Nursing students' experiences and perspectives on institutional care for elderly in totally dependent persons / Experiencias y perspectivas de estudiantes de enfermería sobre cuidado geriátrico institucionalizado en personas con dependencia total

ABSTRACT Objective: To learn the perspectives of nursing students on geriatric care provided in a public home for the aged. Method: Qualitative study - grounded theory. Nineteen students who performed social service at a home for the aged between 2020 and 2021 in the state of San Luis Potosí, Mexico, were interviewed based on the criteria of theoretical saturation. The analysis was based on Strauss and Corbin's proposal and was triangulated with the field diary records. Results: the central emerging category was "Non-humanistic care", the organization and implementation of care obey more to administrative issues and protocols developed from the biomedical medicalizing paradigm. Conclusion: the perspectives dehumanize care, there is no recognition of people's autonomy, and the nursing staff shows weaknesses in psychosocial competences to relate to this population.

RESUMEN Objetivo: conocer las perspectivas de estudiantes de enfermería, sobre el cuidado geriátrico que se brinda dentro de un asilo público. Método: estudio cualitativo-teoría fundamentada. Se entrevistó con base en el criterio de saturación teórica a 19 estudiantes que realizaban servicio social en el asilo entre 2020 y 2021 en el estado de San Luis Potosí, México. El análisis se hizo desde la propuesta de Strauss y Corbin, y se trianguló con los registros en diario de campo. Resultados: la categoría central emergente fue "El cuidado no humanístico", la organización e implementación de los cuidados obedecen más a cuestiones administrativas y protocolos desarrollados desde el paradigma biomédico medicalizante. Conclusión: las perspectivas deshumanizan el cuidado, no hay reconocimiento de la autonomía de las personas y el personal de enfermería muestra debilidades en competencias psicosociales para relacionarse con esta población.

Construction of continuous nursing program for children with congenital imperforate anus based on 5W1H analysis / 中国实用护理杂志

Objective:Based on the framework of 5W1H analysis, to establish the continuous nursing project by delphi expert consultation method for children with congenital imperforate anus after discharge.Methods:This study is observational. Through the literature review, qualitative interview and group discussion to establish the expert correspondence questionnaire from April 2021 to March 2022. Delphi consultation was applied to experts for two rounds of expert consultation, to evaluate the initiative, authority and coordination of expert opinions.Results:Two rounds of expert consultation were carried out with 20 experts.The response rates of two rounds of expert questionnaires were 19/20 and 20/20 respectively, the expert authority coefficients were 0.873 and 0.893 respectively, and the Kendall′s coefficients were 0.311 and 0.405 respectively. The coordination of expert opinions was statistically significant ( P<0.05); After two rounds of expert consultation, it was finally determined that the continuing care plan for children with anal atresia included three first-level indicators (composition and responsibilities of continuing care personnel, implementation methods of continuing care, and implementation content of continuing care), 23 second-level indicators, and 46 third-level indicators. Conclusions:This study have high enthusiasm and authority of experts, and concentrated expert opinions on various indicators. The results are reliable, scientific and comprehensive, which will provide a basis for clinical medical staff to carry out the continuous nursing of children with congenital imperforate anus.

Conhecimento da equipe de enfermagem sobre reanimação cardiopulmonar antes e após capacitação / Conocimiento del equipo de enfermería sobre reanimación cardiopulmonar antes y después de capacitación / Knowledge of the nursing team on cardiopulmonary resuscitation before and after training

Objetivo: avaliar o conhecimento dos profissionais da equipe de enfermagem no atendimento à parada cardiorrespiratória e comparar antes e após capacitação. Método: pesquisa prospectiva e comparativa, realizada em um hospital público em São Paulo, em 2021, com 68 profissionais. Foi aplicado um questionário sobre parada cardiorrespiratória antes e após capacitação, para comparação. Resultados: a maioria dos profissionais reconhece os sinais clássicos de parada cardiorrespiratória e a sequência correta de atendimento, todavia, teve dificuldade em identificar os ritmos chocáveis e as ações após a desfibrilação. A média de acertos antes e após a realização da capacitação foi de 43,65 e 66,11, respectivamente, e corrobora com a eficácia da ação educativa. Conclusão: é extremamente relevante ofertar, sistematicamente, capacitações à equipe, de modo a garantir uma assistência mais segura e eficaz.

Objetivo: evaluar el conocimiento de los profesionales del equipo de enfermería en la atención a la parada cardiorrespiratoria y comparar antes y después de capacitación. Método: investigación prospectiva y comparativa, realizada en un hospital público en São Paulo, en 2021, con 68 profesionales. Se aplicó un cuestionario sobre parada cardiorrespiratoria antes y después de capacitación, para comparación. Resultados: la mayoría de los profesionales reconocen los signos clásicos de parada cardiorrespiratoria y la secuencia correcta de atención, sin embargo, tuvo dificultad en identificar los ritmos chocables y las acciones después de la desfibrilación. El promedio de aciertos antes y después de la realización de la capacitación fue de 43,65 y 66,11, respectivamente, y corrobora con la eficacia de la acción educativa. Conclusión: es extremadamente relevante ofrecer, sistemáticamente, capacitaciones al equipo, de modo a garantizar una asistencia más segura y eficaz.

