A scope review of self-management intervention research in patients with hematopoietic stem cell transplantation / 中华护理杂志

Objective To review the research of self-management intervention in patients with hematopoietic stem cell transplantation,clarify the intervention elements,so as to provide references for clinical practice and future related research.Methods According to the scoping review framework,a literature search was performed in the PubMed,Embase,CINAHL,Web of Science,Cochrane Library,CNKI,Wan fang Database,VIP,CBMdisc for all the studies on self-management intervention of patients with hematopoietic stem cell transplantation.The retrieval time was from the establishment of the database to December,2022.There were 2 researchers who extracted and analyzed the data of the included literature.Results A total of 12 articles were included,including 3 randomized controlled trials,8 quasi-experimental studies,and 1 mixed study.6 studies were conducted with interventions based on the theoretical basis or nursing model such as self-management oriented 5A nursing model,continuous nursing model,problem-based learning theory.The intervention methods of 12 studies included nurse-led self-management guidance,mobile applications,multidisciplinary collaboration,and graphic cards.The intervention time was mostly 1～3 months.The outcome indicators included feasibility evaluation indicators such as operability,ease of use,and user satisfaction of the application,and effect evaluation indicators such as self-management ability,quality of life,and medication compliance of patients.The results showed that self-management interventions could improve patient self-management ability,quality of life,medication compliance,and improve their psychological and nutritional status.Conclusion The research on self-management intervention in patients with hematopoietic stem cell transplantation is still in the development stage,and its positive effect has been preliminarily verified.Medical staff should strengthen the self-management evaluation of patients with hematopoietic stem cell transplantation,play the role of multidisciplinary team,use electronic health intervention methods,and formulate multi-level,scientific and effective self-management intervention programs.

Evidence-based practice of a steroid-resistant patient with severe graft-versus-host disease / 中国实用护理杂志

Objective:To summarize the evidence-based practice of a steroid-resistant patient with severe acute skin graft-versus-host disease caused by donor lymphocyte reinfusion.Methods:Clear the clinical problems of patients, through the development of a rigorous search strategy, according to the "6S" Pyramid model from the top to the bottom of the relevant literature in turn, after the evaluation of evidence level to determine the best clinical evidence.Combined with team experience and patient's actual situation, the acute graft-versus-host disease of steroid-resistant patients was treated while infection was strictly prevented. The non-invasive method of wet healing by topical high concentration tacrolimus smearing and sterile dressing sealing was compared with the invasive optical separation replacement therapy in vitro, which avoided puncture and sterile dressing. A series of possible complications of phototherapy.Results:The patient was relieved of swelling and pain 5 days after treatment, and was discharged on the 15th day of this hospitalization.Conclusions:Local high concentration tacrolimus smear plus aseptic dressing to seal wet healing is a noninvasive method that can relieve and treat severe acute graft-versus-host disease symptoms of steroid resistant patients. It is useful for similar clinical cases.

Studies of height_BMI binding model in predicting the optimal length of the front opening PICC / 中国实用护理杂志

Objective To explore the correlation between PICC optimal prediction length and height, body mass index, and provide a more accurate prediction method for PICC depth management. Methods A total of 100 patients with PICC catheterization in January 2018 were selected for self_controlled study, and two different in vitro measurement methods were used for the same patient at the same time.Traditionally, the Rountree method is used to obtain the predicted length from the puncture point to the right sternoclavicular joint and back down to the third intercostal space (A). This group of methods is used only for measurement and data recording as A control.The experimental measurement method adopted the modified method, that is, the length from the puncture point to the right sternoclavicular joint, plus the predicted length based on the pre_addition of 6-10cm according to the height and body mass index (B). This group of methods was applied to the actual catheterization.The ideal length of the catheter was determined by chest radiograph after catheterization (C).The length of the catheter is predicted by traditional Rountree methods (A) 42.0 ± 2.867cm, experimentally measured (B) 40.30± 2.435cm, and idealized (C)39.81± 2.411cm.Kruskal_wallis H test and analysis of three lengths of data A, B and C were performed, and the correlation between height, body mass index and PICC catheter length was compared through multiple linear regression analysis. Results the length predicted by the experimental method was closer to the ideal length (P=0.657), and the regression model had statistical significance, F(2,97)=36.931, P<0.01, and adjusted, R2=0.421. The included height and body mass index (BMI) were statistically significant in predicting ideal catheter length (P<0.05). Conclusions The length of the catheter was predicted from the puncture point to the right sternoclavicular joint plus 6-10cm according to the height and body mass index, which was closer to the ideal length.

