ABSTRACT
The psychological distress of cancer patients seriously affects their therapeutic effects. Effective psychological rehabilitation of cancer patients significantly improves their survival chance and quality of life. Circadian rhythm results from adaptation to the environment during the organism's evolution. When the endogenous clock system is disrupted or the external environment is changed, the body and the environment are out of synchronization, and the circadian rhythm will be disrupted. Circadian rhythm disorder is a common phenomenon in cancer patients, and the changes of circadian rhythm are closely related to their psychological distress. Many studies believe that the circadian rhythm disorder of cancer patients may directly or indirectly affect their psychology through various mechanisms, and targeted intervention by regulating the circadian rhythm of patients may be an essential means to promote the psychological rehabilitation.
Subject(s)
Humans , Quality of Life , Circadian Rhythm/physiology , Chronobiology Disorders , NeoplasmsABSTRACT
Objective:To evaluate the clinical effects of problem solving therapy on the elderly patients with depression by Meta-analysis.Methods:Randomized controlled trials articles regarding the effects of problem solving therapy on the elderly patients with depression were searched from the database of PubMed, EMbase, Medline, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Database and Wanfang Data electronically. SMD was used as the post merger response, and its 95% CI was calculated. Results:Ten articles were recruited and a total of 1 005 patients were included, 501 patients in the intervention group and 504 patients in the control group. Meta-analysis showed that problem solving therapy was significantly better than the control group in the treatment of depressive symptoms in the elderly patients with depression ( SMD =-0.64, 95% CI -0.98 - -0.31, P<0.05); during the follow-up within 3 months and 6 months after the intervention, the improvement of depression in the intervention group was better than that in the control group ( SMD=-0.62, 95% CI -1.00 - -0.25, P<0.05) and ( SMD =-0.79, 95% CI -1.03 - -0.55, P<0.05), respectively. Compared with the control group, the intervention group had an effect on the improvement of dysfunction ( SMD=-1.28, 95% CI -2.22 - -0.35, P<0.05). Conclusions:Problem solving therapy can improve the depressive symptoms of the elderly patients with depression and the clinical effect remains stable for a certain period of time; problem solving therapy has an improvement effect on the dysfunction of the elderly patients with depression.
ABSTRACT
Purpose@#From the perspective of positive psychology, our study aimed to explore depressive symptomsand psychological well-being among Chinese nurses, as well as analyze the impacts of characterstrengths, self-efficacy and social support on the mental health of nurses. @*Methods@#A cross-sectional and descriptive design using five self-reported questionnaires was used toinvestigate a cohort of 4238 nurses during 2018. A structural equation modeling analysis was used toverify a hypothetical model linking character strengths, self-efficacy, social support, depressive symptoms,and psychological well-being. @*Results@#The prevalence of depression among this cohort of Chinese nurses was 58.1%. The mean scoresfor caring, inquisitiveness, and self-control were 19.93 (SD = 2.82), 15.94 (SD = 3.00), and 16.34(SD = 2.95), respectively. The hypothesized model was a good fit of the data (x2/df = 1.77, p = .183, rootmean square error of approximation = 0.04, goodness of fit index = 1.00, comparative fit index = 1.00,TuckereLewis index = 1.00). Except for the path from self-control to depression, the other hypotheticalpaths investigated were statistically significant. @*Conclusion@#Character strengths were directly and positively associated with psychological well-being.Inquisitiveness was the strongest direct protective factor for depression. In addition, characterstrengths indirectly alleviated depression and increased psychological well-being through mediatingvariables of social support and self-efficacy. This study should alert nurse managers that more attentionshould be paid to the character strengths and mental health of nurses. This study provides evidence forinterventions based on character strengths as a management strategy to support the mental health ofnurses.
ABSTRACT
Coping style is a cognitive or behavioral strategy taken by individuals in the face of stress. Positive coping style is of great significance for improving the physical and mental outcomes of elderly patients with urinary incontinence. Accurate assessment of coping styles for the elderly patients with urinary incontinence can provide reference for the subsequent development of intervention measures. The existing coping style assessment tools for elderly incontinence at home and abroad include specific scale of incontinence, relevant psychological assessment scale, and universal scale. In a word, the progress in the studies on relevant assessment tools is slow, and it mainly focuses on the assessment of female population. The assessment content is relatively single and lacks of pertinence and systematization. In the future, a comprehensive scale with strong adaptability should be developed based on the characteristics of elderly incontinence patients in China.