Objective: to evaluate the knowledge of nursing staff professionals in the care of cardiorespiratory arrest and to compare before and after training. Method: prospective and comparative research, conducted in a public hospital in São Paulo, in 2021, with 68 professionals. A questionnaire on cardiorespiratory arrest before and after training was applied for comparison. Results: most professionals recognize the classic signs of cardiorespiratory arrest and the correct sequence of care, however, had difficulty identifying the shockable rhythms and actions after defibrillation. The average number of correct answers before and after the training was 43.65 and 66.11, respectively, and corroborates the effectiveness of the educational action. Conclusion: it is extremely relevant to systematically offer training to the team in order to ensure safer and more effective care.

Formação continuada remota para os cuidados agudos do National Early Warning Score 2: Adaptação transcultural / Formación remota continua para los cuidados agudos del National Early Warning Score 2: Adaptación transcultural / Remote continuing training for National Early Warning Score 2 acute care: Cross-cultural adaptation

Objetivo: Adaptar transculturalmente o módulo de cuidados agudos do National Early Warning Score 2 para o português brasileiro. Método: Estudo metodológico de adaptação transcultural, autorizado pelo Royal College of Physicians, realizado no período de julho de 2020 a julho de 2021. Aprovado por Comitê de Ética, sob no 4.247.069 e registro na Plataforma Brasil no 36540020.4.0000.5292. Juízes das cinco regiões brasileiras, enfermeiros, avaliaram as equivalências semântica, idiomática, cultural e conceitual entre o material original e as versões traduzidas. Enfermeiros atuantes em 30 hospitais brasileiros, realizaram o teste piloto, com a finalidade de assegurar que a versão adaptada preservava as equivalências em relação ao conteúdo da versão original. A análise qualitativa de adaptação cultural foi executada. Resultados: O módulo foi adaptado transculturalmente, sendo que 94% das avaliações dos juízes foram concordantes sobre a equivalência entre a versão original e a adaptação proposta. Conclusão: O módulo foi adaptado para o português brasileiro.(AU)

Objective: To cross-culturally adapt the acute care module of the National Early Warning Score 2 to Brazilian Portuguese. Method: Methodological study of cross-cultural adaptation, authorized by the Royal College of Physicians, carried out from July 2020 to July 2021. Approved by the Ethics Committee, under No. 4.247.069 and registered at Plataforma Brasil No. 36540020.4.0000.5292. Judges from the five Brazilian regions, nurses, evaluated the semantic, idiomatic, cultural, and conceptual equivalences between the original material and the translated versions. Nurses working in 30 Brazilian hospitals conducted the pilot test, with the purpose of ensuring that the adapted version preserved the equivalences in relation to the content of the original version. A qualitative analysis of cultural adaptation was performed. Results: The module was cross- culturally adapted, and 94% of the judges' assessments agreed on the equivalence between the original version and the proposed adaptation. Conclusion: The module was adapted to Brazilian Portuguese.(AU)

Objetivo: Adaptar transculturalmente el módulo de cuidados agudos del National Early Warning Score 2 para el portugués brasileño. Método: Estudio metodológico de adaptación transcultural, autorizado por el Royal College of Physicians, realizado en el período de julio de 2020 a julio de 2021. Aprobado por el Comité de Ética, bajo n.o 4.247.069, y registro en la Plataforma Brasil n.o 36540020.4.0000.5292. Jueces de las cinco regiones brasileñas, enfermeros, evaluaron las equivalencias semántica, lingüística, cultural y conceptual entre el material original y las versiones traducidas. Enfermeros actuantes en 30 hospitales brasileños realizaron el examen piloto, con la finalidad de asegurar que la versión adaptada preservaba las equivalencias en relación con el contenido de la versión original. El análisis cualitativo de adaptación cultural fue efectuado. Resultados: El módulo fue adaptado transculturalmente, ya que 94% de las evaluaciones de los jueces fueron de acuerdo con la equivalencia entre la versión original y la adaptación propuesta. Conclusión: El módulo fue adaptado para el portugués brasileño.(AU)

Current status and influencing factors of continuous nursing needs among patients with cleft lip and palate / 中国实用护理杂志

Objective:To understand the status of continuing care needs of patients with cleft lip and palate after discharge, and to analyze the influencing factors.Methods:Using convenience sampling method, 401 patients with cleft lip and palate and their nursing families who underwent sequential treatment of cleft lip and palate in Peking university hospital of stomatology from April to August 2021 were selected as the research objects. The general information questionnaire and self-made continuous nursing needs assessment table were used to investigate patients with cleft lip and palate current situation of continuous nursing needs and analyze the influencing factors.Results:The total score of continuing care needs of patients with cleft lip and palate was (91.53±12.07). From high to low, the demand dimensions were health promotion demand, disease self-care demand, doctor-patient communication demand and psychosocial support demand. The results of multivariate linear regression analysis showed that the mode of payment, the number of operations, the intention of rehabilitation guidance, the mode of continuation service and the expected continuation service cycle were the influential factors for the continuing nursing needs of patients with cleft lip and palate ( R2=0.282, F=27.16, P<0.05). Conclusion:Patients with cleft lip and palate have a high demand for continuing nursing. Individualized and effective continuous nursing intervention measures should be developed according to the needs of patients to promote the rehabilitation of patients.

