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Objective At present no deep investigation has been done on the relationship between handgrip strength and appendicular lean mass (ALM) in patients with chronic obstructive pulmonary disease (COPD). The study aimed to explore the present situation of handgrip strength in patients with stable COPD and relationship between handgrip strength and ALM.Methods A total of 93 patients with stable COPD who hospitalized in our department from August 2016 to July 2017 were selected for the study. All the patients underwent handgrip strength test, body composition analysis, as well as the analysis of the relationship between handgrip strength and ALM.Results Multivariate linear regression analysis showed age(X1), education(X2), smoking(X3), course of disease(X4) and lower limb lean mass(X5) could be taken as predictive factors for the variation degree of handgrip strength (R2=50.5%), and multiple linear regression equation was Y=9.959-4.315X1+1.397X2+2.679X3-1.526X4+1.538X5. The variation degree decreased to 48.1% when the course of disease was removed from the model, 28.3% when the limb lean mass was removed, 26.5% when two variables were removed. The correlation coefficients of ALM, upper limb, lower limb and torso lean mass (\[22.32±3.25\]kg, \[6.48±1.05\]kg, \[15.83±2.26\]kg, \[22.27±3.22\]kg) with handgrip strength (\[32.27±7.27\]kgf) were respectively 0.484, 0.436, 0.496 and 0.496 (P＜0.01).Conclusion The handgrip strength in patients with stable COPD is closely associated with ALM, and the course of disease and the lower limb lean mass greatly affect the handgrip strength. Clinical workers should pay extra attention to the relationship in order to give timely clinical intervention.
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Objective To construct the key-point guidelines of bowel preparation for elderly patients with colonoscopy. Methods The guidelines were made based on literature review,theoretical analysis,qualitative interview.Then they were determined by 14 clinical nurse specialists, nursing education experts and medical experts from 6 provinces or cities through two rounds of expert consultations. Results The response rate of two rounds'questionnaire was 100.00%. The authority of experts coefficient in the two rounds were 0.89. The coefficients of variation of the first and second rounds were respectively 0.07~0.27 and 0.05~0.13. The coordination coefficients for the 2 rounds were 0.377 and 0.404 respectively (Χ2=105.473 and 124.307,P<0.001).In the first round,the average of the importance rating was 3.50~4.95, with a standard deviation of 0.35~0.95.In the second round,the average of the importance rating was 4.71~4.93,with a standard deviation of 0.27~0.61.The key-point guidelines of bowel preparation included 3 key points for bowel preparation, 4 key moments,7 key guidance contents, 4 criteria for the process of bowel preparation and the corresponding remedial measures. Conclusion This study established the key-point guidelines of bowel preparation for elderly patientsand the degree of enthusiasm,authority,coordination and concentration of the experts was high so as to provide a reference for the clinical implementation of standardized bowel preparation guidance.
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Objective To investigate the dynamic changes and analyze the influencing factors of quality of life (QOL) among adult patients undergoing hematopoietic stem cell transplantation (HSCT). Methods Totally 143 HSCT patients were investigated by the common questionnaire, the Perceived Social Support Scale (PSSS) and the Functional Assessment in Cancer Therapy—Bone Marrow Transplant (FACT-BMT) before checked in the purification bin,1 month post transplantation and 3 months post transplantation. Results The QOL were different among different time points of HSCT patients (P<0.05). Multiple factors analysis showed that the factors before checked in the purification bin including social support (OR=4.480, P=0.019), residence (OR=3.167, P=0.036) and disease diagnosis (OR=0.036, P=0.042). The factors 1 month post transplantation included social support (OR=3.573, P=0.018), whether or not the platelets were reconstructed during storage (OR=2.735, P=0.018) and whether there were transplant related complications (OR=0.214, P=0.016). The factors 3 month post transplantation included social support (OR=9.639, P<0.01) and whether there were transplant related complications (OR=0.167, P=0.003). Conclusions The QOL was low among HSCT patients, and it dynamically changed at different points. Social support is the only sustainable influencing factor of quality of life. This prompts us that we should pay abundant attention on social support and use it to improve the QOL of HSCT patients.
