Postoperative outcomes among cancer patients undergoing colorectal diversion at Assiut University Hospital: suggested nursing intervention protocol

Colorectal cancer is one of the leading causes of cancer death in both developed and developing nations. Early and late problems may be faced by patients after colostomy surgery. Assessment and management of stoma complications are the responsibility of nurses across the continuum of care and played a central role in the clinical appreciation and postoperative management as evidenced by interest in managing postoperative outcomes and treating the complications. Therefore, the aim of this study was to identify the postoperative outcomes among patients undergoing permanent colorectal diversion, sixty patients were selected from the General Surgical Units in Assiut University Hospital and Upper Egypt Cancer Institute, their age ranged between 30-70 years with mean age of 50.30 +/- 11.28 yrs. Tools used for data collection were Socio-demographic and Medical Data Sheet; Physical and Social Assessment Sheet; Nutritional Assessment Form and Rosenberg's Global Self Esteem scale [RGSLs]. Structured interview was utilized for data collection. The results of the study showed that, 5% had stoma retraction, stoma fistula and mucocutaneous separation and 8.3% had stoma infection and 21.7% had skin breakdown and skin irritation. Half of the sample had gases, and 23.3% suffered from leakage. Social problems and low self-esteem were found among more than half of study subjects. The most of the patients had underweight, subnormal values of hemoglobin, albumin and white blood cells were found. The study concluded that, patients undergoing permanent colorectal diversion exhibited different physical, social, self esteem and nutritional changes and need effective measures to prevent/ reduce these complications Another further study on a larger sample and for 6 months to one year as a minim time for follow up is recommended, encourage preoperative physical, social, psychological and nutritional preparation for colostomy's patient and design a rehabilitation program for patients with permanent colostomy

Predictors to quality of life among Egyptian adult Psoriatic patients

This study was conducted on a consecutive sample of 60 psoriatic patients to investigate the quality of life among Egyptian adult psoriatics and its predictors. The psoriasis disability index [PDI] questionnaire was used to assess the impact of psoriasis on the quality of life. The disease severity was assessed using the psoriasis area and severity index [PASI]; besides, a sociodemographic and background data sheet were used to collect data. The results emphasized that patients with psoriasis had higher total scores in the PDI questionnaire [i.e. Poor quality of life]. The study concluded that males having an adequate income, high level of education and longer periods of illness had the predictors of a better quality of life among psoriatic patients; while, males having severe symptoms, larger extent of disease, positive family history and a higher frequency of previous hospitalization with topical therapies had the identified predictors of a poor quality of life among psoriatic adult patients. The results implicated the need for designing and implementing the quality of life promoting programs for patients with psoriasis emphasizing on active patient and family participation

Impact of a designed care protocol on oral health status of critically ill patients

This study included 60 adult patients aged 20-70 years; those with head or neck surgery and those receiving radiotherapy or chemotherapy were excluded from the study. The patients were sequentially randomized either to a study group [who received the oral care protocol] or a control group [who did not receive the oral care protocol], each group comprised 30 patients. The study tools comprised a socioeconomic and background data sheet, an oral assessment guide [OAG] and the designed oral care protocol [instruction guide] which includes all the instructions related to oral care technique. The results indicated that all components of OAG significantly deteriorated by the 4th day in patients of the control group. On the 4th day, the mean scores for all components of OAG of patients in the study group were significantly better than those for the control group. Patients on Ryle tube feeding had significantly higher scores for inflammation salivary flow, tongue, purulent matter, mucous membrane and the total score. There were no statistically significant differences between patients in whom supportive devices were used with those in whom supportive devices were not used

Nutritional status of mechanically ventilated critically ill patients: comparison between different nutritional supports

This study comprised a convenience sample of 90 adult critically ill patients on mechanical ventilator. Patients were divided into three equal groups [30 each]. The first group received enteral nutrition [EN] via nasogastric tube, the second group received total parenteral nutrition [TPN] and the third group received both types [EN and TPN]. A nutritional assessment sheet and the Maastricht index were utilized to collect data pertinent to the study. The study documented that on admission, all patients suffered from variable degrees of malnutrition. After 14 days, the nutritional assessment revealed that all patients were still malnourished and those who received EN significantly deteriorated. Moreover, diarrhea, which is one of the complications of enteral feeding and a cause for malnutrition, was prevalent among 66.7% of this group