Application of nursing decision support information system in continuing nursing of stroke patients in convalescent period / 中国实用护理杂志

Objective:To explore the effect of the application of nursing decision support information system in the continuing nursing of stroke patients in convalescent period, and to provide guidance for the information-based whole process nursing of stroke patients in convalescent period.Methods:A total of 107 stroke patients in convalescent period admitted to 4 Grade Ⅲ Level A hospitals of Beijing city from March to November 2019 were selected. The patients were divided into control group (53 cases) and test group (54 cases) by coin tossing method. The control group followed uniformly formulated discharge health education manual for post-discharge management and follow-up, while the test group received health guidance and follow-up through the nursing decision support information system. Barthel Index and MOS SF-36 were used to evaluate the activities of daily living and quality of life of the two groups of patients before intervention and 3 and 6 months after the intervention, and the results were compared.Results:There was no significant difference in Barthel Index before the intervention between the two groups( P>0.05). After 3 months of intervention, the Barthel Index ≤ 49, 50-70 and ≥ 71 in the test group were 7, 17 and 27 cases respectively, and 16, 21 and 13 cases in the control group respectively, and the difference between the two groups was statistically significant ( Z=-2.95, P<0.01). After 6 months of intervention, the Barthel Index ≤ 49, 50-70 and ≥ 71 in the test group were 7, 12 and 32 cases respectively, and 10, 15 and 25 cases in the control group respectively,and the difference between the two groups was statistically significant ( Z=-2.21, P<0.05). There was no significant difference in MOS SF-36 before the intervention between the two groups( P>0.05). After 3 and 6 months of intervention, the total score of MOS SF-36 in the test group was (50.51 ± 14.57), (57.06 ± 14.85) respectively, and that in the control group was (42.02 ± 15.48), (45.58 ± 14.97) respectively, and the differences between the two groups were statistically significant ( t=2.84, 3.23, both P<0.05). Conclusions:The application of nursing decision support information system can effectively improve the daily life ability of patients, enhance the quality of life of patients.

Desenvolvimento e avaliação de uma ação educativa com profissionais de enfermagem sobre abordagem ao paciente tabagista / Development and evaluation of an educational action with nursing professionals on the approach to smoking patients

Introdução: As altas taxas de internação de pacientes tabagistas evidenciam a importância do aprimoramento dos cuidados implementados pela equipe de enfermagem. Entretanto, poucos profissionais relatam possuir habilidades para auxiliá-los a pararem de fumar. Nesta perspectiva, a abordagem híbrida de ensino que integra o momento presencial com o ensino à distância (EaD) é uma inovação na educação de profissionais. Assim, este estudo é relevante à medida que desenvolveu e avaliou se um curso utilizando este método de ensino contribui para o aprimoramento da assistência aos tabagistas hospitalizados. Objetivo: Desenvolver e avaliar uma ação educativa realizada com a equipe de enfermagem utilizando método híbrido de ensino sobre abordagem ao paciente tabagista hospitalizado. Método: Esta pesquisa foi conduzida em um hospital universitário brasileiro de maio/2019 a dezembro/2020 e contou com delineamentos distintos. Primeiro, foi realizado um estudo de desenvolvimento e validação por consenso de especialistas e, posteriormente, para avaliar as modificações das práticas assistenciais junto aos pacientes tabagistas após a intervenção educativa foi feito um estudo descritivo. A população foi composta por profissionais de enfermagem e a amostra incluiu todos os que se dispuseram a realizar o curso em EaD e os que participaram da atividade presencial ou videoconferência. Os dados foram coletados em dois momentos: primeiramente, os participantes foram convidados a responder anonimamente um questionário antes do início do curso e, após três meses da participação na etapa presencial, eram convidados a respondê-lo novamente. Ao fim do envio dos formulários, foram avaliados os prontuários dos pacientes hospitalizados para verificar se o preenchimento da anamnese de enfermagem em relação ao status tabágico estava adequado e se a prescrição continha diagnóstico e cuidados específicos para tabagismo. Projeto aprovado em Comitê de Ética em Pesquisa (CAAE 64475916700005327). Resultados: A construção do curso envolveu a escolha dos assuntos, produção e validação dos conteúdos. Como estratégia de ensino utilizou-se abordagem híbrida com etapa online interativa e um encontro presencial para discussão de conceitos e experiências. A etapa online foi realizada por 2.456 profissionais de enfermagem, enquanto a presencial/videoconferência por 170 participantes. O pré-teste foi preenchido por 1.966 profissionais; entre eles, 917 (46,6%) referiram ter aptidão para abordar o paciente fumante. O pós-teste foi respondido por 53 participantes, dos quais 38 (71,6%) se sentiam aptos para abordar o paciente tabagista após ter realizado o curso. Quanto aos 1.128 prontuários de pacientes hospitalizados, 80 (7,1%) eram tabagistas e 85 (7,5%) estavam em abstinência; destes, 73 (44,2%) possuía o registro adequado do perfil tabágico. Para 23 (2%) indivíduos não havia nenhuma informação sobre ser ou não fumante. Os profissionais elogiaram o curso e relataram realizar abordagens visando à cessação do fumo. Conclusão: A abordagem híbrida de ensino para capacitar a equipe de enfermagem sobre cessação do tabagismo é inovadora, de baixo custo e com grande capacidade de difusão do conhecimento. Embora as abordagens não estejam sendo registradas na frequência desejada para auxiliar os pacientes a pararem de fumar, a implementação destas ações, assim como seu registro em prontuário aumentaram. O estudo potencializou melhorias no sistema eletrônico de prontuários da instituição, como por exemplo, a inclusão de diagnóstico e cuidados de enfermagem específicos para indivíduos tabagistas.

