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Objective To explore the effect of cognitive education and behavioral intervention in solid-state high resolution esophageal manometry (HRM) examination. Methods From April 2016 to June 2017, 60 patients with solid-state HRM in the gastrointestinal motility room at the First Affiliated Hospital of Jiaotong University were as the research object. The 60 patients were divided into control group and experimental group with 30 cases each by the method of random numbers. The conventional methods was used in control group to conduct informed counseling before the examination and the coordination guidance in the examination. The conventional methods and cognitive behavioral intervention was used in experimental group at the same time. The successful rate of intubation, the time used for the examination, discomfort symptoms during intubation, the patient's satisfaction in the whole check process and self-evaluation of intubation pain experience in two groups of patients were compared. Results The time used in the experimental group examination was (28.50±8.75) min, and the control group was (33.13± 5.49) min. The difference between the two groups was statistically significant (t=2.584, P=0.015). In the experimental group, the number of nausea, vomiting, and coughing in the intubation process was 11, 0, and 1, respectively, and the control group was 20, 6, and 7, respectively. The difference was statistically significant (χ2=5.406, 4.630, 5.192, all P<0.05). In the experimental group, the scores of the 2, 3, 4, 5, 7, 8, 10, 11, 12, and 13 items of the intubation pain experience self-evaluation in the examination process were (1.00 ± 0.64), (1.37 ± 0.85), (2.80 ± 0.96), (1.50 ± 0.51), (0.87 ± 0.63), (0.77 ± 0.50), (0.60 ± 0.56), (1.07 ± 0.25), (0.57 ± 0.57), (1.50 ± 0.63) points, and the 2, 3, 4, 5, 7, 8, 10, 11, 12 and 13 scores of the control group they were (1.50 ± 0.51), (2.03 ± 0.76), (3.50 ± 0.82), (2.03 ± 0.76), (1.20 ± 0.61), (1.03 ± 0.41), (0.83 ± 0.53), (1.23 ± 0.43), (0.87 ± 0.57), (2.00 ± 1.05) points, respectively. The difference was statistically significant (t=-4.130--2.140, all P<0.05). Conclusions HRM is an important test before the clinical application of a wide range of clinical applications for the detection of esophageal motility disorders and gastroesophageal reflux disease. The degree of patient cooperation with the operation directly affects the high-resolution esophageal manometry test results and self-experience. Medical staff can give patients cognitive education and behavioral intervention before examination, which can effectively reduce the symptoms and pain caused by intubation, improve patient compliance, shorten the time for examinations, improve work efficiency, and improve patient satisfaction. It is worth further promotion and application in clinical examination.
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Objective To investigate the effectiveness and feasibility of standardized nursing training in reducing the incidence rate of post-endoscopic retrograde cholangiopanography(ERCP) pancreatitis. Methods A total of 521 patients were collected from January 2015 to June 2016 in ERCP therapy as control group.The patients in this group did not have standardized nursing training.A total of 289 patients were selected from July 2016 to April 2017 in ERCP therapy as intervention group.The patients in this group were carried out the standardized nursing training. The incidence of hyperamylasemia and post-ERCP pancreatitis was observed in two groups. Results The incidence of hyperamylasemia and post-ERCP pancreatitis was 12.09%(63/521),7.87%(41/521)in control group,and 7.61% (22/289), 3.11% (9/289) in intervention group,the difference was statistically significant between two groups(χ2=3.972,7.258,P<0.05 or 0.01). Conclusions The standard nursing training and intraoperative coordination can reduce its risk factors, and to reduce the post-ERCP pancreatitis and hyperamylasemia has important meaning and function.
