Application and effect evaluation of multidisciplinary team management model: On central venous access device associated skin impairment based on Delphi method.

OBJECTIVE: To establish a multidisciplinary management model based on Delphi method to guide nursing practice and reduce the incidence of CVAD-associated Skin Impairment (CASI) in tumor patients. METHODS: On the basis of literature review and focus group interview, the initial item pool of CASI management model for cancer patients was determined. The Delphi method was used to conduct two rounds of letter consultation with 36 authoritative and representative experts to determine the content and weight of indicators of CASI multidisciplinary management model for cancer patients. RESULTS: Most of the research group were experts with bachelor degree or above. More than 90% of experts have worked for more than 10 years; Areas of expertise include oncology care, venous therapy, wound stomatology, and dermatology. The recovery rate of the two rounds of expert correspondence questionnaire was 100%. The authority coefficient of experts was 0.898, indicating a good degree of authority. Kendall's harmony coefficients were 0.193 and 0.250, with statistically significant differences (p < 0.001). After two rounds of expert letter consultation, a multidisciplinary management model of CASI for cancer patients was initially formed, which included 15 first-level prevention indexes and 38 second-level prevention indexes of CASI for cancer patients. There were 9 first-level indexes and 16 second-level indexes of CASI treatment in tumor patients. CONCLUSION: Cancer patients based on Delphi method to construct CASI multidisciplinary management model has high reliability and scientificity, multidisciplinary management model in the management of patients with tumor CASI exploration will provide new methods for central venous catheter nursing and the new way of thinking, will also be intravenous fluids will provide a scientific basis for professional development and quality improvement and practical experience.

Assessment of defecation function after sphincter-saving resection for mid to low rectal cancer: A cross-sectional study.

PURPOSE: Patients with mid-to low-rectal cancer can have various dysfunctions of defecation after sphincter-saving resection. Defecation dysfunction can manifest as incontinence, urgency, or frequent bowel movements, and is called low anterior resection syndrome (LARS). This study aimed to examine LARS score and objective anorectal function indices in Chinese patients receiving sphincter-saving surgery for mid-to low-rectal cancer. METHOD: This was a single-center cross-sectional study of patients undergoing sphincter-saving resection for low- or mid-rectal cancer and had restoration of trans-anal defecation for at least 1 month seen between January 2019 and June 2020. Patients completed a questionnaire regarding clinical characteristics, and Low Anterior Resection Syndrome (LARS) score and high-resolution anorectal manometry (HR-ARM) were used to assess defecation function. Multivariable analysis was used to identify variables significantly associated with defecation dysfunction. RESULTS: 146 patients completed and returned the questionnaires. 25 healthy adults also participated as control group for the anorectal manometry. Approximately 76% of patients developed LARS after surgery, of which 35.6% had major LARS. In these patients, anorectal manometry indices including initial rectal sensory capacity and rectal fecal sensory capacity, were significantly lower than normal. Logistic regression analysis showed that preoperative chemo-radiotherapy and the tumor inferior margins being close to the dentate line, especially 2-5 cm, were independent risk factors for defecation dysfunction after surgery. CONCLUSIONS: Defecation dysfunction is a frequent occurrence after sphincter-saving resection for mid- and low-rectal cancer. Preoperative chemo-radiotherapy and a shorter tumor inferior margins distance to the dentate line are independent factors for defecation dysfunction.

Self-perceived burden and influencing factors in patients with cervical cancer administered with radiotherapy.

BACKGROUND: Cervical cancer is the fourth commonest malignancy in women around the world. It represents the second most commonly diagnosed cancer in South East Asian women, and an important cancer death cause in women of developing nations. Data collected in 2018 revealed 5690000 cervical cancer cases worldwide, 85% of which occurred in developing countries. AIM: To assess self-perceived burden (SPB) and related influencing factors in cervical cancer patients undergoing radiotherapy. METHODS: Patients were prospectively included by convenient sampling at The Fifth Affiliated Hospital of Sun Yat-Sen University, China between March 2018 and March 2019. The survey was completed using a self-designed general information questionnaire, the SPB scale for cancer patients, and the self-care self-efficacy scale, Strategies Used by People to Promote Health, which were delivered to patients with cervical cancer undergoing radiotherapy. Measurement data are expressed as the mean ± SD. Enumeration data are expressed as frequencies or percentages. Caregivers were the spouse, offspring, and other in 46.4, 40.9, and 12.7%, respectively, and the majority were male (59.1%). As for pathological type, 90 and 20 cases had squamous and adenocarcinoma/adenosquamous carcinomas, respectively. Stage IV disease was found in 12 (10.9%) patients. RESULTS: A total of 115 questionnaires were released, and five patients were excluded for too long evaluation time (n = 2) and the inability to confirm the questionnaire contents (n = 3). Finally, a total of 110 questionnaires were collected. They were aged 31-79 years, with the 40-59 age group being most represented (65.4% of all cases). Most patients were married (91.8%) and an overwhelming number had no religion (92.7%). Total SPB score was 43.13 ± 16.65. SPB was associated with the place of residence, monthly family income, payment method, transfer status, the presence of radiotherapy complications, and the presence of pain (P < 0.05). The SPB and self-care self-efficacy were negatively correlated (P < 0.01). In multivariate analysis, self-care self-efficacy, place of residence, monthly family income, payment method, degree of radiation dermatitis, and radiation proctitis were influencing factors of SPB (P < 0.05). CONCLUSION: Patients with cervical cancer undergoing radiotherapy often have SPB. Self-care self-efficacy scale, place of residence, monthly family income, payment method, and radiation dermatitis and proctitis are factors independently influencing SPB.

Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial.

OBJECTIVE: To compare the value of the subcutaneous tunneling technique versus the normal technique in improving the outcomes of patients undergoing chemotherapy with peripherally inserted central catheters (PICCs). METHODS: One hundred thirty patients were randomly divided into an experimental group (subcutaneous tunneling technique) and control group (normal technique) according to the PICC placement technique, and clinical data were compared between the groups. RESULTS: In total, 129 PICCs were successfully inserted. Compared with the control group, the experimental group had a lower occurrence of complications after placement (especially catheter dislodgement: 3.1% vs. 15.4%, venous thrombosis: 3.1% vs. 15.4%, and wound oozing: 14.1% vs. 27.7%), lower occurrence of unscheduled PICC removal (3.1% vs. 13.8%), greater comfort during placement (14.16 ± 2.21 vs. 15.09 ± 2.49 on a scale ranging from 6 to 30 points, with higher scores indicating lower degrees of comfort), and lower costs of PICC maintenance (median (interquartile range) per-day maintenance cost: 13.90 (10.99-32.83) vs. 15.69 (10.51-57.46) Yuan). The occurrence of complications and amount of bleeding during placement were not significantly different between the two groups. CONCLUSIONS: The subcutaneous tunneling technique can improve PICC placement by reducing complications and costs of maintenance with better patient comfort during placement.

Multidimensional fatigue in patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: incidence, severity, and risk factors.

PURPOSE: To explore the incidence, severity, and risk factors of multidimensional fatigue in patients with nasopharyngeal carcinoma (NPC) receiving concurrent chemoradiotherapy (CCRT). METHODS: This prospective study included 79 patients with NPC in Guangzhou (China) from June 2015 to July 2018. Data were collected before and after CCRT, including demographic and clinical characteristics, nutritional parameters, and fatigue scores, based on completion of the Multiple Dimensional Inventory-20 Questionnaire, with five subscales: General Fatigue, Mental Fatigue, Physical Fatigue, Reduced Activity, and Reduced Motivation. RESULTS: Increased general fatigue was found to be associated with lower lymphocyte count and body mass index <23 kg/m2. Increased physical fatigue was related to age > 42 years. Higher scores for reduced activity were associated with age > 42 years, female sex, and lower serum sodium. Increased mental fatigue was related with lower lymphocyte count and unemployment; and increased total fatigue was associated with lower lymphocyte count, age > 42 years, and 3-6 courses of treatment. Furthermore, 3-6 courses of treatment was an independent predictor of severe general fatigue, while age >42 years was an independent predictor of severe physical fatigue. Importantly, cancer stage IVB and 3-6 courses of treatment could predict severe total fatigue. CONCLUSIONS: Our data demonstrate that fatigue is increased in all dimensions in NPC patients following CCRT, and that the predictors differ for each fatigue dimension. These results could guide the development of targeted interventions that may reduce the impact of cancer-related fatigue in patients with NPC.

Home enteral nutrition after esophagectomy for esophageal cancer: A systematic review and meta-analysis.