Introduction: The high hospitalization rates of smokers demonstrate the importance of improving the care implemented by the nursing staff. However, few professionals report having skills to help them stop smoking. In this perspective, the blended learning to teaching that integrates the presential time with distance learning is an innovation in professional education. Thus, this study is relevant as it developed and evaluated whether a course using this teaching method contributes to the improvement of care for hospitalized smokers. Objective: Develop and evaluate an educational action carried out with the nursing team using a blended learning to teaching the approach to hospitalized smokers. Method: This research was conducted in a Brazilian university hospital from May/2019 to December/2020 and had different designs. First, a study of development and validation was carried out by consensus of experts and, later, to assess the changes in care practices with smokers after the educational intervention, a descriptive study was carried out. The population consisted of nursing professionals and the sample included all those who were willing to take the course in distance education and those who participated in the face-to-face activity or videoconference. Data were collected in two moments: first, participants were invited to anonymously answer a questionnaire before the beginning of the course and, after three months of participation in the face-to-face stage, they were invited to answer it again. At the end of sending the forms, the medical records of hospitalized patients were evaluated to verify whether filling out the nursing anamnesis in relation to smoking status was adequate and whether the prescription contained a diagnosis and specific care for smoking. Project approved by the Research Ethics Committee (CAAE 64475916700005327). Results: The construction of the course involved the choice of subjects, production and validation of content. As a teaching strategy, a blended learning was used with an interactive online stage and a face-to-face meeting to discuss concepts and experiences. The online stage was performed by 2,456 nursing professionals, while the face-to- face/videoconference by 170 participants. The pre-test was completed by 1,966 professionals; among them, 917 (46.6%) reported having the ability to approach the smoker patient. The post- test was answered by 53 participants, of which 38 (71.6%) felt able to approach the smoker patient after taking the course. As for the 1,128 medical records of hospitalized patients, 80 (7.1%) were smokers and 85 (7.5%) were abstinent; of these, 73 (44.2%) had an adequate record of their smoking profile. For 23 (2%) individuals there was no information about being or not a smoker. Professionals praised the course and reported taking approaches aimed at smoking cessation. Conclusion: The blended learning to train nursing staff about smoking cessation is innovative, low-cost and with great capacity to disseminate knowledge. Although approaches are not being registered at the desired frequency to help patients stop smoking, the implementation of these actions, as well as their registration in medical records, increased. The study leveraged improvements in the institution's electronic medical records system, such as the inclusion of diagnosis and specific nursing care for smokers.

Evaluation the effect of continuing nursing based on diabetic foot risk in type 2 diabetic patients / 中国实用护理杂志