Subject(s)
Aged , Female , Humans , Adaptation, Psychological , China , Urinary IncontinenceABSTRACT
Circadian rhythm disorder is a common physiological change of cancer survivors, which is mainly manifested in rest activity rhythm change, sleep wake disorder and the decrease of sleep efficiency at night, which further affect their physiological, psychological outcome and disease outcome. This paper reviews the concept, mechanism, influence and intervention methods of circadian rhythm disorder in cancer patients, in order to provide references for effective intervention of circadian rhythm disorder in cancer survivors.
ABSTRACT
Objective:To summarize the nursing experience of a patient with multiple renal transplants with high sensitization and severe obstructive sleep apnea hypopnea syndrome.Methods:A phased care intervention was implemented through multidisciplinary joint treatment.Results:The transplanted renal function of the patient recovered well, the concentration of immunopreparations was stable, and the patient was cured and discharged after 30 days of hospitalizationConclusion:Preoperative accurate antibody screening and effective desensitization therapy are the prerequisites for successful operation. Postoperative sleep apnea, rejection and observation and nursing of immunosuppressive drugs are implemented. Personalized rehabilitation guidance and psychological care are implemented throughout the whole process. Strengthening missions and attaching importance to continuous care have effectively protected patients' safety.
ABSTRACT
Purpose@#From the perspective of positive psychology, our study aimed to explore depressive symptomsand psychological well-being among Chinese nurses, as well as analyze the impacts of characterstrengths, self-efficacy and social support on the mental health of nurses. @*Methods@#A cross-sectional and descriptive design using five self-reported questionnaires was used toinvestigate a cohort of 4238 nurses during 2018. A structural equation modeling analysis was used toverify a hypothetical model linking character strengths, self-efficacy, social support, depressive symptoms,and psychological well-being. @*Results@#The prevalence of depression among this cohort of Chinese nurses was 58.1%. The mean scoresfor caring, inquisitiveness, and self-control were 19.93 (SD = 2.82), 15.94 (SD = 3.00), and 16.34(SD = 2.95), respectively. The hypothesized model was a good fit of the data (x2/df = 1.77, p = .183, rootmean square error of approximation = 0.04, goodness of fit index = 1.00, comparative fit index = 1.00,TuckereLewis index = 1.00). Except for the path from self-control to depression, the other hypotheticalpaths investigated were statistically significant. @*Conclusion@#Character strengths were directly and positively associated with psychological well-being.Inquisitiveness was the strongest direct protective factor for depression. In addition, characterstrengths indirectly alleviated depression and increased psychological well-being through mediatingvariables of social support and self-efficacy. This study should alert nurse managers that more attentionshould be paid to the character strengths and mental health of nurses. This study provides evidence forinterventions based on character strengths as a management strategy to support the mental health ofnurses.
ABSTRACT
Objective To set up and apply a standardized communication system of adolescents and young adults (AYAs) cancer patients,in order to improve AYAs cancer patients' psychological distress and other negative emotions,as well as promote social support and quality of life of patients.Methods A AYAs cancer patients standardized communication system,suitable for China's national conditions,was preliminarily built.Using randomized controlled trials,a total of 171 subjects,selected from 486 cases of AYAs cancer patients,in the Third Xiangya Hospital of Central South University and Hunan Cancer Hospital from August to September in 2016,were intervened with a set of standardized communication system.The Mental Distress Thermometer (DT),Hospital Anxiety and Depression Scale (HADS),Social Support Rating Scale (SSRS) and Concise Health Status Questionnaire (SF-36) were used as evaluation indexes to observe the psychological distress,emotion,social support and quality of life of the three groups of subjects before intervention,immediately after intervention,1 month after intervention and 3 months after intervention.Results At the follow-up of 3 months after intervention,38 cases were lost,14 cases in communication group (final n =43),11 cases in music therapy group (final n =46),and 13 cases in routine group (final n =44)..There was no significant difference in the evaluation indexes between the communication group,music treatment group and the routine group before intervention (P ＞ 0.05).There were statistically significant differences in scores of psychological pain,anxiety and depression,and social support in the 3 groups,before and immediately after intervention,1 month and 3 months after intervention (P ＜ 0.05).The scores of psychological pain,anxiety and depression,social support and quality of life in the communication group 1 month after intervention were statistically significant compared with those in the music group and the routine group (P ＜ 0.05).Conclusions Compared to music therapy and regular care,the standardized communication system has significant effect on improving the psychological distress of AYAs with cancer,and can also improve their social support level and quality of life.The clinical validation of the standardized communication system can provide reference for psychological rehabilitation of cancer survivors.
