ABSTRACT
Objective:To explore the potential categories of post-operative supportive care demand trajectory for patients with non-small cell lung cancer (NSCLC), analyze the influencing factors, and propose targeted interventions.Methods:This was a prospective observational study. A convenient sampling method was used to select 177 NSCLC patients who received surgical treatment in Shanghai Lung Hospital Affiliated to Tongji University from January 2021 to February 2022. The Supportive Care Demand Scale for cancer patients was used to investigate the level of patients′supportive care demand 1 day before operation, 3 days after operation, 1 day before discharge, 1 week after discharge, 1 month after discharge, and 3 months after discharge, and the potential growth model was used to identify the trajectory category and multi category Logistic regression analysis was used to explore the influencing factors.Results:Three supportive care demand trajectories were fitted out in this study, which were the continuous high demand group (46.33%), the slowly decreasing demand group (30.51%), and the low decreasing demand group (23.16%). With the potential category group 3, low demand reduction group as the reference category, Logistic regression analysis showed that high psychological distress, low social support, high disease stage, high comorbidities were more likely to enter the continuous high demand group ( OR = 0.826 to 18.526, all P<0.05), and high education level (college education and above and high school) were more likely to enter the slowly decreasing demand group ( OR = 6.076, 4.199, both P<0.05). Conclusions:The demand track of NSCLC patients for supportive care after surgery has population heterogeneity. Clinical medical staff should provide personalized social support and emotional support for patients with high disease stage, more complications and low education level in the early postoperative period.
ABSTRACT
Objective:Based on the business reengineering theory, to construct the emergency nursing process of acute massive hemoptysis in hospital and explore the effect of it.Methods:According to the order of hospitalization, 200 patients with acute massive hemoptysis admitted to the emergency department in Shanghai Pulmonary Hospital Affilated to Tongji University from January to June in 2020 were selected as the control group, and the original treatment process was adopted. Two hundred patients admitted to the emergency department of this hospital from July to December in 2020 were selected as the experimental group, and the reconstructed in-hospital emergency nursing process for acute massive hemoptysis was applied. In both groups, the researchers recorded the time spent in each sub-process by using the in-hospital treatment time record of acute massive hemoptysis and collected the clinical outcomes of patients through electronic cases. The time-consuming, treatment efficiency and patient outcome of each link of the treatment process in the backyard of the two groups were compared.Results:Finally, 192 patients were enrolled in the control group and the experimental group. The median time from admission to intravenous use of hemostatic drugs and from admission to endovascular treatment in the experimental group were 21.50(20.00, 22.50) and 82.50(79.50, 84.50) min, which were lower than those in the control group which spent 40.87(37.06, 44.43) and 135.50(123.50, 147.00) min, and the differences between the two groups were statistically significant ( Z=-16.84, 16.63, both P<0.01). The incidence of asphyxia caused by acute massive hemoptysis in the experimental group was 4.2%(8/192), which was lower than that in the control group, which was 13.0%(25/192) . There was a statistically significant difference in the incidence of asphyxia between the two groups( χ2=9.58, P<0.01). Conclusions:The emergency nursing process of acute massive hemoptysis effectively shortens the time of in-hospital treatment of acute massive hemoptysis, further promotes the seamless connection of multiple links of in-hospital treatment of acute massive hemoptysis, and improves the overall efficiency of in-hospital treatment of patients with acute massive hemoptysis.
ABSTRACT
Objective:To explore the path and relationship between social support and ruminant meditation of tuberculosis patients on their post-traumatic growth (PTG).Methods:A total of 156 patients treated from January 2018 to August 2019 were selected as the research objects. The social support rating scale, event-related ruminant meditation questionnaire, and post-traumatic growth rating scale were used for investigation and analysis, and 150 valid questionnaires were obtained. The path analysis method was used to analyze the mutual influence between people.Results:The patient ′s post-traumatic growth, social support and ruminant meditation scores were (62.71±12.28), (38.19±9.79) and (27.28±11.18) points, respectively; social support and purposeful ruminant meditation directly affected tuberculosis patient's PTG (effect value was 0.57); social support indirectly positively affected the patient's PTG through purposeful ruminant meditation (indirect value was 0.77), and purposeful ruminant meditation was the mediating variable. Conclusion:The PTG, ruminant contemplation level and social support of pulmonary tuberculosis patients need to be improved. Social support can directly and indirectly affect the PTG level of pulmonary tuberculosis patients.