Objective@#To establish the effects of the continuing nursing model for prevention of diabetic foot in patients with type 2 diabetics.@*Methods@#A total of 188 patients with type 2 diabetes were divided into high ankle-brachial index(ABI) group (ABI≥0.9) and low ABI group (ABI<0.9) with 94 cases each. High ABI group was divided into intervention group 1 and control group 1 and low ABI group was divided into intervention group 2 and control group 2 with 47 cases each by random digits table method. Finally intervention group 1 and intervention group 2 were combined into intervention group, control group 2 and control group 1 were combined into control group. Patients in control group were given usual care. Patients in intervention group could consult and communicate with specialized nurse in diabetic foot in Wechat, they were assessed by specialty nurse every 3 months. All the patients received intervention for 9 months. The effect of nursing were evaluated through Diabetic Foot Knowledge-Attitude-Practice(KAP) Questionnaire as well as glycosylated hemoglobin.@*Results@#After intervention, KAP scores of the knowledge, attitude, behavior and glycosylated hemoglobin was (93.73±25.88), (18.45±3.08), (38.06±6.43) points and (8.81±2.24)% in intervention group, (93.34±26.06), (18.23±3.03), (37.73±6.58) points and (9.46±2.33)% in control group, there was significant difference between two groups(t=-3.310-5.249, P <0.01). KAP score of knowledge was (94.02±30.58) points in intervention group 1 and (93.72±30.84) points in control group 1,KAP scores of the knowledge, attitude, behavior was (93.45±20.47), (18.70±3.10), (36.40±5.89) points in intervention group 2 and (92.96±20.54), (18.36±3.07), (35.83±6.20) points in control group 2, there was significant difference(t=2.092-3.251, P<0.05 or 0.01). The level of glycosylated hemoglobin was (8.97±2.85)% in intervention group 1 and (8.65±1.42)% in intervention group 2,(9.28±2.97)%, (9.64±1.44)% in control group 1 and control group 2, there was significant difference(t=2.376, 4.953, P<0.05 or 0.01).@*Conclusions@#The continuing nursing model is effective in preventing diabetic foot ulcers in patients with low and high ABI.

Therapy of the status of symptom clusters in patients with cancer receiving FOLFOX6 chemotherapy / 中国实用护理杂志

Objective@#To invest the status of symptom clusters in patients with cancer receiving FOLFOX6 chemotherapy during the course of chemotherapy.@*Methods@#Total 100 patients with cancer receiving FOLFOX6 chemotherapy were investigated using MD. Anderson Symptom Inventory-Chinese (MDASI-C).@*Results@#The top severity of symptoms were lack of appetite and nausea during chemotherapy; weary was the highest score during the intermission of chemotherapy. Exploratory factor analysis showed four main symptom clusters: gastrointestinal symptom clusters, physical symptom clusters, mental symptom clusters and subjective feeling clusters. There were no significant difference in the scores of subjective feeling clusters between chemotherapy and the first day after discharge (P>0.05), other symptom clusters also declined slowly; the symptom clusters began to ease significantly from the three day after discharge (P<0.05).@*Conclusion@#Patients with cancer suffer from multiple symptoms during FOLFOX6 chemotherapy and during the intermission of chemotherapy. The results are good for establishing early predictions of symptom clusters in intermission of chemotherapy.

Effects of continuous nursing on rehabilitation of patients with hypertensive cerebral hemorrhage after puncture drainage / 中国实用护理杂志

Objective@#To observe the effects of continuous nursing(CN) on rehabilitation of patients with hypertensive intracerebral hemorrhage (HICH) and to explore the effective interventive measures for CN.@*Methods@#Totally 129 admitted HICH patients from January to December 2017 were selected and randomly divided into study group (63 cases) and control group (66 cases), the control group was handed with Handbook of stroke prevention and control before discharge, the study group received CN intervention, which included pre-discharge health education, family visits, patient management and video interview via WeChat App, group lecture and psychological support, self-nursing ability, motor function and ability of daily life and emotional condition were evaluated before and post discharge, and the disabled ratio 6 months after discharge between the 2 groups were compared.@*Results@#The 2 groups with the scores of exercise of self-care agency scale (ESCA) were increased significantly compared with before discharge (all P<0.05) ; the study group with the ESCA scores 3 months and 6 months after discharge were significantly higher than the control group [3months:118.5±8.2 vs. 112.3±7.5; 6 months: 127.7±8.7 vs. 119.3±9.1] (all P<0.05) . Fugl Meyer score and Barthel index of the 2 group after discharge were both lower than the pre-discharge levels (all P<0.05); Fugl Meyer score and Barthel index of the study group 3 months and 6 months after discharge were significantly higher than the control group [3 months: Fugl Meyer score 73.3±7.3 vs. 69.4±6.9; Barthel index 56.5±8.0 vs. 51.8±7.3; 6 months: Fugl Meyer score77.6±8.0 vs. 74.5±7.2; Barthel index 67.5±8.7 vs. 63.0±7.4] (all t=2.291-3.454, P<0.05). Two groups with HAD score after discharge were significantly decreased compared with before discharge (P<0.05); the study group with the HAD-A and HAD-D scores 3 and 6 months after discharge were significantly lower than the control group[3 months: HAD-A 6.75±2.23 vs. 8.02±2.85; HAD-D 6.07±1.75 vs. 7.23±1.94; 6 months: HAD-A 5.93±2.04 vs. 6.84±2.37; HAD-D 5.86±1.47vs. 6.75±1.76] (all P<0.05) . The study group with the re-admission rate and disabled ratio within 6 months after discharge were both lower than the control group, but the differences without statistical significance (all P>0.05).@*Conclusion@#The HICH patients added with CN can significantly improve self-care ability, improve prognosis; patient management via WeChat App and group lecture & psychological support are effective measures to carry out CN.