ABSTRACT
Objective@#To investigate the impact of WHO multimodal hand hygiene improvement strategy (MHHIS) on improving hand hygiene compliance of medical staff of organ transplant ICU.@*Methods@#According to the WHO MHHIS, the hand hygiene compliance and correctness before and after intervention of the medical staff was investigated by using double covert observation method from January 2017 to December 2017. The intervention methods included strengthening education and training, improving hand-washing facilities, setting up hand hygiene reminders, adopting feedback mechanisms, and implementing the PDCA cycle. SPSS software was used to statistically analyze the data before and after the intervention.@*Results@#After the intervention, the rates of compliance and correct hand hygiene of organ transplant ICU medical personnel improved from 22.63%(86/380) and 53.49%(46/86) before intervention to 59.31%(309/521) and 79.94%(247/309) after intervention respectively (χ2=120.060,24.566, P<0.01). The rates of compliance of doctors, nurses, interns, and care workers improved from20.45%(9/44),23.53%(68/289), 21.88%(7/32), and 13.33%(2/15) to 44.83%(26/58), 61.85%(167/270), 66.94%(83/124), and 58.62%(34/58), the differences were statistically significant (χ2=6.594-84.133, P<0.05 or 0.01). The difference in the correct rate of hand hygiene between nurses and care workers was statistically significant (χ2=19.541,10.588,P<0.05), but there was no significant difference in the correct rate of hand hygiene between doctors and interns (χ2=1.353, 0.177, P>0.05). The compliance rate of hand hygiene was 15.38%(22/143), 9.90%(11/111), 27.27%(9/33), 26.97%(41/152), 18.26%(21/115), respectively, before the intervention before the patients, before the aseptic operation, after exposure to the blood body fluid, after contact with the patients, and after contact with the surrounding environment. After the intervention, they were 47.59%(79/166), 38.46%(50/130), 65.82%(52/79), 73.04%(168/230), 61.25%(98/160), the difference was statistically significant (χ2=13.948-78.393, P<0.01 The average daily consumption per day of the department's hand-dried hand sanitizers and antibacterial soaps increased from 4.54 ml and 2.59 ml before intervention to 6.48 ml and 4.15 ml after intervention.@*Conclusions@#The WHO MHHIS can effectively improve the hand hygiene compliance of the medical personnel of organ transplant ICU.
ABSTRACT
Objective To explore the effects of WeChat-based peer supports upon medication adherence and quality-of-life in liver transplant recipients .Methods A total of 63 patients with liver transplantation were conveniently divided into intervention group (n=32) and control group (n=31) depending upon their different follow-up periods .In control group ,routine outpatient health guidance was offered while intervention group received 6-week WeChat-based peer supports . Medication compliance and quality-of-life of two groups were evaluated at Month 3/6/12 post-intervention . Results At Month 3 post-intervention ,as compared with control group ,only non-punctual medication improved significantly in intervention group (P<0 .01);at Month 6 post-intervention ,all aspects of drug adherence improved in intervention group (P< 0 .05) ,at Month 12 post-intervention ,drug adherence ,non-punctual medication and missed dosing improved in intervention group ( P> 0 .05 ) . However , inter-group quality-of-life was not statistically significant at Month 3/6/12 post-intervention .Conclusions WeChat-based peer supports may partially improve the immediate compliance of patients with liver transplantation .However ,long-term outcomes and effects on quality-of-life are worth further researches .
