Résumé
Objective:To explore the potential categories of prostate cancer patients′ participation in shared decision making, and analyze the characteristics and influencing factors of different categories of prostate cancer patients′ participation, so as to provide theoretical support for improving prostate cancer patients′ participation in shared decision making.Methods:This was a cross-sectional study. A total of 292 patients with a first diagnosis of prostate cancer without metastasis from three tertiary grade A hospitals in Zhengzhou were selected from October 2019 to October 2020 (Henan Provincial People′s Hospital, the First Affiliated Hospital of Zhengzhou University, the First Affiliated Hospital of Henan University of Chinese Medicine). The general data questionnaire, the Decisional Engagement Scale, Perceived Social Support Scale and Disease Uncertainty Scale were used. Latent class analysis was used to classify prostate cancer patients according to shared decision making participation, and Logistic regression was used to analyze the influencing factors of the potential category.Results:The total scores of the Decisional Engagement Scale, Perceived Social Support Scale and Disease Uncertainty Scale in prostate cancer patients were (67.28 ± 20.77), (62.34 ± 15.39), (95.06 ± 8.05) points, respectively. The shared decision making participation of prostate cancer patients was divided into three potential categories: high participation group 76.4%(223/292), moderate participation group 12.7%(37/292), and low participation group 11.0%(32/292). Taking high participation group as reference, age( OR=1.088, 95% CI 1.161-1.231, P<0.05) and illness uncertainty( OR=1.480, 95% CI 1.414-1.919, P<0.05) were the risk factors for the low participation group; perceived social support was the protective factor ( OR=0.857, 95% CI 0.775-0.946, P<0.05). Illness uncertainty was the risk factor( OR=1.525, 95% CI 1.316-1.767, P<0.05), and perceived social support was the protective factor ( OR=0.829, 95% CI 0.838-0.949, P<0.05) for the moderate participation group. Conclusions:There were obvious classification characteristics of shared decision making participation for prostate cancer patients. Age, perceived social support and illness uncertainty were the influencing factors of it. Interventions should be taken according to the characteristics of each category, to improve the level of shared decision making of prostate cancer patients.
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The reflective ability of nursing staff has been paid more and more attention, nurses' reflection can promote professional competence development, which also can improve clinical practice ability, knowledge expansion ability and innovation ability. Therefore this article reviews the current situation on nurses ′ reflection, the assessment tools, the modes, forms, methods and types, future prospects of clinical nurses reflective practice, in order to provide reference and basis for the relevant research on the reflection practice of clinical nursing staff in China.
Résumé
The reflective ability of nursing staff has been paid more and more attention, nurses' reflection can promote professional competence development, which also can improve clinical practice ability, knowledge expansion ability and innovation ability. Therefore this article reviews the current situation on nurses′ reflection, the assessment tools, the modes, forms, methods and types, future prospects of clinical nurses reflective practice, in order to provide reference and basis for the relevant research on the reflection practice of clinical nursing staff in China.
Résumé
Objective To explore the effect of two different urethral stent flush methods for postoperative complications of hypospadias repair in children patients. Methods A total of 182 cases of children patients who underwent urethroplasty with pedicled double skin flaps from March 2014 to March 2016 were divided into intervention group (n=89) and the control group (n=93) by using random number method. The control group was treated with gentamicin irrigation urethral stent;the intervention group was treated with gentamicin irrigation urethral stent, and the patients were trained to urinate twice with the stent from the fourth day after surgery. The incidence of urinary fistula and urethral stricture within one year after surgery, and the anxiety level of patients' caregivers were assessed. Results The incidence of urinary fistula in the intervention group and the control group were 5.7％(5/87) vs. 15.2％(14/92), and the difference was statistically significant(χ2=4.227, P<0.05). In the intervention group, the cases of non anxiety, mild anxiety, moderate anxiety and severe anxiety respectively were 33(37.9％), 42(48.3％), 8 (9.2％) and 4(4.6％). However, in the control group the cases were 21(22.8％), 46(50.0％), 12(13.0％), 13 (14.1％) respectively. The anxiety degree of patients' caregivers was significantly different between intervention group and control group (Z=2.757, P<0.01). Conclusions The training of early micturition with stent after hypospadias surgery can significantly reduce the incidence of urinary fistula and the anxiety level of caregivers.