ABSTRACT
Objective To investigate the effect of narrative medicine mode in perioperative medical and nursing care for patients underwent radical nephrectomy. Methods A total of 124 patients received radical nephrectomy from February 2014 to October 2016 were selected and divided into experimental group and control group by block randomization grouping method with 62 cases each. Narrative medical treatment and care was applied in experimental group while control group received conventional treatment and care. The psychological status and social support of the patients were evaluated by Zung Self-rating Anxiety Scale(SAS), Self-rating Depression Scale (SDS) and social support rating scale(SSRS), as well as rehabilitation indexes including complications, first feeding time, hospitalization time, costs, etc. Results Anxiety and depression status were existed in both experimental and control groups before operations, and there were no significant difference in all pre-operative scales between two groups (P>0.05). The score of SAS, SDS, SSRS was (44.71 ± 4.67), (40.84 ± 4.05), (43.21 ± 3.60) points after operation and (54.98 ± 5.93), (46.52 ± 5.07), (31.87 ± 3.22) points before operation in experimental group. The score of SAS, SDS, SSRS was (53.24±5.97), (44.63±4.37), (32.61± 2.72) points after operation and (54.92 ± 5.83), (46.53 ± 4.89), (32.16 ± 2.48) points before operation in control group. Significant differences were found between before and after operation in experimental group (t=18.73, 8.85, 18.18, all P0.05). After operation, the complications, first feeding time, hospitalization time and costs was 22.58%(14/62), (2.50±0.92) d, (11.16±3.72) d, (24.6±4.0) thousand yuan in experimental group, which was 48.39%(30/62), (3.98 ± 1.44) d, (15.48 ± 5.44) d, (40.2 ± 3.1) thousand yuan in control group. Significant differences were found between experimental group and control group (χ2=9.02, t=2.07, 8.06, 3.93, P<0.05 or 0.01). Conclusions Narrative medicine mode can provide medical care filled with respect, empathy, and humanistic concern, andimprove patients′psychological status, thus promoting rehabilitation.
ABSTRACT
Objective To investigate postoperative psychological experiences of patients underwent kidney transplant donated by his/her parent,and to discover mental signs and psychological journey in individual growth.Methods Semi-structured in-depth interviews were conducted among 17 patients underwent kidney transplant donated by his/her parent,and Giorgi analysis method was used to analyze data.Results The postoperative psychological experiences of patients mainly contained 4 aspects:posttraumatic growth,rebuilding meaning of life,being grateful for experience,coexisting of hope and challenge.Conclusion The patients have complex psychological experiences,having positive aspects derived from rehabilitation and improved quality of life,as well as negative aspects derived from concerning health of the donor,fear for complication and rejection,and lack of sound supporting system.Medical staff should guide patients to adjust cognitive and behavioral patterns and face life events directly,integrate medical/social support resources and enhance patients' psychological capital to face future life.
ABSTRACT
Objective To study the relationship between the exposure time of puncture needle of infusion bottle stopper and microbial contamination during clinical intravenous transfusion. Methods A total of 600 cases from November 1, 2014 to January 31, 2015 who have received the clinical intravenous transfusion for investigation were selected.When replacing the infusion bottle (bag), inserting the puncture needle slowly across the bottle stopper and making the needle tip be canted to the transfusion bottle mouth (bag) of the rubber plug, gently squeezing the Murphy's tube until solution was not dripping, recording down the exposure time in the air of the needle tip from medicine droplet to the end. To dip the lower part with sterile swabs and culture the swabs in nutrient broth medium. Meanwhile, to replace the next bottle of medicine and get the remaining 2 ml of liquids into the culture broth medium, after 48 h, both of which medium were switched to blood plate culture cultivation for observing the general situation of the bacteria growth. Results Among the 600 cases of clinical transfusion, 24 cases were positive for sterile swabs microorganisms culture, positive rate was 4.0%, among which microorganisms, 15 cases were gram-positive coccus, 3 cases were gram-negative bacillus, 3 cases were gram-positive bacillus and 3 cases were fungi. Correspondingly, 3 cases were positive for liquid broth culture, positive rate was 0.5%as the gram-positive coccus. The exposure time and broth microbial culture result was statistically significant, while the exposure time and medicinal broth microorganisms culture result possesses had no statistical significance. Conclusions Inserting the puncture needle across the bottle stopper could successfully reduce the liquid drug residues in the infusion bottle (bag), however, which might also cause time-dependent microbial contamination during the exposure process in the air.