BACKGROUND: Not only has the placement rate of enteral feeding tubes during operations for esophageal cancer increased, but also has number of patients who choose to continue enteral feeding at home instead of removing the feeding tube at discharge. The impacts of home enteral nutrition (HEN) after esophagectomy in esophageal cancer patients are analyzed. METHODS: A systematic review was conducted in accordance with PRISMA and Cochrane guidelines. English and Chinese databases, including PubMed, Embase, Web of Science, The Cochrane Library, Scopus, CBM, CNKI, and Wan Fang were searched from inception to December 7, 2019. Randomized controlled trials evaluating the short-term outcomes of HEN following esophagectomy in cancer patients were included. The risk of bias of the included studies was appraised according to the Cochrane risk of bias tool. The summary of relative risk/weighted mean difference (WMD) estimates and corresponding 95% confidence interval (95% CI) were calculated using fixed- and random-effects models. RESULTS: Nine randomized controlled trials involving 757 patients were included in the meta-analysis. Compared with oral diet, HEN was associated with significantly increased body weight (WMD 3 kg, 95% CI 2.36-3.63, P < .001), body mass index (WMD 0.97 kg/m, 95% CI 0.74-1.21, P < .001), albumin (WMD 3.43 g/L, 95% CI 2.35-4.52, P < .001), hemoglobin (WMD 7.23 g/L, 95% CI 5.87-8.59, P < .001), and total protein (WMD 5.13 g/L, 95% CI 3.7-6.56, P < .001). No significant differences were observed in prealbumin and gastrointestinal adverse reactions. Physical (WMD 8.82, 95% CI 6.69-10.95, P < .001) and role function (WMD 12.23, 95% CI 2.72-21.74, P = .01) were also significantly better in the HEN group. The nausea/vomiting (WMD -5.43, 95% CI -8.29 to -2.57, P = .002) and fatigue symptoms (WMD -11.76, 95% CI -16.21 to -7.32, P < .001) were significantly reduced. Appetite loss (WMD -8.48, 95% CI -14.27 to -4.88, P = .001), diarrhea (WMD -3.9, 95% CI -7.37 to -0.43, P = .03), and sleep disturbance (WMD -7.64, 95% CI -12.79 to -2.5, P = .004) in the HEN group were also significantly less than the control group. CONCLUSIONS: HEN improved nutrition status, physical and role function, and reduced nausea/vomiting, fatigue, appetite loss, diarrhea, and sleep disturbance compared with an oral diet in esophageal cancer patients postsurgery. HEN did not increase adverse reactions.

Follow-up study on symptom distress in esophageal cancer patients undergoing repeated dilation.

BACKGROUND: Repeated endoscopic probe dilatation is the most preferred treatment for esophageal stenosis which may cause high levels of symptom distress in the patient's home rehabilitation stage. AIM: To explore the changes in the symptom distress level and its correlation with the dilation effect in patients with esophageal carcinoma undergoing repeated dilations for lumen stenosis. METHODS: The difference (R2-R1) between the diameter of the esophageal stenosis opening (R1) of the patients before dilation (R1) and after dilation (R2) was calculated to describe the extent and expansion of the esophageal stenosis before and after dilation. The M.D. Anderson Symptom Inventory was used to describe the symptom distress level of patients with dilation intermittence during their stay at home and to explore the correlation between the dilation effect and symptom distress level. RESULTS: The diameter of the esophagus (R1) increased before each dilation in patients undergoing esophageal dilation (P < 0.05). The diameter (R2) increased after dilation (P < 0.05); the dilation effect (R2-R1) decreased with the number of dilations (P < 0.05). The total symptom distress score significantly increased with the number of dilations (P < 0.05). The symptom distress scores of the patients were negatively correlated (P < 0.05) with the previous dilation effect (R2-R1) and the esophageal diameter (R2) after the previous dilation. After the 1st to 4th dilations, the patient's symptom distress score was negatively correlated with the esophageal diameter (R12) before the next dilation, while there was no significant correlation (P > 0.05) with the other dilations. CONCLUSION: In patients who have undergone repeated dilations, better effect stands for lower symptom distress level and the increase in symptom distress has a prompt effect on the severity of the next occurrence of restenosis.

Effect of video-assisted education on informed consent and patient education for peripherally inserted central catheters: a randomized controlled trial.

OBJECTIVE: To evaluate the effects of a video-assisted education intervention on informed consent and patient education for peripherally inserted central catheters (PICCs). METHODS: We conducted a randomized controlled trial comparing the effects on informed consent of video-assisted patient education and traditional face-to-face discussion in a catheter outpatient ward of a cancer centre in Guangzhou, China, in 2018. Participants were 140 patients randomly allocated (1:1 ratio) to two groups: video-assisted or traditional intervention. General information, patient retention of PICC-related information, working time spent by nurses on the procedure, and patient and nurse satisfaction with the procedure were assessed. RESULTS: The time used for informed consent was significantly shorter in the experimental group (1.02 ± 0.24 minutes) than in the control group (6.87 ± 1.10 minutes). The time used for PICC-related education was significantly shorter in the experimental group (1.03 ± 0.28 minutes) than in the control group (5.11 ± 0.57 minutes). Nurses' degree of satisfaction with the procedure was significantly higher in the experimental group (4.10 ± 0.57) than in the control group (2.60 ± 0.70). CONCLUSION: The use of video-assisted informed consent and patient education in this cancer centre decreased nurses' working time and improved nurses' satisfaction.Clinical trial registration number: ChiCTR1800015664.

