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Objective To investigate the risk factors of postoperative fecal contamination in children pa-tients with Hirschsprung's disease(HSCR),and to construct and evaluate the risk predictive model.Methods The clinical data in 377 children patients with HSCR in 3 class 3A hospitals in Guangxi from Janu-ary 2016 to June 2021were retrospectively analyzed by adopting the convenience sampling method.The pa-tients were divided into the modeling group(n=264)and testing model group(n=113)with a ratio of 7∶3.The risk factors of postoperative fecal soiling were analyzed by the single factor and multiple factors,and the risk predictive model was constructed.The receiver operating characteristic(ROC)curve was used to detect the discriminative ability of the model and the H-L test was used to determine the goodness of fit of the mod-el.The model was prospectively validated in 21 children patients with HSCR from August to December 2021.Results Among 377 children patients with HSCR,the fecal soiling occurred in 131 cases with a incidence rate of 34.75％.The constructed predictive model of fecal contamination risk after HSCR operation:logit(P)=-2.385+1.697 × special type of megacolon+0.929 × Soave+0.105 × length of bowel resection+2.065 × il-literate caregivers+0.808 × caregivers'implementation of postoperative diet+0.867 × postoperative defecation training by caregivers.The area under the curve(AUC)in the modeling group was 0.849,the Yoden index was 0.53,the optimal critical value of the model was 0.32,the sensitivity was 76.00％,and the specificity was 77.00％.The H-L test,X2=6.649,P=0.575.AUC of the testing model group was 0.736,the sensitivity was 81.25％,and the specificity was 78.46％.The prospective validation results showed that the sensitivity and specificity of the model were 66.67％and 100％respectively.Conclusion The constructed model has good i-dentification and predictive ability.
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Objective@#To explore the effect of continuing nursing intervention with traditional Chinese medicine (TCM) characteristics on mental state and quality of life of empty nest elderly patients with hypertension, and to provide evidence-based theoretical basis for the development of continuing nursing care for empty nest elderly patients with hypertension.@*Methods@#Totally 100 cases of empty nest elderly patients with hypertension were randomly divided into study group and control group by random number method, 50 cases in each group; two groups of patients were given regular nursing according to doctor's instructions to adjust blood pressure drugs and hypertension; control group patients were given routine continuing nursing intervention after discharge; study group patients were given traditional Chinese medicine characteristics on the basis of the control group. Sustained nursing intervention; Self-rating Anxiety Scale (SAS) was used to measure the degree of anxiety at admission, discharge and 6 months after discharge. The rate of blood pressure control reaching the standard at admission, discharge and 6 months after discharge and the clinical effect at discharge and 6 months after discharge were compared between the two groups. SF-36 was used to assess the quality of life of the 2 groups at admission, at the time of discharge and 6 months after discharge.@*Results@#There was no significant difference in SAS scores between the two groups at admission and discharge (P>0.05). The SAS score in the study group at 6 months after discharge was (44.65 ± 4.32) points and (46.91 ± 4.56) points in the control group, and there was significant difference (t=2.544, P=0.006). There was no significant difference in the control rates of systolic and diastolic blood pressure between the two groups at admission and discharge (P>0.05). The control rates of systolic blood pressure and diastolic blood pressure in the study group were better than those in the control group at 6 months after discharge (t=4.762,4.336, P = 0.029, 0.037); there was no significant difference in the clinical efficacy between the two groups at discharge (P>0.05), and the clinical efficacy of the study group at 6 months after discharge was better than that of the control group (u=1.997, P=0.046). There was no significant difference in the scores of SF-36 at discharge (P>0.05); the scores of SF-36 at discharge for 6 months in the study group were significantly better than those in the control group (t=4.875-8.975, P=0.000); no cardiovascular and cerebrovascular events occurred in the study group for 6 months, 4 cases of unstable angina pectoris and 4 cases of cerebral infarction occurred in the control group. In 2 cases, the incidence of cardiovascular and cerebrovascular events was 12.00% (6/50). The difference between the two groups was statistically significant (χ2=4.433, P=0.035).@*Conclusion@#Continuous nursing intervention with TCM characteristics can significantly improve the anxiety level of empty nest elderly patients with hypertension, is conducive to the control of blood pressure, improve the clinical efficacy, reduce the incidence of cardiovascular and cerebrovascular events, improve the quality of life of patients, and has the advantages of simplicity, safety and reliability, low cost, and so on. It is worth popularizing and applying.
ABSTRACT
Objective To explore the effect of continuing nursing intervention with traditional Chinese medicine (TCM) characteristics on mental state and quality of life of empty nest elderly patients with hypertension, and to provide evidence-based theoretical basis for the development of continuing nursing care for empty nest elderly patients with hypertension. Methods Totally 100 cases of empty nest elderly patients with hypertension were randomly divided into study group and control group by random number method, 50 cases in each group; two groups of patients were given regular nursing according to doctor's instructions to adjust blood pressure drugs and hypertension; control group patients were given routine continuing nursing intervention after discharge; study group patients were given traditional Chinese medicine characteristics on the basis of the control group. Sustained nursing intervention; Self-rating Anxiety Scale (SAS) was used to measure the degree of anxiety at admission, discharge and 6 months after discharge. The rate of blood pressure control reaching the standard at admission, discharge and 6 months after discharge and the clinical effect at discharge and 6 months after discharge were compared between the two groups. SF-36 was used to assess the quality of life of the 2 groups at admission, at the time of discharge and 6 months after discharge. Results There was no significant difference in SAS scores between the two groups at admission and discharge (P>0.05). The SAS score in the study group at 6 months after discharge was (44.65 ± 4.32) points and (46.91 ± 4.56) points in the control group, and there was significant difference (t=2.544, P=0.006). There was no significant difference in the control rates of systolic and diastolic blood pressure between the two groups at admission and discharge (P>0.05). The control rates of systolic blood pressure and diastolic blood pressure in the study group were better than those in the control group at 6 months after discharge (t=4.762,4.336, P = 0.029, 0.037); there was no significant difference in the clinical efficacy between the two groups at discharge (P>0.05), and the clinical efficacy of the study group at 6 months after discharge was better than that of the control group (u=1.997, P=0.046). There was no significant difference in the scores of SF-36 at discharge (P>0.05); the scores of SF-36 at discharge for 6 months in the study group were significantly better than those in the control group (t=4.875-8.975, P=0.000); no cardiovascular and cerebrovascular events occurred in the study group for 6 months, 4 cases of unstable angina pectoris and 4 cases of cerebral infarction occurred in the control group. In 2 cases, the incidence of cardiovascular and cerebrovascular events was 12.00% (6/50). The difference between the two groups was statistically significant ( χ2=4.433, P=0.035). Conclusion Continuous nursing intervention with TCM characteristics can significantly improve the anxiety level of empty nest elderly patients with hypertension, is conducive to the control of blood pressure, improve the clinical efficacy, reduce the incidence of cardiovascular and cerebrovascular events, improve the quality of life of patients, and has the advantages of simplicity, safety and reliability, low cost, and so on. It is worth popularizing and applying.