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Objective To describe status of cancer-related fatigue (CRF) and its trajectory during three different time node for the operation, chemotherapy, and radiotherapy among breast cancer patients. Methods The convenience sampling method was used for 242 cases diagnosed with breast cancer which prepared for breast cancer resection, prepared to be treated with adjuvant chemotherapy and radiotherapy, and conformed to the sample standard from a tumor hospital and two affiliated hospital of medical college from February 2014 to November 2015 in a city. The follow-up survey of CRF was conducted respectively in the three different point-in-time for one week after the operation, at the end of chemotherapy and radiotherapy. Results After the operation mean rating for general fatigue was mild (2.59±2.41) points, and approximately 76.0% (184/242) patients experienced fatigue to low- grade degree; After the chemotherapy fatigue was significantly increased (6.57 ± 2.43) points, and 75.2% (182/242) patients accounted for severe fatigue; After the radiotherapy mean rating for fatigue was moderate (4.38 ± 2.46) points, and 57.0%(138/242) patients suffered to moderate fatigue. During the whole treatment period the level for general fatigue and four dimensions of fatigue were in the unstable state ofwaveof fluctuations with mild, severe, moderate, and fatigue were statistically different in three different stages of treatment ( F= 43.16,P=0.000). The age and operation method were associated with CRF in thephaseofoperation(age t=7.365, P=0.003; operation method t=5.166, P=0.009), chemotherapy (age t=9.835, P=0.000; operation method t=3.313, P=0.025) and radiotherapy (age t=9.014, P=0.000;operation method t=10.392, P=0.000). Conclusions There is a certain difference with CRF of breast cancer patients at different stage of rehabilitation treatment. There are two factors that could affect CRF such as age and operation method in the whole rehabilitation treatmentperiod.
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Objective To summarize theskill practice as the coremethods and training effect in tumor specialist nurse training , and to explore the suitable effective methods and pattern of China′s national conditions of specialist nurse training in China, for providing a reference for conducting cancer specialist nurse training. Methods Reviewed and analyzed tumor specialist nurse training method to make clear the training effect from 2012 to 2013, 100 students was investigated by using questionnaires , which contain 15 aspects, before and after the training respectively. designskill practice as the coreof the training content (160 hours) and theoretical classes (80 hours), established training evaluation criteria and the organization management system. Results All 100 students had grasped maintenance technology, observation of the complications of treatment, infusion port of the maintenance, the use of chemotherapy drugs, health education for patients with PICC catheter, and the use of effective order, the grasp rate was 100%. Complications rate was decreased significantly after using PICC catheter, (the rate of catheter related blood stream infections and the rate of thrombosis was reduced from the top 35%and 12%before training to 4%and 1%after training respectively (P<0.05). Conclusions In order to train more practical clinical nurse specialists, reduce the complications, raise the overall level of nursing profession, and improve the quality of nursing after using PICC catheter. Skill practice as the core methods in tumor specialist nurse training should be advocated.
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Objective To explore how to establish and safeguard the peripherally inserted central catheters(PICC) maintenance network for the management and practical activity of PICC,so as to provide continuous high-quality PICC maintenance for discharged patients with PICC. Methods 40 nurses each year from 10 cities and 100 country hospitals affiliated with Shanxi Quality Control Center to train in the 1st and 2nd affiliated hospital of Xi`an Jiaotong University were choosen as 214 PICC maintainers. These maintainers were taken into the inner-net of 1st affiliated hospital of Xi`an Jiaotong University management system complete the PICC maintenance net of Shanxi province. Results After the establishment of maintenance network, the number of patients with PICC increased (from 610 cases in 2008 to 1 434 cases in 2014);A large number of PICC management had been down by the qualified nurses in primary hospitals; Duration of PICC in patients days was prolonged; The PICC related complications including thrombophlebitis, catheter infection,occlusion or dislodgment and unplanned extubate were significantly decreased (P < 0.05 respectively). Conclusions Establishment of PICC maintenance network can provide patients with standardized and convenient PICC maintenance service,decrease the incidence of catheter which related complications and ensure patient safety. The application of PICC maintenance network should be used more and more.
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Objective To investigate the effect of Omaha system intervention on social psychology of the elderly,and to provide evidence for effective intervention in elderly with homebound state.Methods 218 cases with homebound conditions were divided into intervention group and control group by random digits table with each group 109 cases.The intervention group accepted intervention including health education,treatment procedures,case management,supervision of the four aspects of 1-3 times a week according to Omaha intervention system for a period of 3 months.The control group was the blank control.And Omaha evaluation form was used to evaluate social psychological and physical effect before and after the intervention.Results 3 months after the intervention,except physiology in the field of neuromusculo-skeletal function of two groups had no significant difference (t=2.03,P＞0.05),scores in the intervention group in the field of physiology (like the circulation) were higher than the control group,the difference was statistically significant [(1 1.20±2.03) vs.(8.72±1.36),P＜0.05].As for psychology (like mental health),scores of intervention group were higher than that of the control group [(12.53±1.42) vs.(8.63±1.33),t=20.12,P＜ 0.05].Conclusions Omaha system can effectively improve the quality of life of elderly with homebound state and maintain their physiological,social and psychological function.