ABSTRACT
Objective To understand the current status and influencing factors of nursing safety management of geriatric care institutions in Shanghai. Methods Adopted questionnaire and experts spot-supervision to survey 25 geriatric nursing hospitals and 12 community health care centers which had more than 200 beds. The questionnaire had four parts including nature of institutions, general information of the managers, nursing risk management status and nursing safety quality status. Results The average score of nursing safety quality was (14.12 ± 2.03) points, there was no statistical significance in nature of institution, size of the institutions, age, education background, professional title, managerial experience, effect of nursing risk report and assessment and contingency plan (P> 0.05), but there was statistical significance in nurse managers′ knowledge about nursing risks, nursing risk management maturity and nurses training(F=2.818, 7.768, 3.555, P<0.05 or 0.01). Multiple linear regression showed that nurse managers′ knowledge about nursing risks, nursing risk management maturity and nurses training were the influence factors of nursing safety quality, and they account for 82.1%, and the regression equation was Y=7.988+0.365X1-0.380X2+0.350X3. Conclusions Strength the construction of nursing management team, perfect nursing management system, regular training could improve nursing safety quality of geriatric institutions in Shanghai.
ABSTRACT
Objective To evaluate the application value of Smart Mask technology guiding micro-catheter in place for intracranial aneurysm embolization in endovascular interventional treatment. Methods The DSA data of 61 consecutive patients with unruptured intracranial aneurysm in the Department Neurosurgery,Changhai Hospital,the Second Military Medical University from August 5 to December 20,2016 were collected retrospectively. The conditions of the guildewire catheter reaching the aneurysms and the coil embolization in the Smart Mask technology group (n = 31)and conventional road map group (n = 30)were compared. The observation indexes included the differences in contrast agent dosage,exposure time,and operation time. Results The contrast agent dosage of the Smart Mask technology group and road map technology group were 192 ± 37 and 215 ± 40 ml respectively,the X-ray illumination quantity were 5913 ±1682 and 6975 ±2036 mGy respectively,and the operation time were 2. 62 ± 0. 29 h and 2. 94 ± 0. 35 h respectively. The differences were statistically significant (all P < 0. 05 ). Conclusion Using Smart Mask technology to assist endovascular embolization of intracranial aneurysms can effectively shorten the operation time,reduce the amount of X-ray radiation and contrast agent,and reduce the risk of operation.
ABSTRACT
Objective To explore the effect of team resource management mode in reducing the door-to-needle time (DNT) of acute ischemic stroke. Methods A total of 272 acute ischemic stroke patients admitted to our hospital from January to December 2014 were set as the observation group. The observation group adopted the team resource management mode which was composed of emergency triage nurses, thrombolysis group nurses, emergency CT nurses, emergency intensive care nurses, interventional radiology nurses, cerebrovascular medicine nurses and rehabilitation medicine nurses. Another 264 acute ischemic stroke patients admitted to our hospital from January to December 2013 were named as the control group who was given traditional emergency treatment mode. The DNT, the activities of daily living and the nursing service satisfaction of patients were compared between the observation group and the control group. Results The DNT, Barthel index and the nursing service satisfaction of patients in the observation group were (44.93 ±11.47) min, 65.26 ±21.36, 93.39% (240/257), which were better than those of the control group, (111.99±11.10) min, 39.53±20.56, 80.41%(197/245), the differences were significant (t=115.516, 14.559, χ2=18.740, P < 0.01). Conclusions The team resource management mode is an effective tool to shorten the DNT, promote the recovery of patients and improve the quality of patients′life.
ABSTRACT
Specialization development of nursing has increasing demand for nursing staff. Competency model is a professional way for the person-post matching, which may replace the job analysis as a new research direction in nursing human resource management. In this paper, the validation and application of nursing competency model were reviewed from the perspectives of competency model, to discuss the thought and method of verifying competency model, so as to lay the foundation for the clinical application of nursing competency model, and promote the rapid development of nursing.
ABSTRACT
Objective To discuss the nursing cooperation for patients with severe aortic stenosis who are receiving transcatheter aortic valve replacement using balloon-expandable aortic valve stent. Methods Percutaneous interventional transcatheter aortic valve replacement was employed in 9 patients with severe aortic stenosis. Active preoperative preparation, sufficient psychological care, close observation of vital signs and effective surgery cooperation during the operation were carried out. The clinical results were analyzed. Results Successful operation was accomplished in all the nine patients. After the surgery, all patients were in good condition, and no nursing-related complications occurred. Conclusion Correct understanding of the cooperation with the procedure of transcatheter aortic valve replacement using balloon-expandable aortic valve stent, excellent preoperative psychological care and active preoperative preparation, etc. are the most important things to ensure a successful surgery.
