupational low back pain among orthopedic nurses, and to investigate the influence of fear-avoidance belief on their work engagement.Methods:A convenient sample of 325 orthopedic nurses were recruited from one tertiary grade orthopedic hospital in Tianjin City. The data collection tools included a demographic questionnaire, which assessed nurses′ demographic information and their general condition of low back pain, the Chinese version of Fear-avoidance Beliefs Questionnaire, and the Chinese version of Utrecht Work Engagement Scale.Results:91.7%(298/325) of orthopedic nurses reported that they had occupational low back pain, and the mean score of fear-avoidance belief was 59.18±14.55, and the mean score of Utrecht work engagement was 40.40±17.49. Nearly 89.3% (266/298) of nurses with low back pain had low or moderate level of work engagement. There was a statistically significant relationship between fear-avoidance belief and work engagement ( r=-0.306, P<0.001). Hierarchical Regression Analysis showed that variables, including higher education, salary per month, sick-leave, quitting job and fear-avoidance belief influenced orthopedic nurses′ work engagement. Specifically, fear-avoidance belief independently can explain 23.6% variation of work engagement. Conclusions:Orthopedic nurses′ occupational low back pain is very common, and the level of work engagement of this population is moderate, and fear-avoidance belief can predict work engagement. This revealed that nursing managers are supposed to pay attention to orthopedic nurses′ occupational low back pain, adopting appropriate nursing interventions to reduce these nurses′ pain, to decrease their fear-avoidance belief, which then in turn strengthen the nurses′ work engagement.
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Objective:To investigate the effect of cluster protection measures on postoperative infection in elderly lumbar disc herniation patients undergoing minimally invasive surgery by using intervertebral foramen mirror surgery.Methods:A total of 98 elderly lumbar disc herniation patients treated with the surgery in our hospital were enrolled from January 2018 to December 2019.They were randomized into the intervention group(n=49)receiving cluster protection measures and the routine group(n=49)receiving conventional protection measures.The incidences of infection and related indexes after surgery were compared between the two groups.Results:A total infection rate was higher in the routine group [16.33%(8/49)]than in the intervention group [4.08%(2/49)]( χ2=4.009, P=0.045). The operation time, out-of-bed activity time, hospitalization days and surgical blood loss were less in the intervention group than in the routine group[(30.4±1.1) min vs.(101.9±51.1) min, (1.6±0.7) d vs.(3.7±1.2) d, (4.3±0.6) d vs.(13.2±3.8) d, (54.8±7.3) ml vs.(142.7±69.6) ml, t=9.759, 10.193, 15.789 and 8.780, all P=0.000]. Conclusions:Compared with the routine prevention measures, the cluster prevention measures can ensure the perioperative safety, shorten the operation time and reduce surgical blood loss, out-of-bed activity time and hospitalization days.Therefore, after careful perioperative treatment and protection, the cluster prevention measures can relieve pain, restore function, reduce the incidences of postoperative infection and complications, and achieve satisfactory nursing results.
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Objective To observe the bacteriostasis of herba houttuyniae liquid in bladder irrigation for treatment of rabbit bladder infection model, and to offer a new way for prevention and treatment of urinary tract infection.Methods Twenty male New Zealand long-eared white rabbits were divided into gentamicin control group and three different concentrations herba houttuyniae groups according to random number table method, each group 5 rabbits. The rabbit bladder infection model was replicated by injecting coli liquid 1 mL (105 cfu/mL) into the urinary bladder through a urethral catheter, and clipping the catheter for 1 hour. After model establishment for 3 days, in the three herba houttuyniae groups, 0.25, 0.50, 1.00 g/mL herba houttuyniae liquid 50 mL were injected into the bladder respectively, and in the gentamicin control group, 160 kU gentamicin was injected into the bladder. Before molding and after molding for 3, 5, 7, 9 days, ear blood in rabbit was taken, and white blood cell (WBC) count and neutrophil percentage (N%) were tested; at the same time, the middle segment morning urine was taken to detect bacteriuria and urine WBC positive rates; after the experiment, the animals were sacrificed, the urinary bladder tissues were taken, and the pathological changes in urinary bladder tissue were observed by a light microscope.Results Before molding, the bacteriuria in animals of each group was negative and the results of urine WBC, blood WBC and N% were within normal range. After molding for 3 days, bacteriuria and urine WBC positive rates reached 100%; with the prolongation of treatment after molding, the above two rates in each group were gradually decreased, and herba houttuyniae 0.50 g/mL and 1.00 g/mL groups appeared statistical significance on the 5th day (bacteriuria positive rate was 60% and 40%, urine WBC positive rate was 60% and 40% respectively, while the gentamicin control group and herba houttuyniae 0.25 g/mL group was still 100% positive, allP < 0.01); on the 9th day, the bacteriuria positive rate in both higher dosage herba houttuyniae groups was 0, in 0.25 g/mL group, it still had the positive rate 20%, showing herba houttuyniae 0.50 g/mL and 1.00 g/mL had stronger inhibitory effect than herba houttuyniae 0.25 g/mL. WBC and N% were increased in each group after molding, and on the 3rd day, WBC and N were significantly higher in each group than those before molding [WBC (×109/L): gentamicin control group 13.00±5.23 vs. 8.95±2.69, herba houttuyniae 0.25 g/mL group 14.52±10.28 vs. 8.73±3.16, herba houttuyniae 0.50 g/mL group 12.97±11.33 vs. 7.83±4.51, herba houttuyniae 1.00 g/mL group 13.03±9.17 vs. 6.45±3.85. N%: gentamicin control group 80.99±14.93 vs. 63.41±7.96, herba houttuyniae 0.25 g/mL group 89.62±9.41 vs. 70.01±9.13, herba houttuyniae 0.50 g/mL group 87.69±11.34 vs. 67.75±8.91, herba houttuyniae 1.00 g/mL group 85.67±12.81 vs. 65.12±4.63]. On the 7th day, WBC and N% fell, and on the 9th day, the WBC and N% were restored to normal range in herba houttuyniae 0.50 g/mL and 1.00 g/mL groups [WBC (×109/L): herba houttuyniae 0.50 g/mL group 8.56±5.38, herba houttuyniae 1.00 g/mL group 7.93±4.82. N%: herba houttuyniae 0.50 g/mL group 65.97±8.35, herba houttuyniae 1.00 g/mL group 65.57±9.12]. Under light microscopy, it was shown that the morphological appearances of tissue cells in various layers of bladder mucosa were normal in herba houttuyniae group, demonstrating that herba houttuyniae fluid in bladder did not cause allergic inflammatory reaction, etc.Conclusion The bacteriostatic action of herba houttuyniae liquid for bladder irrigation in treatment of rabbits with urinary tract infection is better than that of gentamicin.