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Objective:To investigate the effect of citric acid-induced cough on swallowing function and serum substance P in stroke patients with early tracheotomy.Methods:Forty-nine post-stroke tracheotomy patients admitted to the Department of Neurosurgery at the First Affiliated Hospital of Soochow University from January 2018 to July 2019 were selected as study subjects. They were divided into intervention group ( n=24) and control group ( n=25) using the random digit table. The control group was subjected to routine nursing, while the intervention group was given citric acid to induce cough based on routine care. The intervention time was 1 week. The swallowing function and serum substance P levels were compared between the two groups before and after the intervention. Results:After the intervention, 45.8% (11/24) of the patients in the intervention group were assessed as having "strong" swallowing function, compared to 28.0% (7/25) in the control group, with a statistically significant difference in swallowing function between the two groups ( Z= -2.22, P<0.05), and the level of substance P in the intervention group was (283.40 ± 134.82) ng/L, significantly higher than that of the control group (203.59 ± 126.16) ng/L ( t=2.14, P<0.05). Conclusions:Citric acid-induced cough helped stroke patients with early tracheotomy to produce effective swallowing action and up-regulate substance P in serum to promote recovery of swallowing function.
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Objective@#To evaluate the effect of abdominal massage on gastrointestinal tolerance in critically patients with nasogastric tube feeding.@*Methods@#The Chinese Biomedical Literature Database, China National Knowledge Infrastructure, The Wang fang database, Chinese Science and Technology Periodical Database, Cochrane Libraty, PubMed, Embase, CENTRAL were searched. Two researchers conducted quality evaluation and data extraction on studies that met the inclusion criteria. Data were analyzed with RevMan5.3 software.@*Results@#Eight randomized controlled trials were included, including 628 patients. The results of Meta-analysis showed that abdominal massage could reduce the gastric residual volume of critically ill patients (WMD=-45.45, 95%CI -56.62--34.28, P<0.01), and reduce the incidence of gastric retention (OR=0.13, 95%CI 0.06 -0.29, P<0.01), incidence of abdominal distension (OR=0.23, 95% CI 0.13-0.43, P<0.01), incidence of vomiting (OR=0.14, 95% CI 0.06-0.36, P<0.01).@*Conclusions@#For critically ill patients with nasogastric tube feeding, abdominal massage can reduce the gastric residual volume and reduce the incidence of gastric retention, distension and vomiting.
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Objective:To investigate the effects of exercise prescription on quality of life in patients with pituitary adenomas after surgery.Methods:A total of 82 patients with pituitary adenomas who met the inclusion criteria from December 2017 to September 2018 were enrolled. The control group received routine nursing care. The intervention group was given exercise prescription on the first day after surgery and 3 months after discharge from hospital. Both groups of patients completed the Health Status Survey(SF-36) before and after the intervention.Results:Before the intervention, there was no significant difference in baseline date of patients between two groups( P>0.05). After intervention, the general health dimension score (53.03±11.30) of the control group was significantly higher than the score within the group before treatment ( Z value was -4.398, P<0.05). The physiological function (86.67±7.46), physical function (66.67±29.28), role-emotional (71.30±22.75), vitality (68.33±8.78), general health dimension (61.39±10.66) of the intervention group were significant higher than the score within the group before treatment ( Z values were -4.809--2.041, P<0.05) . After the intervention, the significant difference were found in role-physical, general health, vitality, social function(77.18±15.71) and physiological health dimensions (73.75±10.00) between the intervention and control group ( Z values were -3.122- -2.467, t value was 3.044, P<0.05). After the intervention, non-function patients′ physiological function (72.06±23.19), general health (60.59±10.75), vitality (69.71±10.23) and social function (81.04±10.22) were significantly higher than the control group ( Z values were -2.832- -2.059, P<0.05). Conclusion:Exercise prescription can improve the quality of life in patients with pituitary adenomas after surgery.
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Objective:To evaluate the effect of abdominal massage on gastrointestinal tolerance in critically patients with nasogastric tube feeding.Methods:The Chinese Biomedical Literature Database, China National Knowledge Infrastructure, The Wang fang database, Chinese Science and Technology Periodical Database, Cochrane Libraty, PubMed, Embase, CENTRAL were searched. Two researchers conducted quality evaluation and data extraction on studies that met the inclusion criteria. Data were analyzed with RevMan5.3 software.Results:Eight randomized controlled trials were included, including 628 patients. The results of Meta-analysis showed that abdominal massage could reduce the gastric residual volume of critically ill patients ( WMD=-45.45, 95%CI -56.62--34.28, P<0.01), and reduce the incidence of gastric retention ( OR=0.13, 95%CI 0.06 -0.29, P<0.01), incidence of abdominal distension ( OR=0.23, 95% CI 0.13-0.43, P<0.01), incidence of vomiting ( OR=0.14, 95% CI 0.06-0.36, P<0.01). Conclusions:For critically ill patients with nasogastric tube feeding, abdominal massage can reduce the gastric residual volume and reduce the incidence of gastric retention, distension and vomiting.