Effect of continuous nursing care on quality of life in patients with rheumatoid arthritis / 中国实用护理杂志

Objective@#To study the effect of continuous nursing care on quality of life in patients with rheumatoid arthritis after discharge.@*Methods@#Patients with rheumatoid arthritis who were admitted to hospital from August 2016 to August 2017 were selected as the study subjects. According to the random number table method, they were divided into the control group and the research group, and the lost cases were eliminated. There were 99 cases in the control group and 94 cases in the research group. The control group was given routine care, and the research group conducted continuous nursing care measures on the basis of the control group. The morning stiffness time, pain score, disease activity, patient health status and nursing satisfaction of the two groups were observed before and 6 weeks after discharge.@*Results@#Six weeks after discharge, the morning stiffness time (23.76±12.76) min of the research group was significantly higher than that of the control group (38.22±14.53) min, the difference was statistically significant (t=3.865, P<0.05). Six weeks after discharge, the VAS (2.01±0.68) and HAQ (0.42±0.34) points of the research group were lower than those of the control group (4.17±1.30), (0.92±0.63) points, the difference was statistically significant (t=4.073, 3.916, P<0.05). The nursing satisfaction of the research group was 94.68%(89/94), and that of the control group was 78.79%(78/99), and the difference was statistically significant (χ2=9.416, P < 0.05).@*Conclusions@#The implementation of continuous care mode after discharge from patients with rheumatoid arthritis is beneficial to alleviate clinical symptoms such as morning stiffness and pain. Moreover, it can also improve patient health and quality of life, increase risk of disease progression, and care satisfaction is high which can help to protect the harmony between nurses and patients.

Effect of extended nursing based on traditional Chinese medicine characteristics to mental status and quality of life in empty nest elderly patients with hypertension / 中国实用护理杂志

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.

Evaluation the effect of continuing nursing based on diabetic foot risk in type 2 diabetic patients / 中国实用护理杂志

Objective To establish the effects of the continuing nursing model for prevention of diabetic foot in patients with type 2 diabetics. Methods A total of 188 patients with type 2 diabetes were divided into high ankle-brachial index(ABI) group (ABI≥0.9) and low ABI group (ABI<0.9) with 94 cases each. High ABI group was divided into intervention group 1 and control group 1 and low ABI group was divided into intervention group 2 and control group 2 with 47 cases each by random digits table method. Finally intervention group 1 and intervention group 2 were combined into intervention group, control group 2 and control group 1 were combined into control group. Patients in control group were given usual care. Patients in intervention group could consult and communicate with specialized nurse in diabetic foot in Wechat, they were assessed by specialty nurse every 3 months. All the patients received intervention for 9 months. The effect of nursing were evaluated through Diabetic Foot Knowledge-Attitude-Practice(KAP) Questionnaire as well as glycosylated hemoglobin. Results After intervention, KAP scores of the knowledge, attitude, behavior and glycosylated hemoglobin was (93.73±25.88), (18.45±3.08), (38.06±6.43) points and (8.81 ± 2.24)% in intervention group, (93.34 ± 26.06), (18.23 ± 3.03), (37.73 ± 6.58) points and (9.46±2.33)% in control group, there was significant difference between two groups(t=-3.310-5.249, P<0.01). KAP score of knowledge was (94.02±30.58) points in intervention group 1 and (93.72±30.84) points in control group 1,KAP scores of the knowledge, attitude, behavior was (93.45 ± 20.47), (18.70 ± 3.10), (36.40 ± 5.89) points in intervention group 2 and (92.96 ± 20.54), (18.36 ± 3.07), (35.83 ± 6.20) points in control group 2, there was significant difference(t=2.092-3.251, P<0.05 or 0.01). The level of glycosylated hemoglobin was (8.97±2.85)% in intervention group 1 and (8.65±1.42)% in intervention group 2,(9.28± 2.97)% , (9.64 ± 1.44)% in control group 1 and control group 2, there was significant difference(t=2.376, 4.953, P<0.05 or 0.01). Conclusions The continuing nursing model is effective in preventing diabetic foot ulcers in patients with low and high ABI.

Therapy of the status of symptom clusters in patients with cancer receiving FOLFOX6 chemotherapy / 中国实用护理杂志

Objective To invest the status of symptom clusters in patients with cancer receiving FOLFOX6 chemotherapy during the course of chemotherapy. Methods Total 100 patients with cancer receiving FOLFOX6 chemotherapy were investigated using MD. Anderson Symptom Inventory-Chinese (MDASI- C). Results The top severity of symptoms were lack of appetite and nausea during chemotherapy; weary was the highest score during the intermission of chemotherapy. Exploratory factor analysis showed four main symptom clusters: gastrointestinal symptom clusters, physical symptom clusters, mental symptom clusters and subjective feeling clusters. There were no significant difference in the scores of subjective feeling clusters between chemotherapy and the first day after discharge (P>0.05), other symptom clusters also declined slowly; the symptom clusters began to ease significantly from the three day after discharge (P<0.05). Conclusion Patients with cancer suffer from multiple symptoms during FOLFOX6 chemotherapy and during the intermission of chemotherapy. The results are good for establishing early predictions of symptom clusters in intermission of chemotherapy.

