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Objective To explore the impact of the three-level assistance model based on the narrative nursing theory on the mental health status of medical staff.Methods 140 medical staff working in a third class hospital in Xiangyang City were selected as the research object.The three-level assistance model based on narrative nursing theory was used to intervene them from September 2021 to July 2022.The symptom self-assessment scales before and after the intervention were compared.Results Before the intervention,the total score of SCL-90(156.37±32.56)points and the scores of various symptom factors of medical staff were higher;After the intervention,the total score of SCL-90(133.35±43.48)points and the scores of various symptom factors were lower than those before the intervention and the difference was statistically significant(P<0.05).Conclusion The three-level assistance model based on narrative nursing theory can reduce the total score of SCL-90 and the scores of various symptom factors,improve the mental health status and mental health level.
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Objective:To investigate the cognition and attitude of nephrology nurse to palliative care for patients with end-stage renal disease, and to provide reference for the promotion and application of palliative care in patients with end-stage renal disease.Methods:Using the phenomenological research method, the purpose sampling method and the principle of data saturation, the semi-structured interviews were conducted among 12 nurses from the Department of Nephrology in Xiang Yang NO.1 People ′s Hospital, Hubei University of Medicine in November 2021. The data were analyzed, summarized and extracted by Colaizzi 7-step analysis method. Results:The cognition and attitude of nephrology nurses to palliative care of patients with end-stage renal disease were summarized into three themes. They were: different cognition of palliative care; attitudes towards palliative care for end-stage renal disease patients (positive feelings, negative feelings); difficulties in the implementation of palliative care (difficult decision-making, unknown timing and effect, lack of social policy support, traditional thought constraints).Conclusions:Interviewees lacked cognition to palliative care and have different attitudes. In order to promote the application of palliative care in patients with end-stage renal disease, relevant publicity and education should be strengthened, the palliative care system of end-stage renal disease should be improved, and social support for palliative care should be enhanced.
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Objective:To evaluate the effect of whole-body vibration training on exercise ability and quality of life in patients with Chronic obstructive pulmonary disease (COPD).Methods:Randomized controlled trials on the application of whole-body vibration training in COPD patients were retrieved from PubMed, Medline, EMbase, Web of Science, Wanfang, VIP, CNKI, Chinese biomedical literature database, and the literature was independently screened according to the inclusion and exclusion criteria, the data were extracted, a literature quality evaluation was performed, and the data were meta analyzed by using RevMan5.3.Results:A total of 9 RCTs was included in this study. Meta-analysis results showed that whole-body vibration training could improve the exercise endurance in COPD patients ( WMD=41.65, 95%CI 6.68-76.63, P=0.02), and improve their balance ability ( WMD=-2.31, 95%CI-3.38--1.23, P<0.01). There was no significant difference in improving BODE index, quality of life and lung function in COPD patients ( P>0.05). Conclusions:Whole-body vibration training helps improve exercise endurance and balance in COPD patients as a complementary or alternative exercise method for COPD patients. The impact on BODE index, quality of life, and lung function still needs further evaluation through clinical multicenter, large sample, high-quality research.
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Objective:To explore the influence of training mode based on core competence of nurses on comprehensive performance, critical thinking ability and clinical communication ability of nursing students.Methods:A total of 102 Batch 2015 nursing students from the four-year program of Hubei University of Medicine who were interned in a "three A" general hospital in Shiyan City from May 2018 to January 2019 were selected as subjects, and were randomized into the control group ( n=51) and the intervention group ( n=51). The control group received traditional training mode and the intervention group adopted the training mode based on core competence of nurses. The two groups of nursing students were graded on the critical thinking scale and clinical communication ability scale before practice and at 2 months, 4 months, 8 months after intervention respectively. The comprehensive performance of two groups was assessed before and after 8 months of intervention. All data were analyzed by SPSS 19.0. Results:Comparison of effect, interaction effect, time effect of critical thinking scale and clinical communication ability scale between the two groups showed significant differences ( P<0.05). The comprehensive performance differences between the two groups were statistically significant after the intervention ( P<0.05). Conclusion:The practice training mode based on core competence of nurses can effectively improve the comprehensive performance, critical thinking ability and clinical communication ability of nursing students.