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Objective To investigatethe status of physician-nurse collaboration in nutritional support among neurosurgical patients in secondary and tertiary hospitals in Suzhou, and to analyze the influence factors and to provide the basis for promoting cooperation consciousnes and quality of work. Methods One hundred and seventy-seven physicians and 506 nurses were investigated by the Nurse-Physician Collaboration Scale(NPCS) in 15 secondary hospitals and 15 tertiary hospitals in Suzhou. Results The cooperative status of physicians in tertiary hospitals was better than that of nurses (t=2.597, P=0.010). The cooperative status of nurses in tertiary hospitals was better than that in secondary hospitals (t=2.080, P=0.009). There was no significant difference in the cooperation between physicians and nurses in secondary hospitals (t=1.845, P=0.066). Multiple regression analysis showed that sex, profession, professional title, age, education degree and work seniority were the influence factors of physician-nurse collaboration intertiary hospitals (t=2.771, 2.597,F=3.745-12.513,P<0.01 or 0.05). Conclusions The physician-nurse collaboration in nutritional support among neurosurgical patients in secondary and tertiary hospitals is in good shape.Administrators should pay attention to influence factors of physician-nurse collaboration, and take measures to promote quality of medical care and nursing care.
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Objective To evaluate the effect of mind mapping health education on the compliance behavior in patients with lumbar disc herniation (LDH) undergone surgery treatment.Methods A total of 68 LDH patients expected to surgery treatment were selected as objects of study,with 34 patients respectively in the control group and experimental group,the control group had undergone the nursing routine for LDH,while the experimental group had received the Mind-Map health education on the bases of routine care.Data were collected at the time point of admission to hospital,time to discharge,1 month and 6 months after discharge by the tools of questionnaire of the knowledge and LDH compliance and SF-36 scale.Results The scores of questionnaire of the knowledge for the experimental group at the time point of discharge,1 month and 6 months after discharge were (52.38 ± 6.99),(52.68 ± 7.87),(51.03 ±8.55) points,which were higher than those in the control group of (24.79 ± 3.33),(25.18 ± 2.87),(23.41 ±3.54) points,the differences were statistically significant (t =27.59,27.50,27.62,P＜ 0.01).The scores of compliance questionnaire for the experimental group at the time point of lmonth and 6 months after discharge were (71.47 ± 16.62),(66.82 ± 20.11) points,which were higher than those in the control group of (43.32 ± 17.70),(49.35 ± 14.17) points,the differences were statistically significant(t=28.15,13.82,P＜ 0.01).Within groups,the scores of SF-36 scale of each group at the point of 6 months after charge were higher than at the point of admission,the differences were statistically significant (t =2.53-11.41,P＜0.05).Among groups,the differences of SF-36 scale scores at the point of admission of two groups were not statistically significant (P＞ 0.05),while the SF-36 scale scores of experimental at the point of 6months after discharge were apparently higher than that of control group,and the differences were statistically significant (t =1.70-5.68,P＜ 0.05).Conclusions Mind mapping health education can broaden patients' knowledge to LDH,improve the compliance to medical stuff,thus promote the recovery of LDH and improve the quality of life.
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Objective To investigate the status and influencing factors of the methods used by nurses verifying the nasogastric tube placement blinded inserted in adult, and to explore the best practice of nursing staff to verify the nasogastric tube placement. Methods We designed the questionnaire and conducted survey to the clinical nursing staff in accordance with the American Association of Critical-Care Nurses practice alert. Results Air bolus auscultation (70.53％,675/957) and aspirate appearance (68.97％,660/957) were the most used method during insertion procedure. There was insufficient in the cognition of X-ray as the gold standard and the use in clinical.The department, work years, specialist nursesand hospitallevel impact X-ray use(all P <0.05).Age, education,title,hospital level, specialist nurses and department impact the cognition of X-ray as the gold standard(all P <0.05). Conclusions Nurses still use the traditional methods to verify the nasogastric tube placement. There is a certain gap between clinical practice and AACN practice alert in themethods used to verify nasogastric tube placement.As the gold standard to verify gastric tube placement, the use and cognition of X-ray are impacted by many factors, including the department, specialist nurses, hospital level, et al. Therefore, hospital should establish a knowledge sharing platform, which will help to spread the advantages and disadvantages of various methods used in verifying the nasogastric tube placement, and then to strengthen the cognition with different people. Furthermore, based on potential influencing factors, it is necessary to further explore new bedside effective method of verifying the nasogastric tube placement and seek the best practice to validate the method of blind intubation of nasogastric tube.