Effects of continuous nursing on rehabilitation of patients with hypertensive cerebral hemorrhage after puncture drainage / 中国实用护理杂志

Objective To observe the effects of continuous nursing(CN) on rehabilitation of patients with hypertensive intracerebral hemorrhage (HICH) and to explore the effective interventive measures for CN. Methods Totally 129 admitted HICH patients from January to December 2017 were selected and randomly divided into study group (63 cases) and control group (66 cases), the control group was handed with Handbook of stroke prevention and control before discharge, the study group received CN intervention, which included pre-discharge health education, family visits, patient management and video interview via WeChat App, group lecture and psychological support, self-nursing ability, motor function and ability of daily life and emotional condition were evaluated before and post discharge, and the disabled ratio 6 months after discharge between the 2 groups were compared. Results The 2 groups with the scores of exercise of self-care agency scale (ESCA) were increased significantly compared with before discharge(all P<0.05); the study group with the ESCA scores 3 months and 6 months after discharge were significantly higher than the control group [3months:118.5±8.2 vs. 112.3±7.5;6 months:127.7±8.7 vs. 119.3±9.1](all P<0.05). Fugl Meyer score and Barthel index of the 2 group after discharge were both lower than the pre-discharge levels (all P<0.05); Fugl Meyer score and Barthel index of the study group 3 months and 6 months after discharge were significantly higher than the control group [3 months:Fugl Meyer score 73.3±7.3 vs. 69.4±6.9;Barthel index 56.5±8.0 vs. 51.8±7.3;6 months:Fugl Meyer score77.6± 8.0 vs. 74.5±7.2;Barthel index 67.5±8.7 vs. 63.0±7.4] (all t=2.291-3.454, P<0.05). Two groups with HAD score after discharge were significantly decreased compared with before discharge (P<0.05); the study group with the HAD-A and HAD-D scores 3 and 6 months after discharge were significantly lower than the control group[3 months:HAD-A 6.75±2.23 vs. 8.02±2.85;HAD-D 6.07±1.75 vs. 7.23±1.94;6 months:HAD-A 5.93±2.04 vs. 6.84±2.37;HAD-D 5.86±1.47vs. 6.75±1.76](all P<0.05). The study group with the re-admission rate and disabled ratio within 6 months after discharge were both lower than the control group, but the differences without statistical significance (all P>0.05). Conclusion The HICH patients added with CN can significantly improve self-care ability, improve prognosis; patient management via WeChat App and group lecture&psychological support are effective measures to carry out CN.

Effect of continuous nursing care on quality of life in patients with rheumatoid arthritis / 中国实用护理杂志

Objective To study the effect of continuous nursing care on quality of life in patients with rheumatoid arthritis after discharge. Methods Patients with rheumatoid arthritis who were admitted to hospital from August 2016 to August 2017 were selected as the study subjects. According to the random number table method, they were divided into the control group and the research group, and the lost cases were eliminated. There were 99 cases in the control group and 94 cases in the research group. The control group was given routine care, and the research group conducted continuous nursing care measures on the basis of the control group. The morning stiffness time, pain score, disease activity, patient health status and nursing satisfaction of the two groups were observed before and 6 weeks after discharge. Results Six weeks after discharge, the morning stiffness time (23.76 ± 12.76) min of the research group was significantly higher than that of the control group (38.22 ± 14.53) min, the difference was statistically significant (t =3.865, P<0.05). Six weeks after discharge, the VAS (2.01 ± 0.68) and HAQ (0.42 ± 0.34) points of the research group were lower than those of the control group (4.17±1.30), (0.92±0.63) points, the difference was statistically significant (t =4.073, 3.916, P<0.05). The nursing satisfaction of the research group was 94.68%(89/94), and that of the control group was 78.79%(78/99), and the difference was statistically significant (χ2=9.416, P<0.05). Conclusions The implementation of continuous care mode after discharge from patients with rheumatoid arthritis is beneficial to alleviate clinical symptoms such as morning stiffness and pain. Moreover, it can also improve patient health and quality of life, increase risk of disease progression, and care satisfaction is high which can help to protect the harmony between nurses and patients.

Effect of extended nursing based on traditional Chinese medicine characteristics to mental status and quality of life in empty nest elderly patients with hypertension / 中国实用护理杂志

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.

