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The communication between professional health caregivers, which mainly composed of medical staff, and patients and their families plays an important role in hospice care. The effective doctor-patient communication can guide terminal patients and their families to establish a correct medical view, reduce excessive medical treatment, and improve the quality of life for terminal patients. This paper briefly described the communication context of hospice care, the communication subject and the current situation of hospice care, analyzed the problems and challenges encountered by professional health caregivers, which mainly including medical staff, in the communication context of hospice care diagnosis and hospice care, and made the prospects of the development of effective communication measures.
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Objective Compare the effect of thoracic and abdominal mediastinal tube placement on pain and comfort in patients with minimally invasive esophageal cancer and nursing care. Methods 108 patients with squamous cell carcinoma of the thoracic esophagus were selected from December 2016 to May 2017. The patients were divided into chest group and abdominal group according to the random number comparison table, each with 54 cases. All patients underwent minimally invasive radical resection of esophageal carcinoma. The mediastinum drainage tube was placed at different locations of the chest and abdomen after operation. The duration of intubation, total drainage volume, number of dressing change before and after extubation, degree of pain and comfort after surgery were recorded, drainage tube failure and the incidence of related complication were compared between the two groups. Results There was no significant difference in duration of intubation, total drainage volume, drainage tube failure and the incidence of related complication between Patients with mediastinal tubes placed through the chest and abdomen(P>0.05). The times of dressing change before and after extubation in the abdominal group were (2.8 ± 1.0), (1.9 ± 0.6) times, those in the chest group were (4.5 ± 1.2), (3.6 ± 1.1) times, there were significant difference between the two groups (t=7.841, 9.377, P<0.01). The NRS and VAS score at 1-4 days and extubation in the abdominal group were significantly lower than those in the chest group, the abdominal group were (3.2±1.0), (2.7±0.8), (2.3±0.7), (1.9±0.7), (1.5±0.6) points and (3.7±0.8), (3.4±1.4), (3.0± 0.7), (2.6±1.0), (2.6±1.0) points, the chest group were (3.7±1.3), (3.3±1.1), (2.8±0.8), (2.3±0.8), (2.3±0.7) points and (5.0±0.9), (4.3±1.4), (4.1±1.3), (3.3±1.2), (3.6±1.0) points, there were significant difference between the two groups (t=2.443-7.247, P<0.01 or 0.05). Conclusions Intraoperative abdominal minimally invasive radical mediastinal tube placed esophageal cancer, can significantly relieve pain and improve patient comfort, reduce the frequency of dressing change before and after extubation, not only quickly improve the rehabilitation of patients, but also can avoid the waste of medical resources, it is worthy of clinical promotion.
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Objective: To investigate the changes of neuronal activation in taste-related nuclei following intraoral taste stimulation with binary taste mixtures of sucrose and NaCl. Methods: Neuronal activation in response to intraoral taste stimulation with 0.5 mol · L-1 sucrose, 0.3 mol · L-1 NaCl, sucrose+NaCl mixture and distilled water was evaluated in taste-related nuclei by using c-Fos-like immunoreactivity(c-FLI) in the rats deprived of water overnight. Results: The consumption of sucrose+NaCl mixture was lower than that of sucrose solution. Intraoral sucrose or NaCl stimulation induced more c-FLI than distilled water in the external lateral subnucleus of the rostral parabrachial nucleus (PBN), but the c-FLI induced by intraoral sucrose+NaCl mixture stimulation was less than that induced by sucrose solution in this subnucleus. Compared with distilled water, the intraoral sucrose or sucrose+NaCl mixture stimulation induced more c-FLI in the central amygdala. Conclusion: These results suggest that salty taste has a suppressive effect on the neuronal activations induced by sweet taste in the external lateral subnucleus of rostral PBN in rats.