Construction and verification of a nomogram model for predicting pain after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma / 中国实用护理杂志

Objective:To establish a predictive model of moderate to severe pain in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE).Methods:264 patients with HCC who underwent TACE operation in Southern Medical University from January 2017 to April 2018 were selected as the modeling set. The pain was assessed by numeric rating scales. The patients were divided into pain group ( n=96) and non-pain group ( n=168) according to whether moderate to severe pain occurred within 24 hours after the operation. Binary Logistic regression analysis were performed for variables that were statistically significant in the univariate analyses. The predictive nomogram was constructed and the internal validation was performed. In addition, 87 patients with HCC who underwent TACE operation from January 2020 to June 2020 were selected as the validation set for external validation. Results:In the modeling set, 96 patients (36.36%) had moderate to severe pain within 24 hours after TACE operation in 264 patients with HCC, and the dosage of morphine intramuscularly injected within 24 hours was 1015 mg, with an average of 10.57 mg per patient. Multivariate Logistic regression analysis showed that preoperative pain, the distance between the tumor and capsule ≤2 cm, high prothrombin activity, dosage of lipiodol>10 ml, and several thromboembolic tumors were independent risk factors for moderate to severe pain after TACE ( P<0.05). Age>50 was the protective factor of moderate to severe pain after TACE ( P<0.05). The area under ROC curve was 0.799 (95% CI: 0.745-0.853) in the modeling set. The area under Roc curve for internal validation and external validation were 0.780 and 0.788, respectively. The calibration curves showed satisfactory agreements between the model predicted probability and the actually observed probability. Conclusion:The predictive model of moderate to severe pain after TACE was established in this study has good differentiation and accuracy, it has certain guiding significance for predicting the high-risk group of moderate to severe pain after TACE operation and formulating the targeted prevention strategy.

De novo malignancies after liver transplantation: clinical characteristics and management strategies / 中华肝胆外科杂志

Objective:To investigate the clinical characteristics of de novo malignancies (DNMs) after liver transplantation (LT) and to study the clinical management strategies.Methods:Adult LT recipients who were regularly followed-up in the Organ Transplantation Center, the Affiliated Hospital of Qingdao University from January 2005 to April 2021 were enrolled in this study. The clinical characteristics of DNMs were retrospectively analyzed. Of 601 LT recipients, there were 105 females and 496 males, aged (51.4±9.6) years old. They were divided into the DNMs group ( n=26) and the non-DNMs group ( n=575) according to whether there were DNMs on followed-up. Clinical data including age, sex, basic diseases before LT and operation time were collected. These patients were follow-up in outpatient clinics. Results:Twenty-six patients were diagnosed to develop DNMs after LT, but there were 28 DNMs (of which 2 patients were diagnosed to have DNMs twice). The incidence of DNMs after LT was 4.3% (26/601), the median time from LT to DNMs was 42 (20, 70) months, and the cumulative incidence rates of DNMs were 0.5%, 2.0%, 6.3%, 21.0% and 34.5% at 1, 3, 5, 10 and 15 years after LT, respectively. Among the 28 DNMs, digestive system tumors were most common, with 17 lesions (60.7%), followed by 3 lesions (11.1%) of lung cancer, 2 lesions (7.4%) of lymphoproliferative diseases, and 1 lesion (3.7%) of cervical cancer, thyroid cancer, soft palate cancer, eyelid cancer, laryngeal cancer, and prostate cancer. The follow-up time of 55.9 (36.6, 102.5) months in the DNMs group after LT was longer than the 33.4 (18.5, 58.9) months in the non-DNMs group ( P<0.001). The 1, 5, and 10 year survival rates of patients with DNMs after LT were 96.3%, 83.5%, and 49.8%, respectively. The 1, 5, and 10 year survival rates of patients with non-DNMs after LT were 94.5%, 77.7%, and 75.4%, respectively. There was no significant difference in the cumulative survival rates between the two groups (log rank=0.402, P=0.526). Conclusion:The incidence of DNMs in LT recipients was 4.3%. The majority of them were digestive system tumors. Early diagnosis and treatment of DNMs significantly improved the prognosis and quality of life of these patients.