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Objective To investigate the effect of bowel preparation before colonoscopy and its influencing factors. Methods A total of 283 patients with colonoscopy were recruited by convenience sampling method. They were investigated with basic information questionnaire of bowel preparation and their intestinal cleanliness were assessed by the Ottawa Assessment Scale. The status of bowel preparation and it′s influenced factors were analyzed. Results The total score of Ottawa Assessment Scale was (5.37 ± 2.22) points, and the efficiency of intestinal cleaning was only 59%(167/283). Logistic regression analysis showed that age (OR=1.033, P=0.013); history of chronic constipation (OR=10.341, P=0.000);history of appendectomy (OR=5.349, P=0.007); walking time during medication (OR=0.350, P=0.000);incomplete intake of the preparation (OR=0.078, P=0.000), the time interval between the initiation of ingestion and the onset of bowel activity (OR=1.034, P=0.000), defecation frequency (OR =0.794, P=0.004);characteristics of last stool (OR=0.159, P=0.000) were influencing factors of intestinal cleanliness. Conclusions The intestinal cleanliness of patients with colonoscopy is still at a low level. In the future, medical personnel should identify patients with risk factors early, and give them specific bowel preparation, so as to improve the quality of bowel preparation effectively.
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Objective To determine the value of five repetition sit-to-stand test (FTSST) to evaluate lower limb function in the patients with chronic obstructive pulmonary disease (COPD).Methods Sixty-one patients with COPD were tested for FTSST,isokinetic testing muscle strength for lower limb,6-minute walking test.The relationship between FTSST time and muscle strength,6-minute walking test distance (6MWD) were analyzed.Results FTSST time was (7.86±2.21) s,extensor peak torque was (67.58± 24.83) Nm,extensor relative peak torque was 0.95(0.46) Nm/kg,6MWD was (444.05±112.53) m.FTSST time related to extensor peak torque,extensor relative peak torque,6MWD and types of complication,correlation coefficient values were-0.303,-0.393,-0.428,F =2.813,P ＜ 0.05.Multivariate linear regression analysis showed that when the dependent variable was FTSST time,the variables of the equation were 6MWD and types of complication.Conclusions FTSST can be used for the rapid evaluation of lower extremity function in patients with COPD.The lower limb function gets worse,the FTSST time will be longer.Nursing staff should pay more attention to the lower limb function of patients with COPD,along with complications,using FTSST to evaluate lower extremity function.
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Objective To evaluate the effect of breathing exercise program (shrinking lips abdominal breathing combined with vertical breathing gymnastics) on dyspnea, pulmonary function, exercise tolerance and quality of life in patients with moderate to severe chronic obstructive pulmonary disease(COPD). Methods A total of 90 hospitalized patients with moderate to severe COPD were randomly divided into the experimental group and the control group with 45 cases in each group. The experimental group lost one case and the control group lost three cases, 86 patients finished the experiment. During hospitalization, on the base of conventional treatment and care, the experimental group received training of shrinking lips abdominal breathing combined with vertical breathing gymnastics after medical staff′s care, with folk music as the background. Exercise frequency:morning, afternoon, 2 times per day, 15 min per time and continue to exercise with researchers′ guidance after discharge. In the control group:take exercises by self, take routine follow-up after discharge. The intervention continued for three months. The indicators such as dyspnea, pulmonary function, exercise tolerance and life quality of both groups were assessed respectively before and after the intervention. Results There were no significant differences in dyspnea symptoms, lung function, exercise endurance, quality of life between two groups before intervention (P>0.05). The dyspnea scored 1.43±0.87 after intervention in the experimental group, and 1.93 ±0.97 in the control group, there was significant difference (Z=-2.293, P=0.022). The 6 min walking test distance was (371.34 ± 67.74) m after intervention in the experimental group, and (301.57 ± 61.67) m in the control group, there was significant difference(t = 4.988, P =0.000). The St. George′s Respiratory Questionnaire (respiratory symptoms, limited activity, influence disease) score and total score were 54.73 ± 11.96, 52.55 ± 14.48, 55.45 ± 10.01, 54.56 ± 10.79 after intervention in experimental group respectively, and 61.19 ± 10.72, 61.35 ± 14.66, 60.48 ± 9.39, 60.93 ± 10.16 in the control group, there were significant differences(t=-2.815--2.397, P0.05). Conclusions The program of shrinking lips abdominal breathing combined with vertical breathing gymnastics can relieve dyspnea in patients with moderate to severe COPD, improve exercise tolerance and quality of life, which is a safe and effective rehabilitation for patients with COPD.