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Objective To evaluate the prophylactic effect of abdominal breathing exercises on radiation pneumonitis in patients with chest malignant tumors.Methods 100 patients with chest malignant tumors were given radiotherapy and divided with random digit table into the exercise group and the control group with 50 patients in each group.The incidence rate of radiation pneumonitis in both groups was compared.The prophylactic effect of abdominal breathing exercises on radiation pneumonitis was evaluated.Results The incidence of radiation pneumonitis in abdominal breathing exercise group was significantly reduced [34％ (17/50) vs.56％ (28/50),Z=2.397,P＜0.05],the incidences of grade Ⅰ [22％ (11/50) vs.30％ (15/50)] and grade Ⅱ [12％ (6/50) vs.18％ (9/50)] radiation pneumonitis decreased,and no grade Ⅲ and Ⅳ radiation pneumonitis occurred.Conclusions The incidence of radiation pneumonitis in patients with chest malignant tumors treated with radiation therapy may be decreased by abdominal breathing exercises,which may be widely applied in patients treated with radiation therapy.
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Objective To know the effects of using hierarchical management for psychiatric nursing in psychiatric ward,and then to offer some rationales and theoretical support for hospital management.Methods The fine hierarchical management was implemented from Janurary 2012 in Xi'an Mental Health Center and the metal hygiene clinics of Xi'an Jiaotong University.Before and after the hierarchical management carried out,the nursing care quality was assessed among the family members of hospitalized patients by using satisfaction survey questionnaires,flight rate of patients was evaluated,and at the same time,nursing care quality and the nurse comprehensive ability was inspected.And then,the EPIDATE 3.0 and SPSS16.0 software was used to analyze and compare the satisfaction scores.The nurse comprehensive ability,and nursing care quality scores before and after implementation.Results The nurse comprehensive ability were improved.The satisfaction scores of family members of hospitalized patients was higher than that before implementation after the fine management implementation,which had statistical difference,P＜ 0.05.The satisfaction rate of patients' family member was 96.77％(2 543/2 628) after the fine management implementation,which was significant higher than that of before implementation,91.19％(2 382/2 612),x2=107.66,P＜0.05.Flight rate of patients was reduced after the hierarchical management,which was significantly lower than that of in before,P＜0.05.Nursing care quality scores were higher than those of in before,which has a statistical difference respectively,P＜0.05.Conclusions The hierarchical management could improve the satisfaction of family numbers,reduce the flight rate of patients,enhance nursing care quality and improve the nurse comprehensive ability.It would reduce the incidence of medical malpractice.The fine hierarchical management is worth to be applied and generalized in nursing care of psychiatric nursing in psychiatric ward.
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The paper reports a review on the current situation of the hierarchy and quality of the evidence related to both national and international evidence-based nursing research and practice.The limitations and barriers have been analyzed from both research methodology and data acquisition technique aspects.The available evidences provided by past studies are limited in post hoc indicators (e.g.hospital stay,fatigue,stress or sleep quality,etc.) and subjective methodologies (e.g.questionnaire,self-report or interview,etc.),that restrains the further development of evidence-based healthcare,in terms of its reliability,validity and application.The advantages/disadvantages and feasibility of new potential technologies,such as body sensors and smart phones,have also been discussed.
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Objective To know the masons of delaying to receive medical treatment among patients with breast cancer, and then reference to related health education. Methods 13 patients with breast cancer were selected in this research, interviewed them by phenomenological method to know their reasons of delaying to receive medical treatment, analized the results of interview by Clolaizzi method. Results The were five themes for patients with breast cancer about delaying to receive medical treatment, they were not understand breast cancer-related knowledge, shortage of method of self-examination, psychological factors, working pressure and family factors, social environment factors. Conclusions We should strengthen breast cancer-related health education when changed women's traditional ideas and ameliorated their family and social environment.