Qualitative reserach on the attitude of obstetricians and midwives towards developing Nurse Practitioner / 中国实用护理杂志

Objective:To understand the attitudes of obstetricians and midwives towards the development of nurse practitioner in China.Methods:The phenomenological method in qualitative research was used to conduct semi-structured interviews with 24 medical staff in the third-A general hospitals and women and children's hospitals in Guangzhou and Dongguan City. The interview data were analyzed by Colaizzi's 7-step analysis method.Results:Four themes were extracted, namely, unanimous approval attitude, imperfect midwifery discipline and management system, insufficient independent practice capacity, low support and recognition in midwifery area.Conclusions:Obstetricians and midwives hold a positive attitude towards the development of midwifery nurse practitioner. At the same time,its development is restricted in many aspects. They can gradually develop midwife′s legislation, improve the management system, try some prescription rights, and increase the education and talents of midwifery subjects. Cultivation and promotion of social recognition will help gradually train midwifery nurse practitioner in China.

Comparative analysis of care behaviors between inpatients and nurses / 中国实用护理杂志

Objective To compare the evaluation of care behaviors among inpatients and nurses, in order to know the implementation of caring behavior from different perspectives, and to provide evidence for better humanistic care in hospitals. Methods The nurses' humanistic practice ability scale and the caring behavior scale were used to investigate 160 nurses and inpatients respectively in The Third Affiliated Hospital of Southern Medical University. Results The total score of nurses' self rating for caring behavior was (4.15 ± 0.58) points, while the score of self-management ability was lowest, which was (3.84 ± 0.67) points;and the total score of nurses' caring behaviors was (3.49 ± 0.92) points, while the lowest scoring dimensions were respect and connection (3.42 ± 0.95) points. Nurses and patients both feel better at basic care (such as meeting basic needs, providing good environment), psychological care (such as giving support and) and professional care (such as health education), but both of them think that nurses did not do good enough in the provision of high-level emotional needs (such as diversified care, spiritual sustenance)and participation in nursing programmes. Conclusions The evaluation of nursing caring behavior is in the middle and upper level, which shown that the nurses have certain humanistic care and practical ability in clinical practice, and have been recognized by patients, but there is still a lot of room for improvement, and suggested that nursing administrators should give nurses enough respect and consideration while considering patients.

The investigation of the healthy work environment in emergency departments in tertiary hospitals of Guangdong province / 重庆医学

Objective To investigate the health status of nurses in emergency departments in tertiary hospitals of Guangdong province.Methods Fourteen tertiary hospitals were selected by using convenience sampling method,and 382 emergency nurses were chose by cluster sampling and their healthy work environment was evaluated by using Essentials of Magnetism Ⅱ scale(EOM Ⅱ).All the participants were asked to finished the Essentials of Magnetism Ⅱ scale.Results The healthy work environment in the tertiary hospitals' emergency departments in Guangdong had higher score than the magnet hospitals in America,but lower job satisfaction and nursing quality.There were significant differences in different shift and education of the emergency nurses.The job satisfaction and nursing quality could influence the healthy work environment.Conclusion The healthy work environment in tertiary hospitals' emergency departments of Guangdong province is good,but the job satisfaction and nursing quality is low.

Evaluation on application effects of medical students′practical base website for humanistic quality ;education / 中国实用护理杂志

Objective To evaluate medical students′ achievements of studying through the practical base website for humanistic quality education. Methods Totally 61 students from school of nursing and 135 students from the first clinical medical college of Southern Medical University in Guangzhou were organized as volunteers. They were divided into the intervention group and the control group (98 people per group) in completely random method by the Random Number Generators of SPSS 20.0. With a two-month experiment, the humanistic knowledge scores and humanistic caring ability scores of these two groups were investigated by the Humanistic Knowledge Test Paper and the Caring Ability Inventory. And the learning effects of the website by the intervention group was evaluated with the self-designed questionnaire. Results There was no significant difference (P>0.05) between students in the intervention group and the control group when it came to general information. Before the experiment, the score of humanistic knowledge test paper, the total score of caring ability inventory, the score in the dimension of cognition, patience, and courage of the intervention group were 6.29 ± 0.58, 172.40 ± 10.00, 58.98 ± 4.22, 51.56 ± 5.22, 61.86 ± 6.40, the scores of the control group were 6.36 ± 0.63, 172.65 ± 13.49, 59.31 ± 4.05, 50.83 ± 6.56, 62.52 ± 7.28, there were no significant differences between the two groups (all P>0.05). After the experiment, the score of humanistic knowledge test paper, the total score of caring ability inventory, the score in the dimension of cognition and courage of the intervention group were 7.82± 0.62, 182.34 ± 12.78, 65.04 ± 9.12, 65.17 ± 6.58, the scores of the control group were 6.37 ± 0.60, 170.73 ± 8.92, 58.29±5.61, 62.36±6.90, there were significant differences between the two groups (t=2.92-16.67, all P0.05). As shown by the evaluation made by students in the intervention group about the learning effect of the website, the average score was the highest in the field of skills (3.95 ± 0.58), followed by the cognitive field (3.92 ± 0.46) and emotional field (3.75 ± 0.66). Most of the respondents believed that web-based learning could deepen students′ understanding of humanistic quality education (4.13 ± 0.57), independent web-based learning could strengthen the application of online resources (4.06±0.59) and students could master communicative skills required in different situations through web-based learning (4.05 ± 0.58). Conclusions Students are satisfied with the practical base website for humanistic quality education, the website has rich learning contents and can improve students′ interests and motivation. Through web-based learning, humanistic knowledge and humanistic caring ability of students can be improved to some extent. But the website is still in development, it needs an evaluation indicators system in order to do further research for all application effects of the website.