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Objective To explore life experience in chronic obstructive pulmonary disease (COPD) patients with the habit of exercise for more than 5 years,to enhance the confidence of participating in the rehabilitation in other patients, to help the medical staff pay more attention to guide the patients with COPD to take up the rehabilitation exercise. Methods The narrative research method in qualitative research was used to analyze the collected data. Results The study found that the coping approach of the contradiction between exercise and dyspnea, the ability to live together with the disease peacefully and the enthusiasm of persuing life were deserved to be learned. Conclusions Full of perseverance and persisted rehabilitation exercise may alleviate the symptoms, reduce the number of acute exacerbation of COPD and improve the quality of life for COPD patients. Medical staff should encourage COPD patients to participate in the rehabilitation in the right time with appropriate methods.
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Objective To explore the influence of application of health management strategy on quality of life in outpatients with functional dyspepsia (FD). Methods A total of 140 FD patients were divided into the intervention group and the control group by random digits table method with 70 cases in each. The patients in the intervention group received the researchers on the implementation of health management strategy, and the patients in the control group were given routine outpatient health education and telephone follow- up. Before and after the intervention in one month or three, the FD patients Quality of Life Scale (FDDQL) was used to evaluate the quality condition of the patient's life. Results Eventually 65 cases in the intervention group and 61 cases in the control group completed the research. 1 months after intervention in the intervention group, total score of life quality and score of each dimension rose faster, in addition to the dimension of pressure, total score and daily activities, anxiety, diet, sleep, feeling unwell, health, disease control dimension scores were 73.84 ± 3.45, 81.22±4.55, 71.58±6.19, 73.05±5.14, 74.74± 5.58, 74.72±3.91, 79.26±5.85, 73.75±6.32, higher than 60.59 ±5.06, 76.04±6.06, 68.41±9.78, 69.52±6.68,66.63±9.87, 64.37±6.24, 54.50±7.96, 50.76±7.54, the difference was statistically significant (t =2.160-20.590, P < 0.01 or < 0.05). Three months after intervention, the intervention group the total score of life quality and score of daily activities, anxiety, diet, sleep, feeling unwell, health, disease control, pressure dimension scores were 76.35±3.74, 85.21±5.34, 80.15±5.86, 73.21±4.99, 75.49±6.81, 75.46±3.80, 79.35± 6.39, 74.06±6.74, 70.86±7.00, significantly higher than 58.60±5.22, 72.02±6.53, 59.26±7.81, 60.90±6.36, 61.19±9.08, 62.24±6.02, 54.15±8.25, 50.13±7.67, 60.02±5.67 in the control group, the difference of two groups was statistically significant (t = 5.726-19.946, P < 0.01). Conclusions Using health management strategy intervention for FD outpatients will improve FD patient′s quality of life.
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Objective We aimed to explore the real experience of parents of children with acute leukemia during lumbar puncture,so as to provide the theoretical and practice evidence for development of individualized nursing measures.Methods Twenty parents of children with acute leukemia participated in semi-structured interviews regarding their experience of lumbar puncture.The data were colected and analyzed by the Colaizzi phenomenological methodology.Results Three themes were extracted including heavy psychological burden,lack of related knowledge of lumbar puncture and demand of multipolarity.Conclusions Attention should be paid closely to parents of children with acute leukemia during lumbar puncture.The individualized nursing measures should be taken by medical workers in order to truly meet their needs,make them stay in a good state and cooper-ate with medical workers to complete the treatment of children.
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Objective To analyze the feeling of nursing undergraduates after one semester of earlyclinical placement.Methods School of Nursing at Soochow University initiated Early Clinical PlacementI for the undergraduates recruited from poverty-stricken areas in 2013.Results Each student hadgained a profound understanding of nursing.Conclusions Early clinical placement is helpful for under-graduate to cultivate interest towards nursing and broaden thinking.