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Objective: To examine self-reported symptoms by the patients receiving cancer therapy, and find out the symptoms that should be coped with and managed during the treatment. Methods: A pilot study was conducted on self-reported symptoms on 185 patients receiving chemotherapy and/or radiotherapy for different cancers. The Therapy-Related Symptoms Checklist (TRSC) was used. Results: Severe symptoms on the TRSC subscales: loss of appetite, feeling sluggish, weight loss, nausea and hair loss, were reported by the patients. The frequently reported symptoms by those on chemotherapy were nausea, feeling sluggish, weight loss, vomiting, and taste change. The frequently reported symptoms by those on radiotherapy were feeling sluggish, weight loss, loss of appetite, difficult sleeping, and changing taste. The symptoms of loss of appetite, feeling sluggish, weight loss, hair loss, and nausea were both frequently reported by those on radiotherapy and those on chemotherapy. Conclusion: Symptom monitoring may be facilitated by TRSC, based on the severity and frequency of reported symptoms, more patients and caregivers could know which symptoms should be preferential interventions.
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Objective To examine self-reported symptoms by the patients receiving cancer therapy, and find out the symptoms that should be coped with and managed during the treatment. Methods A pilot study was conducted on self-reported symptoms on 185 patients receiving chemotherapy and/or radiotherapy for different cancers. The Therapy-Related Symptoms Checklist (TRSC) was used. Results Severe symptoms on the TRSC subscales: loss of appetite,feeling sluggish, weight loss, nausea and hair loss, were reported by the patients. The frequently reported symptoms by those on chemotherapy were nausea, feeling sluggish, weight loss, vomiting, and taste change. The frequently reported symptoms by those on radiotherapy were feeling sluggish, weight loss, loss of appetite, difficult sleeping, and changing taste. The symptoms of loss of appetite, feeling sluggish, weight loss, hair loss, and nausea were both frequently reported by those on radiotherapy and those on chemotherapy. Conclusion Symptom monitoring may be facilitated by TRSC, based on the severity and frequency of reported symptoms, more patients and caregivers could know which symptoms should be preferential interventions.
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@#Objective To investigate the influence of psychosocial factors to emotional disorder of tumor patients. Methods 76 patients with tumor and other 76 patients with tumor were including. All the patients themselves completed once through the following questionnaires: Symptom Check List (SCL-90),Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Life Event Scale (LES). However, Hamilton Depression rating scale (HAMD) and Hamilton Anxiety rating Scale (HAMA) were measured by the researchers. Results The occurrence rate of depression and anxiety in tumor patients was clearly higher than that of the control group (P<0.01), while the negative life event increased. Conclusion The occurrence rate of the emotional disorder among tumor patients is clearly higher than the control group, which may be related with the negative life event.
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With regard to the ethical nursing for patients suffering from cervical cancer,eight strategies are developed: To help establish credible relationship between nurses and target patients by psychological and ethical nursing and health education such as nursing on nutrition,skin,vaginal irrigation,radio-colitis,radio-cystitis and discharge instruction to the patients.
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Objective: To analyze relevant ethical issues in safeguarding the right of informed consent among patients with cancer in the course of medical treatment and convalescence,so as to protect their legal right of informed consent and provide a more rational and humanistic medical treatment and nursing.Methods: Phenomenological method was adopted in this research and 13 subjects who met our criteria were interviewed randomly.Results: After reading,analyzing,introspecting,and classifying the data,8 themes of relevant ethical issues are concluded for the right of informed consent among patients with cancer in the course of medical treatment and convalescence,including the informed consent right of independent hospitalization,the informed consent right on one's own illness state,the informed consent right on medical insurance,the informed consent right on medical risks,the informed consent right on therapeutic schedule,the informed consent right on medical documents,the informed consent right on inspection,and family member's rights of informed consent.Conclusion: In order to provide a more rational and humanistic medical treatment and nursing for patients with cancer,relevant ethical issues of patients' informed consent right must be stressed and well settled,so as to better preserve patients' rights of informed consent.