ABSTRACT
Objective:To explore the optimal postpartum nursing intervention method of elderly second-birth parturient based on the best evidence and evaluate its effect so as to improve the quality of clinical nursing.Methods:Based on the best evidence obtained from the previous study, the optimal nursing examination index of the elderly second parturient was established, and the evidence of best practice was obtained by using the evidence-based nursing method, and the 2017 revised version (the third edition of) Johns Hopkins evidence-based nursing practice model) was used to guide nurses to apply the evidence to clinical practice. During the period from March to May 2019, the baseline review was completed, including 82 pregnant women and 43 nurses. The evidence was incorporated into clinical practice in June 2019. From July to October 2019, the same indicators and inclusion and exclusion criteria were used to evaluate the effectiveness of evidence application in 43 nurses (including midwives) and 85 elderly second-child parturients in obstetric wards (including baby-friendly areas). The anxiety, depression, maternal satisfaction and nurses' correct implementation rate of the best evidence were compared before and after the application of evidence.Results:After the use of evidence-based intervention, the implementation rate of nurses was above 80%. The anxiety score of parturient decreased from 55.29±10.11 to 41.74±10.35, the difference was statistically significant ( t value was 8.55, P<0.001), and the depression score decreased from 57.77 ±8.32 to 47.86 ±9.33, the difference was statistically significant ( t value was 7.23, P<0.001). Maternal satisfaction increased from 92.68% (76/82) to 98.82% (84/85), the difference was statistically significant ( χ2 value was 3.92, P< 0.05). Conclusion:The result of practice shows that through evidence-based nursing intervention, we can further standardize the postpartum optimal nursing paradigm of elderly second-child parturients in China. Reduce postpartum anxiety and depression and improve maternal satisfaction. And quality review still needs to be continuously promoted and implemented in clinical practice in order to continuously improve the quality of nursing and ensure sustainability.
ABSTRACT
Objective Through testicular sperm aspiration (TESA),testicular biopsy,and detection of serum reproductive hormone levels and testicular volume in azoospermia patients,to explore the correlation between spermatogenic function of testis and serum FSH,LH,INHB levels,and testicular volume.Methods 76 cases of azoospermia patients were collected as the research objects.Chemiluminescence method was employed to detect the levels of serum reproductive hormone,and testis model was used to detect testicular volume.Routine disinfection was given to make TESA.According to TESA results,patients were divided into sperm group (group A),and azoospermia group (group B).According to testicular biopsy results,patients were divided into normal spermatogenic function group (group C),sperm maturation block group(group D),permatogenic dysfunction group (group E),and sertoli-cell-only syndrome group (group F).At the same time,40 cases of healthy male were selected as the control group (group G),and they received sperm routine examination,serum reproductive hormone and testicular volume detection.Results The level of serum FSH,LH,INHB and testicular volume in group A and C had no significant difference compared with that in group G(P＞0.05).The level of serum FSH and LH was significantly higher in group C than that in group G.The level of serum INHB and testicular volume was significantly lower than that in group G (P＜0.05).The level of serum FSH in group E was higher than in group G.The level of serum INHB in group D and E was lower than that in group G,and the difference was statistically significant (P＜0.05).Spearman correlation analysis showed that the spermatogenic function of testis was negatively correlated with serum FSH and LH levels,and positively correlated with serum INHB level and testicular volume (P＜0.05).Conclusion The detection of serum FSH,LH,INHB levels and testicular volume has important clinical value for predicting testicular spermatogenie function in azoospermia patients,and can be used to guide clinical testicular sperm aspiration.