The experiences of family resilience in patients with permanent colostomy and their spouses: A dyadic qualitative study.

PURPOSE: With the prolonged survival time of patients with permanent colostomy for colorectal cancer, they and their spouses face tremendous pressure and development dilemmas that can easily lead to family adaptation crises. This qualitative study amid to explore the dyadic experiences of family resilience among Chinese patients with permanent colostomy and their spouses. METHODS: A phenomenological research method was adopted. Semi-structured, in-depth, face-to-face interviews with 10 dyads of patients with permanent colostomy and their spouses were recruited through purposive sampling from a public tertiary hospital in China from March 2023 to July 2023.The Dyadic interview analysis and Colaizzi methods were used to analyze the interview data. RESULTS: Three themes and nine subthemes were developed. (1) family crisis and dichotomous coping with stress-family crisis and coping pressure caused by enterostomy; (2) Adjustment and adaptation within the family-Joint adjustment and adaptation within the couple's family; and (3) integration and utilization of multi-dimensional social external resources (micro-level, meso-level, and macro-level). CONCLUSIONS: Couples living with permanent colostomy often undergo a complex emotional journey, experiencing varied levels of individual stress as they navigate social interactions and daily activities, which can contribute to a decline in family adaptation. With the help of the perspective of family advantage, health practitioners should pay attention to the evaluation of individual factors and family environmental resources, to fully mobilize advantage resources and give effective interventions to improve the family and social adaptation level of patients and their spouses.

Effects of a Nurse-Led Phone Follow-up Education Program Based on the Self-efficacy Among Patients With Cardiovascular Disease.

BACKGROUND: The integration of self-efficacy (SE) theory within a nurse-led telephone follow-up education program (NP-FEP) has not been extensively evaluated for patients with cardiovascular disease. OBJECTIVES: The aim of this study is to determine the effectiveness of an NP-FEP in improving SE (primary outcome) and achieving goals related to cardiovascular risk (secondary outcome) for patients with cardiovascular disease. METHODS: In June and July 2013, a total of 403 patients with cardiovascular disease in Shanghai were randomized into the intervention and control groups. Personalized end goals were established for improving cardiovascular risk for each patient. The control group received conventional follow-up education, whereas the intervention group was contacted by telephone 11 times over a 6-month period with staged goals developed based on SE theory. Self-efficacy scores and goals for reducing cardiovascular risk were assessed at baseline, at the end of the 6-month intervention, and 12 months after enrollment. RESULTS: The SE scores in both groups increased at 6 months and decreased slightly at 12 months. The baseline SE scores were similar between the groups (P > .05), but the average SE scores were increased more for the intervention group than for the control group at 6 (P < .05) and 12 (P < .05) months. In addition, the final goal achievement rates for the intervention group were significantly higher than for the control group (P < .05). The difference between the 2 groups was reflected by differences in cardiac disease risk factors defined by the World Health Organization. CONCLUSION: The NP-FEP improved SE and facilitated achievement of goals related to risk factors in patients with cardiovascular disease for at least 1 year.

New standardized nursing cooperation workflow to reduce stroke thrombolysis delays in patients with acute ischemic stroke.

OBJECTIVE: We assessed the effectiveness of a new standardized nursing cooperation workflow in patients with acute ischemic stroke (AIS) to reduce stroke thrombolysis delays. PATIENTS AND METHODS: AIS patients receiving conventional thrombolysis treatment from March to September 2015 were included in the control group, referred to as T0. The intervention group, referred to as T1 group, consisted of AIS patients receiving a new standardized nursing cooperation workflow for intravenous thrombolysis (IVT) at the emergency department of Shanghai East Hospital (Shanghai, People's Republic of China) from October 2015 to March 2016. Information was collected on the following therapeutic techniques used: application or not of thrombolysis, computed tomography (CT) time, and door-to-needle (DTN) time. A nursing coordinator who helped patients fulfill the medical examinations and diagnosis was appointed to T1 group. In addition, a nurse was sent immediately from the stroke unit to the emergency department to aid the thrombolysis treatment. RESULTS: The average value of the door-to-CT initiation time was 38.67±5.21 min in the T0 group, whereas it was 14.39±4.35 min in the T1 group; the average values of CT completion-to-needle time were 55.06±4.82 and 30.26±3.66 min; the average values of DTN time were 100.43±6.05 and 55.68±3.62 min, respectively; thrombolysis time was improved from 12.8% (88/689) in the T0 group to 32.5% (231/712) in the T1 group (all P<0.01). In addition, the new standardized nursing cooperation workflow decreased the National Institutes of Health Stroke Scale (NIHSS) scores at 24 h (P<0.01) (T0: prethrombolysis, 6.97±3.98; 24 h postthrombolysis, 3.33±2.09; 2 weeks postthrombolysis, 2.25±1.01 and T1: prethrombolysis, 7.00±3.89; 24 h postthrombolysis, 2.60±1.66; 2 weeks postthrombolysis, 2.21±1.02). CONCLUSION: The new standardized nursing cooperation workflow reduced stroke thrombolysis delays in patients with AIS.

Pilot study on the Chinese version of the Life Space Assessment among community-dwelling elderly.

PURPOSE: To translate the Life Space Assessment (LSA) into Chinese and to examine the reliability and validity of the Chinese version of the LSA (LSA-C) among community-dwelling elderly. MATERIALS AND METHODS: Data were collected from 100 community-dwelling elderly people (50 males and 50 females) aged over 65 years (72.23±5.05) in Shanghai. The criterion convergent validity was evaluated by bivariate Pearson correlation analysis separately between the LSA-C and physical health section of the Short Form 36 Health Survey Questionnaire (SF-36-PH), Activities of Daily Living Scale (ADLs), Instrumental Activities of Daily Living Scale (IADLs), and Mini Physical Performance Test (Mini-PPT). The construct validity was estimated using mental health section of the Short Form 36 Health Survey Questionnaire (SF-36-MH), Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). The test-retest reliability of the LSA-C was tested after two weeks by inter-class correlation method. RESULTS: The test-retest reliability of the LSA-C was 0.76. The criterion convergent validity, which was evaluated by bivariate Pearson correlation analysis between the LSA-C and SF-36-PH, IADLs, and Mini-PPT, was 0.595 (P<0.001), 0.567 (P<0.001), and 0.433 (P<0.001), respectively. The construct validity, which was evaluated by the SF-36, GDS, and MMSE, was 0.704 (P<0.001), -0.544 (P<0.001), and 0.424 (P<0.001), respectively. CONCLUSIONS: The LSA-C has acceptable reliability and validity and is significantly correlated with other health evaluation tools with respect to, e.g., health status, daily function, physical performance, presence of depression, and cognitive status. These results demonstrate that the LSA-C can be applied to health evaluations and interventions in community-dwelling elderly in China.