RESUMO
Objective:To develop a training system for head and neck oncology nurses to improve the emergency response competency to recognize and response to acute and critical medical conditions.Methods:Based on literature review and semi-structured interviews with 12 nurses, two rounds of consultation with 15 head and neck cancer care specialists from 6 Tertiary hospitals using Delphi method were conducted to establish the training system for head and neck oncology nurses.Results:The authority coefficients of experts were 0.87 and 0.89, respectively. The coefficient of variation of each item ranged from 0 to 0.167. The coefficients of concordance ranged from 0.243 to 0.403 ( P<0.01). There was statistical significance after Chi-square test ( χ2 values were 14.60-436.64, all P<0.01). In the final training system, training aims included 5 first-level indicators and 16 second-level indicators; training contents included 5 first-level indicators, 16 second-level indicators, and 60 third-level indicators. Conclusions:The authority coefficients and the coefficients of concordance of the experts for the training system were both high. The training system can be applied to improve the emergency response competency of head and neck oncology nurses.
RESUMO
Insomnia has become a common central nervous system disease. At present, the pathogenesis of insomnia is not clear. Animal models can help us understand the pathogenesis of the disease and can be used in transformational medicine. Therefore, it is very necessary to establish an appropriate model of insomnia. Clinical data show that insomnia patients with high levels of thyroxine and often accompanied by cardiovascular problems, a common mechanism underlying all of these physiological disruptions is the sympathetic nervous system. Combined with the characteristics of chronic onset of clinical insomnia, an insomnia model induced by long-term intraperitoneal injection of thyroid hormone has been created in our laboratory. In this paper, the insomnia-like state of the model was evaluated based on three validity criteria. Face validity has been demonstrated in metabolism, the Morris water maze, electrocardiogram (ECG) and electroencephalogram (EEG). Structure validity has been proved by the results of targeted metabolomics. After treatment with diazepam, a commonly used clinical anti-insomnia drug, the above physiological and pathological disorders were reversed. The results of comprehensive analysis show that the established thyrotoxicosis-associated insomnia model meets the validity requirement to establish an appropriate animal model of insomnia. The model presented in this article might help to study pathogenetic mechanisms of clinical insomnia, as well as to test promising methods of insomnia treatment.
RESUMO
Objective To observe the effects of homemade head and neck fixation pillow in patients with oral and maxillofacial free flap transplantation. Methods Totally 114 patients who needed head and neck fixation after oral and maxillofacial free flap transplantation were divided into the observation group (58 cases) and the control group (56 cases) based on the admitted consequence. Besides the routine treatment and nursing measures, the observation group received head and neck fixation with homemade head and neck fixation pillow, while the control group received traditional fixation with sandbags. The patients′ comfortable degree, compliance, occipital skin condition and the nurses′evaluation of clinical application were investigated. Results The degree of comfort were (2.93 ± 1.28) points in the observation group and (4.96±1.25) points in the control group, respectively. The comfortable degree was higher in the observation group than that in the control group, the difference was statistically significant (t=-8.569,P<0.05). There were 43 patients with complete compliance, 15 with partial compliance, and 0 with no compliance in the observation group respectively, while 18 with complete compliance, 35 with partial compliance, and 3 with no compliance in the control group respectively. The compliance was better in the observation group than that in the control group, the difference was statistically significant (P<0.05). None of the patients in the observation group had pressure ulcer, while 3 patients in the control group had stageⅠpressure ulcer. 96.9％of the nurses considered the homemade head and neck fixation pillow was easy to operate. 100.0％of the nurses considered the homemade headand neck fixation pillow could immobilize the patient′s head and neck effectively. Conclusion The homemade head and neck fixation pillow is easy to operate and can effectively immobilize the patient′s head and neck, protect the patient′s occipital skin, as well as improve patient′s comfort and compliance.
RESUMO
Objective To evaluate the effectiveness of discharge planning in patients after total laryngectomy. Methods One hundred and four patients were randomly divided into the intervention group and the control group, there were 52 cases in each group. The patients in the control group were received routine nursing, while the patients in the intervention group were received discharge planning based on routine nursing. The patients'days of hospitalization, scores of the Exercise of Self-care Agency Scale (ESCA) at discharge and 4 weeks after discharge, scores of University of Washington Quality of Life Questionnaire (UW-QOL) at 4 weeks after discharge and re-admission rate were compared between the two groups. Results The ESCA scores in the intervention group at discharge (108.62 ± 11.23) and 4 weeks after discharge (116.35 ± 12.08) were significantly higher than those of the control group at discharge (96.16±10.34) and 4 weeks after discharge (105.20±10.76) respectively (t=5.886, 4.970, P0.05). The re-admission rate in the intervention group (2/52,3.85%) was significantly lower than that of the control group (8/52,15.38%) (χ2=3.983, P<0.05). Conclusions Discharge planning can improve the ability of self-care and quality of life in patients after total laryngectomy, and reduce the re-admission to hospital.