ABSTRACT
Objective To investigate the impact of WHO multimodal hand hygiene improvement strategy (MHHIS) on improving hand hygiene compliance of medical staff of organ transplant ICU. Methods According to the WHO MHHIS, the hand hygiene compliance and correctness before and after intervention of the medical staff was investigated by using double covert observation method from January 2017 to December 2017. The intervention methods included strengthening education and training, improving hand-washing facilities, setting up hand hygiene reminders, adopting feedback mechanisms, and implementing the PDCA cycle. SPSS software was used to statistically analyze the data before and after the intervention. Results After the intervention, the rates of compliance and correct hand hygiene of organ transplant ICU medical personnel improved from 22.63% (86/380) and 53.49% (46/86) before intervention to 59.31% (309/521) and 79.94% (247/309) after intervention respectively (χ2＝120.060, 24.566﹐P<0.01). The rates of compliance of doctors, nurses, interns, and care workers improved from 20.45% (9/44),23.53% (68/289), 21.88% (7/32), and 13.33% (2/15) to 44.83% (26/58), 61.85% (167/270), 66.94%(83/124), and 58.62%(34/58), the differences were statistically significant (χ2＝6.594-84.133, P<0.05 or 0.01). The difference in the correct rate of hand hygiene between nurses and care workers was statistically significant (χ2＝19.541,10.588,P<0.05), but there was no significant difference in the correct rate of hand hygiene between doctors and interns (χ2＝1.353, 0.177, P＞0.05). The compliance rate of hand hygiene was 15.38% (22/143), 9.90% (11/111), 27.27% (9/33), 26.97% (41/152), 18.26% (21/115), respectively, before the intervention before the patients, before the aseptic operation, after exposure to the blood body fluid, after contact with the patients, and after contact with the surrounding environment. After the intervention, they were 47.59 %(79/166), 38.46%(50/130), 65.82%(52/79), 73.04%(168/230), 61.25% (98/160), the difference was statistically significant (χ2＝13.948-78.393, P<0.01 The average daily consumption per day of the department's hand-dried hand sanitizers and antibacterial soaps increased from 4.54 ml and 2.59 ml before intervention to 6.48 ml and 4.15 ml after intervention. Conclusions The WHO MHHIS can effectively improve the hand hygiene compliance of the medical personnel of organ transplant ICU.
ABSTRACT
Cancer is the most cause death of among adolescents and young adults (AYAs).Psychological distress caused by cancer affects AYAs' effective coping abilities of disease,physical symptoms and treatment.This paper mainly introduces the related concepts,screening tools and intervention progress of psychological distress of AYAs cancer patients to deepen the understanding of these among clinical professionals and provide reference for implement effective interventions to patients.
ABSTRACT
Objective To translate and revise the Individualized Care Scale-Patient Version(ICS-P) into Chinese,then to assess the reliability and validity of the Chinese version of the Individualized Care Scale-Patient Version (C-ICS-P).Methods Standard forward-back translation techniques were used in the translation of the ICS-P according to the Brislin translation model.Cross-cultural revision of the translated ICS-P was carried out through group discussion and pretesting.Totally 223 patients were recruited through convenience sampling method from a tertiary hospital in Changsha and investigated using general information questionnaire and the C-ICS-P,and its reliability and validity were assessed.Results The C-ICS-P contained two subscales,and both C-ICS-P-A and C-ICS-P-B contained 3 factors explaining 61.330％ and 65.263％ of the total variance.The dimensions of C-ICS-P-A were clinical characteristics (6 items),personal life characteristics (4 items) and participation willingness (5 items);the dimensions of C-ICS-P-B were clinical care (6 items),personal life care (4 items) and decisional control over care (5 items).The Cronbach's α coefficients of C-ICS-P-A and its dimensions were 0.897,and 0.730～0.774;the Cronbach's α coefficients of C-ICS-P-B and its dimensions were 0.909,and 0.688～0.754.Split-half reliability was 0.856 for C-ICS-P-A and 0.688～0.754 for its dimensions;split-half reliability was 0.889 for C-ICS-P-B and 0.750～0.758 for its dimensions.Analysis of content validity of the C-ICS-P indicated that I-CVI was at least 0.83,S-CVI was 0.943.Conclusion The reliability and validity of C-ICS-P are satisfactory and well meet the requirements of psychological measurement,indicating C-ICS-P is a reliable and valid instrument in the context of Chinese culture.