ABSTRACT
Objective To discuss the importance of balloon occlusion test before interventional treatment of the intracranial giant intemal carotid artery aneurysms and to sum up the nursing experience in assisting the procedure. Methods Proper perioperative nursing measures were carried out for 12 patients, who suffered from intracranial giant internal carotid artery aneurysm and underwent spring coil occlusion treatment. Nursing measures included mental care, observation of the vital signs, prevention of the complications, etc. Results Neither death nor exacerbation of the condition occurred in all the 12 patients. The patients were discharged from the hospital with a mean hospitalization of nine days. During a follow-up period ranged from 4 months to one year, seven patients had no disagreeable feeling, one patient complained of discomfort but no abnormality was found on follow-up DSA, and disappearance of the aneurysm was observed in 4 patients. Conclusion The monitoring of the vital signs, the prevention of the complications and the standard nursing care are the key points for ensuring a successful operation in treating intracranial giant intemal carotid artery aneurysms with spring coil occlusion.
ABSTRACT
Objective To know the relative efficiency condition in some cardiovascular surgical ICU for the nursing administrator to allocate the nursing resources.Methods Used the C2R model and the G2GS2 model to evaluate the effeciency of nursing manpowers in 12 cardiovascular surgical ICUs.Results The percentage of decision-making unit was 75% from the aspect of pure technique.The inefficent units can achieve the same levels of effeciency as the efficiency units by altering their inputs.Conclusions The coexistence of insufficiency and lower effeiciency were found in the nursing resource utilization of some cardiovascular surgical ICU,with a DEA based approach,we are able to provide scientific basis for the resource allocation through identifying the level of nursing efficiency.
ABSTRACT
OBJECTIVE: To observe and discuss the dynamic changes of interleukin-2 (IL-2) and soluble interleukin-2 receptor (sIL-2R) and their significance in the patients with primary liver cancer after transarterial chemoembolization (TACE) therapy combined with Jinglong Capsule. METHODS: A total of 48 patients with primary liver cancer, who failed to be treated by major surgery, were randomly divided into two groups: Jinlong Capsule group (TACE therapy plus Jinlong Capsule) and control group (TACE therapy alone). There were 24 cases in each group. The levels of peripheral blood IL-2 and slL-2R were measured before the first TACE and 1, 7 and 15 days after the second TACE respectively by using double-antibody sandwich enzyme-linked immunosorbent assay. The data from Jinlong Capsule group were compared with those from the control group. RESULTS: The level of sIL-2R in Jinlong Capsule group was significantly lower than that in the control group (P<0.05), while the level of IL-2 was significantly higher than that in the control group (P<0.05). CONCLUSION: Jinlong Capsule can significantly improve the lymphocyte function of the patients with primary liver cancer after TACE. The levels of IL-2 and sIL-2R can be considered as the valuable parameters for evaluating the effects on primary liver cancer, and Jinlong Capsule is helpful for the patients with primary liver cancer.
ABSTRACT
Objective:To study the inhibitory effects of an adenovirus(Ad)-based short hairpin RNA(shRNA) expression system on expression of vascular endothelial growth factor receptor(VEGFR) and on growth of colon carcinoma cells in vitro and in vivo.Methods: RNA interference pAd-Easy/VEGFR vector was used to transfect 293 cells via Lipofectamine 2000.The adenoviral vector carrying VEGFR was used to transfect CW2 cells and the transfection efficiency was determined by fluorescent microscope and flow cytometry.The expression of VEGFR was examined by RT-PCR and Western blotting.The cell growth was observed with MTT method and the growth curve was plotted.Nude mouse was transplanted with CW2 cells to establish colon cancer tumor model and the growth of tumor was observed daily.Micro-vessel density(MVD) was detected by immunohistochemistry.Results: The recombinant pAd-Easy carrying shRNA against VEGFR was verified by sequencing.Flow cytometry showed that the transfection efficiency of CW2 cells was 99.7%.RT-PCR and Western blotting showed that the expression of VEGFR in pAd-Easy/VEGFR group was obviously decreased.The growth curve showed that the cell growth in the pAd-Easy/VEGFR group was obviously slowed down.We also found that the tumor growth in the nude mouse model was obviously inhibited and the MVD was also decreased.Conclusion: pAd-Easy/VEGFR-mediated VEGFR shRNA can effectively inhibit the expression of VEGFR in CW2 cells and suppress tumor growth in vivo.