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Objective To investigate the value of serum interleukin-6 (IL-6) ,haptoglobin (HPT) and amy-loid A (SAA) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) with pneumonia.Methods 87 cases of acute exacerbation of COPD without pneumonia and 76 cases with pneumo-nia ,admitted in the hospital from December 2015 to March 2017 ,were selected as COPD without pneumonia group and COPD with pneumonia group.62 healthy people who underwent the healthy assessment during the same period were selected as the control group.The changes of serum IL-6 ,HPT and SAA levels in three groups ,the value of serum IL-6 ,HPT and SAA levels in detecting COPD with pneumonia and the correlation of IL-6 ,HPT and SAA were compared.Results COPD patients with serum IL-6 ,HPT and SAA were higher than group COPD with pneumonia group and control group ,and COPD is not associated with serum IL-6 , HPT and SAA in pneumonia group than the control group (P<0.05) ;IL-6+ HPT+SAA diagnostic specifici-ty ,sensitivity and positive predictive value is higher than IL-6 ,HPT and SAA (P<0.05) ;IL-6 and HPT was positively related with SAA and HPT was positively correlated with SAA.The serum levels of IL-6 ,HPT and SAA in the COPD with pneumonia group were higher than those in the COPD without pneumonia group and the control group ,and the serum IL-6 ,HPT and SAA levels in the COPD without pneumonia group were higher than those in the control group ,and the difference was statistically significant (P<0.05).The diagnos-tic specificity ,sensitivity and positive predictive value of the combined detection of IL-6 ,HPT and SAA levels were higher than those of single detection of IL-6 ,HPT and SAA level ,and the difference was statistically sig-nificant (P<0.05) ;IL-6 level was positively correlated with HPT and SAA levels ,and HPT was positively correlated with SAA level.Conclusion The levels of serum IL-6 ,HPT and SAA in patients with acute exacer- bation of COPD increased.The combined detection of the three had relatively high sensitivity and specificity , and the levels of IL-6 ,HPT and SAA were positively correlated.
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Objective To investigate the application value of the carbohydrate antigen 125(CA125)and ovarian cancer risk pre-diction model(ROM A)in risk assessment for endometrial endometriosis patient in Yangchun area.Methods A total of 433 cases of endometrial endometriosis patient in 3 hospitals were selected as the objects of the retrospective research.ELISA method was used to detect the CA125 and human epididymis protein 4(HE4)levels before operation.ROMA formula was used to calculate the RO-MA index cutoff value,correlation between CA125 level and ROMA index cutoff value and staging of endometriosis cysts and post-operative pregnancy rate was analyzed,and the CA125 level and ROMA index cutoff value in endometriosis risk assessment were discussed.Results The endometrial cyst stage Ⅰ,Ⅱ,Ⅲ,the serum CA125 level and the ROMA index truncation value of the preg-nant women were lower than those of the non pregnant women,and there is a statistically significant difference in comparison(P<0.05);the serum CA125 level and ROMA index cutoff value and staging of ovarian endometriosis cyst showed a positive correlation (r=0.986 2,0.988 3;P<0.05);the level of serum CA125 and the truncated value of ROMA index were negatively correlated with the pregnancy rate of patients with endometriosis(r=0.597 5,0.952 8;P<0.05);the accuracy,specificity,sensitivity,positive and negative prediction value and diagnostic coincidence rate of ROMA index in patients with endometriosis after operation were higher than those of CA125(P<0.05).Conclusion CA125 and ROMA index can be used for risk assessment of patients with endometrio-sis and assessment of postoperative pregnancy risk,but the evaluation value of ROM A index is better than that of CA 125.
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Objective To investigate the risk factors for conversion of laparoscopic cholecystectomy (LC) to laparotomy.Methods In 1020 LC patients,36 patients with conversion of LC to laparotomy were chosen as the case group,108 patients with successful LC were chosen as the control group.Univariate analysis and Logistic multivariate regression model were used to analyze the risk factors for conversion of LC to laparotomy.Results Age > 65 years (0R=3.234,95% CI:0.532-6.853),course of disease > 72h (OR =2.342,95% CI:0.568 ~ 5.656),history of upper abdominal operation (OR =2.453,95% CI:0.345-7.453),thickness of gallbladder wall ≥ 6 mm (OR =2.453,95% CI:0.453-6.343),white bloodcell count > 15.0 × 109/L (OR =4.532,95% CI:0.535-8.329) were risk factors for conversion of LC to laparotomy.Conclusion Preoperative comprehensive evaluation the risk factors and selecting suitable program have important clinical significant in reducing the rate of conversion LC to laparotomy.
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Objective: To study the accuracy of MRI-CT image registration in order to find a more effective method of image fusion and a standard for the evaluation of post-operative intra-cranial tumor radiotherapy.Methods: Twenty-four patients with intra-cranial tumor underwent MR T1-weighed sequence and post-operative location CT scan under the same location condition.The trans-axial MR T1-weighed sequence and CT image were registered and the correlation between registration scores and errors was analyzed by the method of Tris-Axes Landmark.The linear registration errors were observed in the three-dimensional space of every patient.Results: An improved linear correlation was found between registration scores and errors(r=-0.985,y=-0.551 3x+5.351 4).The registration met the clinical standard when the scores exceeded 6.61.Conclusion: Tris-Axes Landmark is a preferable registration method to be used in clinical radiotherapy for rapid and precise evaluation of MRI-CT image registration accuracy.