ABSTRACT
Objective To investigate the risk factors of bloodstream infection-related death after liver transplantation.Methods The retrospective case-control study was adopted.The clinical data of the 107 patients with bloodstream infection from 365 liver transplantation patients who were admitted to the Third Xiangya Hospital of Central South University (220 patients) and South Central Hospital Affiliated to Wuhan University (145 patients) from January 1,2002 to December 31,2015 were collected.The patients received modified piggyback liver transplantation.The second or third generation celphalosporin or carbapenems antibiotics were preventively used against infection according to the bacterial culture results before surgery,and the immune inhibitor basic program after surgery was FK506 + prednisone.The observation indicators included:(1) the bloodstream infection status after liver transplantation:incidence of bloodstream infection,frequency of bloodstream infection,inadequate antiinfection treatment,primary infection position,microorganism infection type,bacterial culture results and bloodstream infection-related mortality.(2) The risk factors of blood stream infection-related death after liver transplantation in univariate and multivariate analyses in cluded:the gender,age,resource of donor,usage of immune inhibitor,time between infection and liver transplantation,infection temperature,primary infection position(intraperitoneal or biliary infection),pathogenic microorganism type,nosocomial infection,inadequate antibiotic usage,serum creatinine level,serum albumin (Alb) level,white blood cell (WBC) in peripheral blood,lymphocyte in peripheral blood,platelet (PLT) in peripheral blood and septic shock indexes.The patients were followed up by outpatient examination and telephone interview up to January 31,2016,the follow-up contents included the survival status of the patients,vital signs,using status of immune inhibitor,immune inhibitor concentration,blood routine,biochemical indexes,surgery,other infection-related complications and acute rejection.Continuous variables with normal distribution were represented as ~ ± s.The univariate analysis was done by the Chi-square test.The multivariate analysis was done by the Logistic regression model.Results (1) The bloodstream infection status after liver transplantation:186 bloodstream infections were happened in 107 patients undergoing liver transplantation,with a total incidence of bloodstream infection of 29.32％ (107/365).The incidence of bloodstream infection was 28.18％ (62/220) in the Third Xiangya Hospital of Central South University and 31.03％ (45/145) in the South Central Hospital Affiliated to Wuhan University,with no statistical difference (x2=0.186,P ＞0.05).Of 107 patients,56 patients had once bloodstream infection,31 had twice bloodstream infection and 20 had three times or more bloodstream infection (frequency of the most bloodstream infection was 6).The inadequate anti-infection treatment was applied to the 41.12％ (44/107)of patients with liver transplantation and bloodstream infection.The number of patients with primary infection positions in abdomen,lung,urethra,intravascular catheter and unknown sites were 40,39,3,1 and 24,respectively.The Gram positive bacteria,Gram negative bacteria,fungus and mixed infection of microorganism infection type were detected in 28,24,4 and 51 patients,respectively.There were 102 patients with nosocomial infection.Bacteria culture results in 186 strains of blood sample illustrated:84 strains were Gram positive bacteria as major pathogenic bacteria,among which enterococcus (31 strains) and staphylococcus aureus (23 strains) were dominant strains.The bloodstream infection-related mortality was 37.38％ (40/107),including 35 patients dying of septic shock.(2) The univariate analysis showed that the gender,resource of the donor,infection temperature,type of microorganism,serum creatinine level,serum Alb level,WBC in peripheral blood,PLT in peripheral blood and septic shock were the risk factors affecting bloodstream infection-related death after liver transplantation (x2=5.801,5.920,13.047,12.776,11.366,7.976,25.173,9.289,51.905,P ＜0.05).The multivariate analysis showed that serum Alb level ＜ 30 mg/L and septic shock were the independent risk factors affecting bloodstream infection-related death after liver transplantation (OR =5.839,44.983,95 ％ confidence interval:1.145-29.767,12.606-160.514,P ＜ 0.05).Conclusion It is prone to happen bloodstream infection after liver transplantation,and serum Alb level ＜ 30mg/L and septic shock are the independent risk factors affecting bloodstream infection-related death after liver transplantation.
ABSTRACT
OBJECTIVE@#To explore the application and the effect of early recognition of deteriorating patient program in department of cardiac surgery.@*METHODS@#We used the early recognition of deteriorating patient program in the cardiac surgery groups, including cardiac surgeons, nurses in ward, ICU and operation rooms of the cardiac surgery department, and compared the satisfaction of nurses and doctors, handover time, handover score of critical patients, and rate of unplanned ICU admission before and after the intervention.@*RESULTS@#After using the early recognition of deteriorating patient program, the satisfaction of doctors and nurses was increased, the handover time was lowered 0.56 min/time (t=2.22, P<0.05), the handover score of critical patients enhanced by 19.59 points (t=30.57, P<0.001), the rate of unplanned ICU readmission after the operation reduced by 4.8% (χ2=4.14, P<0.05).@*CONCLUSION@#Early recognition of deteriorating patient program can improve the safety of cardiac patients, enhance the self-confidence of nurses and work efficiency.