Continuous nursing care for cardiac rehabilitation of a pesaatient with frequent ventricular tachycardia after myocardial infarction complicated with ventricular aneurysm / 中国实用护理杂志

0bjective Summarized the Continuous nursing care for cardiac rehabilitation of a patient with frequent ventricular tachycardia after myocardial infarction complicated with ventricular aneurysm Methods A comprehensive systematic evaluation of a patient with frequent myocardial infarction complicated with ventricular aneurysm and ventricular tachycardia was conducted to develop an individualized continuous care plan, and continued supervision and management after discharge to ensure that the plan was implemented on time and timely. Results After standardized follow-up care, there was no chest tightness, palpitations, shortness of breath, etc. in the daily activities of the patient, no ventricular tachycardia, and no further hospitalization until June 2018. Conclusions The continuous nursing of cardiac rehabilitation in patients with myocardial infarction complicated with ventricular aneurysm and frequent ventricular tachycardia can improve the prognosis of the disease, improve the quality of life, and provide theoretical basis and practical experience for clinical nursing work.

Application of continuing nursing in home management of pelvic organ prolapse patients with pessaries / 中国实用护理杂志

Objective To analyze the effect and application value of continuation nursing in the management of pelvic organ prolapse (POP) patients. Methods From June 2016 to December 2017, 50 patients with POP who were treated with pessary were randomly divided into study group and control group by randomized comparison digital table. The study group was followed by family continuation care. The nursing guidance was compared at the time of enrollment, 3 months and 6 months after enrollment, and the difference between the two groups in terms of disease awareness, daily behavioral ability, psychological state and complications were compared. Results The study group was significantly better than the control group in terms of disease awareness, daily behavioral ability, psychological state and satisfaction rate of nursing services (t=13.2667-19.8533,χ2=0.12-4.56, P<0.05). Conclusion The application of pessary in the treatment of POP patients in the home management can be used to reduce complications and improve the quality of life of patients. It has application and promotion value.

Efetividade da educação a distância no conhecimento de enfermeiros sobre estomias intestinais de eliminação / Eficacia de la educación a distancia en el conocimiento de enfermeros sobre ostomías intestinales de eliminación / Effectiveness of distance education on nurses' knowledge about bowel elimination ostomies

Resumo OBJETIVO Avaliar a efetividade da educação a distância no conhecimento de enfermeiros da atenção primária sobre estomias intestinais de eliminação. MÉTODOS Estudo quase-experimental, do tipo antes-depois, realizado com 41 enfermeiros, no período de junho a julho de 2015, por meio de instrumento construído e validado no Brasil. Para comparar os escores de acertos no pré e pós-teste foi utilizado o Teste de Wilcoxon. Foram considerados estatisticamente significantes os resultados dos testes que apresentaram α menor ou igual a 0,05. RESULTADOS Na avaliação do conhecimento dos enfermeiros verificou-se que cinco obtiveram acertos superiores a 80% no pré-teste. Após a educação a distância, o número de enfermeiros que obtiveram acertos superiores a 80% aumentou para 32. Houve diferença estatística significativa no conhecimento dos enfermeiros após intervenção educativa (p=0,000), com percentual de melhoria de 96,7% no geral. CONCLUSÕES A educação a distância pode ser uma metodologia efetiva para educação permanente de enfermeiros.

Resumen OBJETIVO Evaluar el efecto de la educación a distancia en el conocimiento de enfermeros de la atención primaria sobre ostomías intestinales de eliminación. MÉTODOS Estudio cuasi-experimental, del tipo antes-después, realizado con 41 enfermeros, en el período de junio a julio de 2015, por medio de un instrumento construido y validado en Brasil. Para comparar los puntajes de aciertos en el pre y post-test, se utilizó el Test de Wilcoxon. Se consideraron estadísticamente significantes los resultados de las pruebas que presentaron α menor o igual a 0,05. RESULTADOS En la evaluación del conocimiento de los enfermeros, se verificó que cinco obtuvieron aciertos superiores al 80% en el pre-test. Después de la educación a distancia, el número de enfermeros que obtuvieron aciertos superiores al 80% aumentó a 32. Hubo diferencia estadística significativa en el conocimiento de los enfermeros luego de la intervención educativa (p = 0,000), con porcentual de mejora del 96,7% en general. CONCLUSIONES La educación a distancia puede ser una estrategia efectiva para la educación permanente de enfermeros.

Abstract OBJECTIVE To evaluate the effectiveness of distance education on primary care nurses' knowledge about bowel elimination ostomies. METHODS A quasi-experimental, before-after study conducted with 41 nurses, from June to July 2015, by means of an instrument constructed and validated in Brazil. The Wilcoxon's test was used to compare the correct scores in the pre- and post-test. The results of the tests that presented α less than or equal to 0.05 were considered statistically significant. RESULTS In the evaluation of nurses' knowledge, five obtained correct answers above 80% in the pre-test. After distance education, the number of nurses that obtained scores greater than 80% increased to 32. There was a statistically significant difference in nurses' knowledge after an educational intervention (p=0.000), with a 96.7% overall improvement. CONCLUSIONS Distance education can be an effective strategy for nurses' permanent education.