Psychological status and intervention progress of hematopoietic stem cell transplantation patients / 中国实用护理杂志

Hematopoietic stem cell transplantation (HSCT) patients undergo tremendous psychological stress during the long course of treatment, which affected the quality of life and the prognosis of the disease. This paper reviews the psychological state of HSCT patients in recent years,to provide a basis for psychological support in appropriate time. The psychological status of HSCT patients is mainly manifested as anxiety, depression, loneliness and post_traumatic stress disorder. The main influencing factors of bad psychological status include: gender, personality, physical function, family and social support, coping style; Intervention measures are: health education, music therapy, comprehensive nursing intervention, palliative care.

Studies of height-BMI binding model in predicting the optimal length of the front opening PICC / 中国实用护理杂志

Objective@#To explore the correlation between PICC optimal prediction length and height, body mass index, and provide a more accurate prediction method for PICC depth management.@*Methods@#A total of 100 patients with PICC catheterization in January 2018 were selected for self-controlled study, and two different in vitro measurement methods were used for the same patient at the same time.Traditionally, the Rountree method is used to obtain the predicted length from the puncture point to the right sternoclavicular joint and back down to the third intercostal space (A). This group of methods is used only for measurement and data recording as A control.The experimental measurement method adopted the modified method, that is, the length from the puncture point to the right sternoclavicular joint, plus the predicted length based on the pre-addition of 6-10cm according to the height and body mass index (B). This group of methods was applied to the actual catheterization.The ideal length of the catheter was determined by chest radiograph after catheterization (C).The length of the catheter is predicted by traditional Rountree methods (A) 42.0 ± 2.867cm, experimentally measured (B) 40.30± 2.435cm, and idealized (C)39.81± 2.411cm.Kruskal-wallis H test and analysis of three lengths of data A, B and C were performed, and the correlation between height, body mass index and PICC catheter length was compared through multiple linear regression analysis.@*Results@#the length predicted by the experimental method was closer to the ideal length (P=0.657), and the regression model had statistical significance, F(2,97) =36.931, P<0.01, and adjusted, R2=0.421. The included height and body mass index (BMI) were statistically significant in predicting ideal catheter length (P<0.05).@*Conclusions@#The length of the catheter was predicted from the puncture point to the right sternoclavicular joint plus 6-10cm according to the height and body mass index, which was closer to the ideal length.

Psychological status and intervention progress of hematopoietic stem cell transplantation patients / 中国实用护理杂志

Hematopoietic stem cell transplantation (HSCT) patients undergo tremendous psychological stress during the long course of treatment, which affected the quality of life and the prognosis of the disease. This paper reviews the psychological state of HSCT patients in recent years,to provide a basis for psychological support in appropriate time. The psychological status of HSCT patients is mainly manifested as anxiety, depression, loneliness and post-traumatic stress disorder. The main influencing factors of bad psychological status include: gender, personality, physical function, family and social support, coping style; Intervention measures are: health education, music therapy, comprehensive nursing intervention, palliative care.

Identification and repositioning of catheter malposition during PICC insertion in 113 cancer patients / 中华护理杂志

This paper summarized identification and reposition strategies of catheter malposition in 113 cancer patients with peripherally inserted central catheters(PICCs) during catheterization.In the process of PICC catheterization,catheter malposition was identified by ultrasound and ECG in a real-time manner.A series of timely and effective reposition procedures were performed by internal jugular vein blocking,breathing combined with anterior segment wire withdrawal Overall,111 cases were successfully repositioned,the success rate was 98.23％,and 2 cases failed because of other reasons such as diseases.