The study on the concept and structure elements of the nurse humanistic practiceability / 中国实用护理杂志

Objective Toestablishthe concept and structure elements of the nurse humanistic practiceability. Methods Using documentandtheoretical analysis to definethe concept of the nurse humanistic practiceability. And usestructuralanalysis to explain the structural elementsto formDelphiexpert consultationquestionnaire, which was investigated for 18 experts in 5provinces includingnursing education, nursing management, nursing clinicalcare,medical humanitiesandhumanistic medicine,and eventually established thetheory and structure model of the nurse humanistic practiceability. Results The effective recovery rates of the questionnaire were 81.8%(18/22)and 100%(18/18). The authority coefficients were 0.924, and the total consistency coefficients were 0.307 and 0.367 with statistical significance. TheDelphi expert consultation has established the concept, six-level structural elementsand15sub-elements. And for the first-class,the average value was 3.94-5.00,the coefficients variation of was 0.00-0.20;for the secondclass,the average value was 3.89-5.00,the coefficient variation were 0.00-0.19. Conclusions The study onconceptand structure elements of nurse humanistic practice ability has completed, which provide theoretical basis for improvement of nurse humanistic practice ability.

The development and the reliability and validity test of the satisfaction evaluation questionnaire about humanistic caring of head-nurses to nurses / 中国实用护理杂志

Objective In order to provide evidence for researches related to evaluating the humanistic caring ability of head-nurses, we developed the questionnaire and launched reliability and validity test for it. Methods Through analyzing in documents, theories and scales, launching a 2-round experts consultation for 19 experts, the questionnaire consists of 3 first-class indicators, 8 second-class indicators and 36 third-class indicators. A total of 217 nurses, from third-grade class-A hospital who had a more than 5-year clinical experience, were selected by convenient sampling. Finally, the reliability and validity of the questionnaire had been summarized. Results The Cronbach α was 0.937 for the total questionnaire and 0.743-0.898 for each sub-scales. The split half reliability coefficient for the total questionnaire was 0.801 and 0.748-8.872 for each sub-scales. Test result of questionnaire content validity demonstrate the CVI was 0.91 for the total factors and 0.83-1.00 for each factor.Through exploratory factor analysis, 8 common factors were abstracted and cumulative variance contribution rate was 65.852%. Conclusions The questionnaire, developed for evaluating the humanistic caring ability of head-nurses, shows acceptable reliability and validity, and it′s worth to be popularizing and using in future.

Investigation of the knowledge level of the caregivers about pressure ulcer in patients with high risk of pressure ulcer in rural community / 中华老年医学杂志

Objective To investigate the knowledge level of the caregivers about pressure ulcer in patients with high risk of pressure ulcer in rural community,and to provide the scientific basis for the prevention and treatment of pressure ulcer.Methods 216 caregivers for patients with high risk of pressure ulcer in rural community were chosen from Mar.2012 to May 2013.The investigation on the awareness of pressure ulcer was performed by using questionnaire survey.Results The awareness rate of pressure ulcer in caregivers was 41.5 ％.The caregivers had gender difference (174females and 42 males).Most of the caregivers were 41 to 50 years old (124 cases,57.4％).Most caregivers had 1 ～ 2 years work experience (94 cases,43.5％).Most of them had low level of education (170 cases,78.7％) and non-professional training (178 cases,82.4％).The questionnaire score was higher in young caregivers than in the olders(F=2.483,P＜0.05).The questionnaire score was higher in caregivers having a long working lifetime(F=3.624,P＜0.05),higher educationalbackground (F=5.139,P＜ 0.01) and discipline training (t=7.346,P＜ 0.01) than in caregivers not having them.Conclusions The awareness rate of the knowledge about pressure ulcer is low in caregivers for patient with high risk of pressure ulcer in rural community.It is necessary to strengthen the guidance and training in caregivers to reduce the incidence of pressure ulcers and the medical cost,and improve the quality of life in patients with high risk of pressure ulcer in rural community.