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Objective To carry out the surveillance with sentinel mice in the key water areas of schistosomiasis endemic re-gions in Yunnan Province,so as to establish and perfect the surveillance and forecast system of schistosomiasis. Methods Six villages of three counties with schistosomiasis heavy endemic status were selected as the survey points. Then ,the surveillance and forecast with the sentinel mice were carried out in the key water areas in the survey points. The recovered sentinel mice were dissected in laboratory,and their serum antibodies against schistosome were detected. Meanwhile,the suspicious infested water contacts of the residents and livestock in the surveillance sites were investigated,and the endemic data of schistosomiasis in the survey points in recent 3 years were collected and analyzed. Results Totally 282 sentinel mice were placed in the water area, 252 were recovered,with a recovery rate of 90.78%,and 8 mice were dead,with a mortality rate of 3.13%. The number of mice with schistosome egg granuloma and adult worm detected were both 0,and the worm burden and the positive rate of serum anti-bodies against schistosome were both 0,too. The persons who contacted with the suspicious infested water were mainly villagers and students by harvesting and playing. The Oncomelania hupensis snail areas,the infection rates of residents and livestock were obviously declined in recent 3 years. Conclusions There are no positive sentinel mice found in the key water areas of the surveillance sites in Yunnan Province,which suggests that the schistosome infection risk of residents and livestock is low. How-ever,the comprehensive control measures,surveillance and forecast with sentinel mice in the key water areas of schistosomiasis endemic regions still should be strengthened.
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Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.
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Objective To systematically evaluate the relationship between stroke location and post-stroke depression (PSD) in first-ever stroke patients.Methods The studies on the relationship between stroke location and PSD published from January 1980 to March 2016 were retrieved from databases,including Chinese science and technology journal full-text database (VIP),China journal full-text database (CNKI),Wanfan database,PubMed,ISI Web of Science,Ovid database and Elsevier Science Direct.RevMan5.3 software was adopted for data consolidation and analysis.Results A total of 14 studies,including 1 952 cases of patients were included.The meta analysis indicated that no direct relationship was found between stroke location and PSD in first-ever stroke patients [random effects model,95 ％CI(0.89,1.43),P＜0.01].The results of subgroup analysis indicated that the PSD was associated with the right hemisphere lesion when the Hamilton Depression Scale (HAMD) was adopted for assessment [fixed effects model,95 ％ CI(1.21,1.76),P＜0.01],while the relationships were not found in the subgroup analysis of time course after stroke and the aphasia occurrence.Conclusion Stroke location may be not directly associated with PSD,further studies are needed to ascertain the relationship between stroke location and PSD.
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Objective To understand the Oncomelania hupensis distribution and infection status in the schistosomiasis sur?veillance sites of Yunnan Province,so as to provide the evidence for making the control and prevention measures. Methods Eighteen administrative villages were selected as the surveillance sites where the schistosomiasis endemic was serious in 18 epi?demic counties,one village for one county. The snail status was investigated with the systematic sampling and environmental sampling methods,and the infection status of the snails was detected by a microscope and loop?mediated isothermal amplifica?tion(LAMP). The surveillance database was established and descriptively analyzed. Results In 2015,the total surveillance ar?ea was 1 826.55 hm2,and the area with snails was 55.03 hm2,that was reduced by 57.70% as compared to that in 2013,and by 40.63% as compared to that in 2014. No new snail area was discovered,and also no schistosome infected snails were discovered. Totally 718 532 frames were surveyed,and the occurrence rate of frames with snails was 0.45% and the density of living snails was 0.013 9 snail/0.1 m2. In the endemic controlled areas,the snail area and density of living snails were both the highest. The snails concentrated on the environments of paddy field,ditch,bottomland,small reservoir,and dry land,and the vegetations of rice,dry crop,weed and wood. The snail area,occurrence rate of frames with snails,total number of snails and number of liv?ing snails all showed a downward trend. No infected snails were found for three years. Conclusions The Oncomelania hupensis snails have been effectively controlled in the national schistosomiasis surveillance sites of Yunnan Province. However,the com?prehensive snail control measures still should be continually strengthened in order to consolidate the achivements.
