Relationship between therapeutic nursing modalities among cirrhotic patients and quality of life

Was to assess the relationship between therapeutic nursing modalities among cirrhotic patients and quality of life. Methods: sixty adult male and female liver cirrhotic patients, were selected randomly, free from any associated comorbid diseases as hepatic encephalopathy, congestive heart failure. The patients were interviewed in the medical unit, and instructed about the importance of educational sessions, they were divided into groups, compromising 5 to 7 patients. Matching was done for subjects within each group in relation to age, duration of the disease and educational level, and one close patient's relative attended in the educational sessions. Cirrhotic therapeutic nursing modalities sessions were carried out for the patients in groups in four sessions of one hour twice weekly during two weeks. Cognition about the-disease was assessed and quality of life was evaluated through knowledge assessment sheet and health promotion lifestyle profile before and after the educational sessions. A booklet was prepared in Arabic for each patient containing the main guidelines of the program. Results revealed that more than half of the study subjects were females > 40 years, and most [93.3%] of them were married, non-educated and living in rural areas. Findings revealed also deterioration in knowledge assessment scores and in all quality of life dimensions; self actualization, social, psychological, physical, nutrition, health responsibility of patient with cirrhosis before program in both sexes without any statistical differences. There were significant positive correlations between total knowledge and quality of life dimensions among the study groups treated by different nursing modalities after one and 3 month post educational program. As well, there were significantly better score of all items of nutrition for cirrhotic patients at immediate post program, and at 3 month post program than pre program and better scores of all items of selfcare for cirrhotic patients in post program. It is recommended that assessment of cirrhotic patients health related quality of life [HRQL] should be an essential part of nursing practice and an annual community survey must be done for screening of people who have virus C. Further research should be done to determine effect of application of an educational program about liver cirrhosis upon their Quality of life

Evaluation of parenteral nutrition on the immune system of patients with polytrauma

Nutritional support for trauma and critically ill patients has been advocated to promote immune system recovery and to prevent as much tissue break down and nutritional deficit. The present study aiming to assessment of the parenteral nutrition on the immune system of patient with multiple trauma. Compare the effect of early parenteral nutritional and conventional hospital diet on the nutrition and immunology markers in trauma patients. A convenient sample of 40 severely traumatized patients within 8 hours after trauma they were enrolled sequentially into conventional [n = 20] and total parenteral nutrition [n = 20] groups [TPN]. Criteria for subject inclusion were, age 18-<45 years, Injury severity score [ISS] 20-40 score. Tools of data collection, four tools were utilized to collect data pertinent to the study. These tools were, nutritional assessment sheet, trauma scales and [APACHE] score [checklist], parenteral nutrition plans, evaluation tool which includes [Anthropometric measurement, Laboratory studies Immunological parameters]. Total parenteral nutritional has positive impact for trauma patients on anthropometric measurement, [weight loss, TSF and MAC] which was observed at the end of therapy [7th day.] for the conventional group while there were no changes for the same parameters in TPN group. As regard, laboratory tests, there were significantly increase in the values of total serum protein and albumin among patients of the TPN group after the end of therapy at [7th day] .As regard immune function, it was found that the mean values of [IL-10, IL-6, CD8] were significantly dropped in the TPN group after the end of therapy as compared to the admission. Also there were significantly increase in the values of complement C3, IGA, CD4, and CD4/CD8 ratio among patient of the TPN group at [7th day]. Establishment and implement of standardized protocol of parenteral nutrition support using nutritional screening and physical assessment forms, for the critically ill patients