Status survey on humanistic care quality of nurses in department of aged homes in Guangzhou / 中国实用护理杂志

Objective To investigate the current status and the related influencing factors of humanistic care quality of nurses in department of aged homes in Guangzhou,for the future to carry out humanistic care education,and provide a reference for improving humanistic care quality of nurses.Methods 270 nurses from 8 department of aged homes in Guangzhou were investigated by convenience sampling and evaluation table on humanistic care quality of nurses.The affected factors were analyzed by multiple stepwise regression.Results The aggregate score of humanistic care quality of nurses in this study was (113.59±9.78),which was lower than the reference score (118.36±16.75) of humanistic care quality of nurses of some general hospitals in Shanghai in 2010,offered by Liu Yuxiao,the designer of the evaluation table.The scores were correlated with 4 impact factors including home,politics status,care index of colleagues,whether to accept the education and training of humanistic care;multiple stepwise regression analysis indicated that care index of colleagues and whether to accept the education and training of humanistic care were the main factors.Conclusions Humanistic care quality of nurses in department of aged homes in Guangzhou was in lower level,and especially caring ability and the attitude towards caring.Department of aged homes should cooperate with universities,to establish a set of training courses on humanistic care quality of nurses in department of aged homes.Through the systematic,standardized training,to improve humanistic care quality of nurses and the quality of nursing service.

Medical students' understanding about urban-rural integration / 中华医学教育探索杂志

Objective To investigate medical students' cognitive status and attitude toward urban-rural integration and to find the influencing factors in an aim to provide information for the process of urban and rural integration.Methods Sampling survey was conducted among the junior students who were major in eight-year clinical medicine,five-year clinical medicine and nursing (undergraduate) with self-made questionnaire.The data entry was done by 19.0 SPSS software and descriptive statistical analysis and ONE-WAY ANOVA were used to do statistical analysis.Results Students who didn't know urban-rural integration accounted for 53.2％,while 80.7％ students supported urban-rural integration.Students' major and residence were two influencing factors of working in the countryside.Conclusion Measures should be taken to raise students' awareness of urban-rural integration based.Targeted measures should be adopted based on students' majors and residences.

Making suggestions of nursing postgraduates' training mode reform through the state of their core competence / 中国实用护理杂志

Objective To make suggestions of reform of nursing postgraduates' training mode according to the state of their core competence. Methods 297 nursing postgraduates were investigated using the assessment form of nursing postgraduate's core competence, the questionnaire of training mode and general conditions. Results Nursing postgraduate's core competence were not good, the four lowest scored ability respectively were English ability, scientific research ability, teaching ability, grasping ability of professional knowledge and skill. Conclusions In order to promote the teaching quality, we should reform the training mode from the following aspects: to make clear training target; to make clear professional direction, formulate and carry out training program effectively; to increase the courses related with profession; to reinforce the study of public English and professional English ; to improve the ability of scientific research; to strengthen and perfect the teaching practice; to consolidate the basic knowledge,the basic theory and the basic skill of nursing; to build a unified and normal evaluation system.

The research of compound nutrition to reduce stress damage in moist heat and wound rats / 中国实用护理杂志

Objective To probe into the changes of rats' plasma SOD,MDA,NO and rectal temperature at moist heat and wound stress in order to build a basis for research of enhancing resistance to stress resporise in human. Methods 56 moist beat and wound rats were randomly divided into the control group and the nutrition group with 28 rats in each group.then each group was subsequently divided into 4 period oftime.All the backs of rats were scalded in superficial degree Ⅱ by 99℃water and exposed to the same conditions:temperature at(37.O±0.5)℃and relative humidity at(65±5)%.The control group' was imbued with double-distilled water for one week,while in the nutrition group,compound nutrient was imbued for one week.SOD,MDA,NO and rectal temperature at 4 time points were compared between the two groups.Results The differences of rectal temperature,NO and SOD changes between the control group and the nutrition group were remarkably significant.Conclusions Early nutrition is effective in reducing stress,decreasing organ injury caused by NO,SOD and MDA level and alleviated the damage of body.