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Objective To revise the Symptom Distress Scale for postoperative patients with pituitary tumor and to test its reliability and validity. Methods On the base of previous qualitative interview and literature review, Delphi consultation was performed to identify items of the Symptom Distress Scale for postoperative patients with pituitary tumor. By convenience sampling method, totally 191 patients from four first-class ternary hospitals in Jiangsu province were investigated effectively by this scale. Results A scale of 4 factors and 16 items was identified by expert interviews, item analysis, exploratory factor analysis and the four factors could explain 69.812%of the variance. The Cronbachαcoefficient of the scale was 0.920, the content validity index was 0.915, and the interrater reliability was 0.860. Conclusions Symptom Distress Scale for postoperative patients with pituitary tumor has good reliability and validity to assess the symptom distress of pituitary tumor patients after operation.
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Objective To understand the prevalence and the nursing status of incontinence and incontinence-associated dermatitis (IAD),analyze the risk factors of the occurrence of IAD,and to provide effective measures for the prevention and management of IAD.Methods Using the questionnaire survey, 1 318 hospitalized patients in 2 grade three hospitals of Suzhou were investigated,and then the results were analyzed.Results The prevalence of incontinence was 10.70％(141/1 318),among the prevalence of urinary incontinence was 4.63％(61/1 318),fecal incontinence was 4.32％(57/1 318);with 24.11％(34/141) of incontinent patients having IAD;disposable pad and briefs were the most common containment devices,only 36.17％ (51/141) of the incontinent inpatients using skin protectant after perineal skin clean.Single factor analysis revealed that IAD was related with wards, types of incontinence, character of stools, frequency of feces, antibiotics, modes of nutrition support, Braden scores, level of albumin and prealbumin.Unconditional Logistic regression indicated that risk factors of IAD included the level of serum albumin (OR=0.769, P＜ 0.05), Braden scores(OR=0.335, P＜ 0.05) and frequency of feces(OR=11.076, P ＜ 0.05).Conclusions Incontinence and IAD are common in hospitalized patients,low serum albumin, low Braden scores and high frequency of feces are the risk factors of IAD.The clinical nurses have not paied enough attention on the prevention of IAD, lacked relevant knowledge and skin care regimen.
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Objective To understand the experiences of patients prior to operation with recurrent glioma based on the Corbin and Strauss chronic illness trajectory framework. Methods Fourteen patients participated in the semi-structure interviews.Data were analyzed with Colaizzi′s phenomenologica l procedure. Results Based on the Corbin and Strauss chronic illness trajectory framework, experiences of patients prior to operation with recurrent glioma were extracted. (1) Illness-related work including severe symptoms of illness and lack of knowledge of illness. (2) Biographical work including loss of biography and identity of self. (3) Everyday life work including change of social roles, complicated mood combined negative experience and positive experience, heavy economic burden. Conclusions Nursing staff should attach importance to experiences of patients, and provide targeted interventions for successful operations and recovery of physical and spiritual healing.
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Objective To determine the optimal suetioning negative pressure based on various sputum viscosity in brain-in-jured patients with tracheotomy. Methods Forty-three traumatic brain-injured patients with traeheotomy were recruited in the study. The negative pressure was determined based on the grade of sputum viscosity. Grade Ⅰ sputum was suetioned with the negative pressure of 13.3kPa,16.0kPa,20.0kPa and 24.0kPa, while Grade Ⅱ sputum with 20.0kPa,24.0kPa,26.TkPa and 29.3kPa,and Grade Ⅲ sputum with 26.7kPa,29.3kPa, 33.3kPa and 37.2kPa. The oxygen saturation(SpO2)was mort-itored before and lmin,3min,5min after endotracheal suctioning. At the same time,the suctioning time and tissue trauma were recorded. The data were analyzed by repeated measures analysis of variance with SPSS 13.0 software. Results The results showed that the optimal negative pressure was 13.3-16.0kPa for grade Ⅰ sputum,24.0-26.7kPa for grade Ⅱ sputum and 33.3kPa for grade Ⅲ sputum,which could ensure the minimum decrease of SpO2 and control the suctioning time within 25s or 30s respectively. Conclusion For traumatic brain-injured patients,varions negative pressure should be selected based on the sputum viscosity by the clinical nurses when suctioning is performed,in order to avoid hypoxemia and tissue trauma caused by suctioning.