Changes in inflammatory factors, oxidative stress, glucose and lipid metabolism, and insulin resistance in patients with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common disease in women, affecting women's menstruation and significantly impacting women's physical and mental health. Studies have shown that insulin resistance has an important relationship with polycystic ovary. It is of great significance to explore the changes of inflammatory factors, oxidative stress, glucose and lipid metabolism, and insulin resistance in patients with PCOS. In the study process, 642 polycystic ovary patients in the first half of 2019 were divided into insulin resistance (n=357) and non-insulin resistance (n=285) groups. Oxidative stress index, glucose, and lipid metabolism index, and inflammatory factors were detected during the study process. The results showed that the levels of hs-CRP, TNF- α, and IL-6 in the IR group were 5.9mg/L, 9.2µg/L, and 87.2ng /ml, while those in the non-IR group were 4.6mg/L, 6.3µg/L and 51.5ng/ml, respectively. Thus, IL-6 and insulin levels maintain a dynamic balance. Low levels of IL-6 can promote insulin secretion, while high levels can inhibit its secretion. The results of this study will provide a specific clinical reference value for the prevention and treatment of polycystic ovary syndrome.

Effects of monitor alarm management training on nurses' alarm fatigue: A randomised controlled trial.

BACKGROUND: Chaotic monitor alarm management generates a large number of alarms, which result in alarm fatigue. Intensive care unit (ICU) nurses are caretakers of critically ill patients, the effect of alarm management affect patient safety directly. OBJECTIVES: To evaluate the effect of monitor alarm management training based on the theory of planned behaviour for reducing alarm fatigue in intensive care unit nurses. DESIGN: A randomised, single-blind trial. This article follows the requirements of CONSORT statement. PARTICIPANTS: The study was conducted from February 2019-May 2019 in a tertiary A-level hospital. 93 ICU clinical nurses were included, and they were randomly assigned into two groups. INTERVENTION: Nurses in the experimental group (n = 47) received a 12-week alarm management training course based on the theory of planned behaviour. Nurses in the control group (n = 46) received regular training. All nurses' alarm fatigue scores were measured with a questionnaire before and after the study period. Total number of alarms, nonactionable alarms and true crisis alarms were recorded continuously throughout the study period. RESULTS: For baseline comparisons, no significant differences were found. By the analysis of independent samples one-way ANCOVAs, the nurses' adjusted alarm fatigue scores at the post-test in the experimental group were significantly lower than those in the control group (p < .001). After the study period, adjusted total number of alarms and nonactionable alarms recorded in the experimental group were both significantly lower than those recorded in the control group (p < .001). After the study period, no significant difference between the two groups was noted in the adjusted number of true crisis alarms (p > .05). The interventions did not cause adverse events in either group of patients and did not cause adverse events in patients. CONCLUSION: Intensive care unit nurses' alarm fatigue was effectively decreased by the monitor alarm management training based on the theory of planned behaviour. RELEVANCE TO CLINICAL PRACTICE: (1) Monitor alarm training based on the theory of planned behaviour is effective in reducing nonactionable alarms and lowering alarm fatigue in ICU nurses. (2) The intervention considering the social psychological aspects of behaviour is effective in rebuilding the nurses' awareness and behaviour of alarm management. (3) Nurses are the direct users of monitoring technology. Hospital administrators should attach importance to the role of nurses in the medical monitoring system. We suggest that nursing managers implement training programmes in more ICUs in the future to improve alarm management ability and lower alarm fatigue in ICU nurses.

The Role of Spirituality in Patients Undergoing Hematopoietic Stem Cell Transplantation: a Systematic Mixed Studies Review.

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) has become the standard treatment for many diseases, but it is an intense and distinctive experience for patients. HSCT-related mortality is present throughout the whole process of transplantation, from pretransplantation to recovery. Long-term rehabilitation and the uncertain risk of death evoke feelings of vulnerability, helplessness, and intense fear. Zimmermann et al. proposed that spiritual well-being is an important dimension of quality of life and that patients at the end stage of life require spiritual support in addition to physical care, psychological care, and social support. Therefore, the purpose of this review is to examine the role of spirituality in the process of HSCT. METHOD: A systematic mixed studies review (SMSR) was based on Pluye and Hong's framework to understand the role of spirituality in patients' experiences while undergoing HSCT. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement to report the results of integration. RESULTS: Fifteen original qualitative studies, 19 quantitative studies, and one mixed method study were included in the systematic mixed studies review. The evidence from the review revealed the following three themes: the spiritual experiences of HSCT patients, the spiritual coping styles of HSCT patients, and the spiritual need changes brought about by HSCT. DISCUSSION: Few medical institutions currently offer spiritual healing, although HSCT patients with different cultural backgrounds may have different spiritual experiences and spiritual coping styles. Psychotherapists or nurses should be considered to provide spiritual care for patients undergoing HSCT, to help patients cope with disease pressures, promote HSCT patients' comfort, and improve their quality of life.