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Objective:To explore the optimal evidence for the nursing management of limb spasm in patients with spinal cord injury.Methods:Based on the "6S" evidence model, the databases including CNKI, Wanfang, PubMed and Cochrane Library, the guideline websites such as the National Guideline Clearinghouse, Guidelines International Network and Registered Nurses′ Association of Ontario, and the websites of professional associations such as the Royal College of Physicians, American Spinal Injury Association and Canadian Spine Association were systematically searched. Search period of each database was set from the year of inception until July 2022. Two investigators independently screened the literatures related to the management of limb spasm in patients with spinal cord injury, and conducted quality evaluation and evidence recommendation level evaluation.Results:Totally 17 literatures consisting of 6 guidelines, 3 expert consensuses, 5 systematic reviews, 2 evidence summaries, and 1 clinical decision were included. Moreover, 30 pieces of evidence were summarized from 3 aspects, including evaluation and identification, drug therapy (chemical denervation, and oral medication), rehabilitation training (hydrotherapy, electrical stimulation, magnetic stimulation, vibration therapy, heat and cold therapy, body position, and exercise therapy).Conclusion:Nursing staff can set up a multidisciplinary team according to the clinical environment and take into consideration of the characteristics of spinal cord injury patients to provide personalized interventions involving evaluation and identification, drug therapy, rehabilitation training, etc., so as to alleviate the degree of limb spasm.
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Objective:To understand the current status of nurses' awareness and needs for the Employee Assistance Program (EAP), as to provide basis for the hospital to formulate EAP.Methods:Using the purpose sampling method, 352 ICU nurses from the Nanjing Drum Tower Hospital Affiliated of Nanjing University Medical School were selected as the research subjects from December 2019 to January 2020. Finally, 350 valid questionnaires were obtained. Use the EAP demand questionnaire to investigate the ICU nurses' awareness and demand for EAP.Results:Among the 350 nurses in the intensive unit, 214 cases (61.14%) had never understood EAP, only 8 (2.29%) had understood and experienced the EAP, and 332 cases (94.86%) believed that the hospital′s implementation of EAP was a benefit provided to nurses. The top two service requirements were: "Relief of work pressure" and "mental health consultation", and hope to receive mixed-mode EAP services; in ICU and CCU, nurses hope EAP can help resolve work-family conflicts; in EICU, they need to provide Specific job skills training services.Conclusions:ICU nurses have insufficient cognition of EAP and urgently need to obtain EAP implementation knowledge; at the same time, it is necessary to formulate an implementation plan that meets ICU nurses′ needs for EAP, that is, to relieve work pressure and carry out psychological counseling to ensure that EAP is launch successfully in ICU nurses.
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Objective To investigate the effects of telmisartan on the blood glucose, blood lipid, blood insulin, and insulin resistance in the hypertensive patients with dyslipidemia, and also its effect on controlling blood pressure. Patients and Methods A total of 96hypertensive patients (34 females, 62 males) with dyslipidemia were included (mean age 51.2±9.6, range 42-65 years). Patients were randomized to receive either telmisartan 80 mg/day (n=46) or enalapril 10 mg/day (n=50) for 6 months. The levels of blood pressure (BP), heart rate (HR), and biochemical data were measured before therapy and at the end of the 3-month treatment and 6-month treatment, respectively. Meanwhile, insulin resistance was evaluated by using a homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity (HOMA-IS). Results In the telmisartan group, the mean blood pressure was obviously lower than that of pre-therapy (P＜0.05), and the levels of triglyceride (TG), HOMA-IR, and HOMA-IS were all obviously lower than those of pre-therapy and of the enalapril group at the end of the 3-month-treatment period (P＜0.05). After 6 months of treatment, the levels of TG, HOMA-IR, and HOMA-IS in the telmisartan group were significantly lower in comparison with those of pre-therapy, the enalapril group (P＜0.01), and 3-month-treatment (P＜0.05). Post-prandial12 hour blood glucose (P2HBG) in the telmisartan group decreased significantly after 6-month treatment compared with that of pre-therapy and the enalapril group (P＜0.05). The level of high density lipoprotein (HDL) cholesterol was significantly higher after 6-month treatment in the telmisartan group than with pre-therapy and the enalapril group(P＜0.05). Conclusions Telmisartan could not only control blood pressure steadily and effectively, but also decrease blood TG, increase HDL cholesterol and insulin sensitivity, and lower insulin resistance.
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3 month),that Valsartan can improve LAreconstruction significantly,and improve LV function,as well as the long-term prognosis of persistent AF.