The Prevalence and Correlates of Prehospital Delay and Health Belief in Chinese Patients With Colorectal Cancer.

The objective of this study was to describe prehospital delay and health beliefs in Chinese patients with colorectal cancer. A total of 756 adult Chinese patients with a first-time diagnosis of colorectal cancer were recruited during 2016 in Guangzhou, China. All patients completed the Chinese-language version of a questionnaire developed specifically for this study as well as the Chinese-language version of the Champion Health Belief Model Scale. The results of this study showed that the median length of the prehospital delay was 12 weeks and that the average delay was 18.29 (SD = 14.66) weeks. The rate of prehospital delay was 47.35%. The score of health beliefs among these patients was 115.56 (SD = 9.00) and the average score of the entries was 3.21 (SD = 0.25). Health beliefs about colorectal cancer were negatively correlated with prehospital delay. A multiple logistic regression showed that the level of health beliefs, frequency of physical examinations, occupation, and the site of the cancer were the major factors influencing prehospital delay (p < .05). The patients had a low rate of physical examination (41.40%), and colorectal cancer screening was not routine prior to their physical examination. This study showed that the incidence of prehospital delay among Chinese patients with colorectal cancer was 47.35%. Multiple factors influenced prehospital delay among Chinese patients with colorectal cancer.

Effect of tunneled and nontunneled peripherally inserted central catheter placement: A randomized controlled trial.

PURPOSE: To compare the effect of tunneled and nontunneled peripherally inserted central catheter placement under B-mode ultrasound. METHODS: A single center, randomized, controlled, nonblinded, prospective trial was conducted in Guangzhou, China, between July 2018 and May 2019. A total of 174 participants were randomized to the experimental group (tunneled peripherally inserted central catheter) or the control group (nontunneled peripherally inserted central catheter) and were followed until extubation. Basic characteristics, peripherally inserted central catheter characteristics, the incidence of complications, and the costs of peripherally inserted central catheter placement and maintenance were collected. Data were analyzed by intention-to-treat. RESULTS: A total of 168 of the participants had successful peripherally inserted central catheter placements (85/87, 97.7% in the experimental group and 83/87, 95.4% in the control group, P = 0.682). Compared to the control group, the experimental group had a lower incidence of complications during the placement (18.4% vs 32.2%, P = 0.036), a lower incidence of wound oozing (27.6% vs 57.5%, P < 0.001), a lower incidence of medical adhesive-related skin injury (9.2% vs 25.3%, P = 0.005), a lower incidence of venous thrombosis (1.1% vs 9.2%, P = 0.034), a lower incidence of catheter dislodgement (1.1% vs 9.2%, P = 0.034), and lower costs of peripherally inserted central catheter maintenance at 1, 2, and 3 months (P < 0.05). CONCLUSION: Tunneled peripherally inserted central catheter may be recommended for good effectiveness.

Analysis of the perceptions and attitudes to participate in radical and palliative clinical trials among Chinese lymphoma and head/neck cancer patients.

Objective: The purpose of this prospective study was to investigate the perceptions and attitudes to participate in radical and palliative clinical trials among Chinese lymphoma and head/neck cancer patients. Patients and Methods: A self-developed questionnaire was administered to hospitalized patients in the Department of Medical Oncology in Sun Yat-Sen University Cancer Center between 20 September 2014 and 20 September 2015. This study included lymphoma patients who were enrolled into a radical treatment clinical trial, and head/neck cancer patients participating in a palliative clinical trial. Results: There were 136 lymphoma patients and 87 head/neck cancer patients who completed and returned the questionnaire. The questionnaire return rate was 100%. More than 90% of the patients in both groups showed trust and acceptance for medical care personnel, and more than 50% of the patients in both groups were in hope of trying new medication, receiving free medication, and receiving new treatment at an earlier rate. As compared with those in the radical trials, patients in the palliative clinical trials were more likely to hope to try new medication (P<0.001) and receive a new treatment at an earlier date (P=0.025), but less likely to hope to receive free medication (P=0.047). Conclusions: This study reveals several shared perceptions and needs of patients in both the radical (lymphoma) and palliative (head/neck cancer) settings and explores the differences in patients' attitudes between radical clinical trials and palliative clinical trials. These findings may provide a basis for improving recruitment of patients for different types of clinical trials and ensuring that patients have a better understanding of clinical trials.

Barriers and facilitators to participation in clinical trial among lymphoma patients from Sun Yat-sen University Cancer Center in China: An observation study.

Recruitment rate of clinical trials in cancer patients is pretty low in China. Little is known about factors influencing trial recruitment in Chinese cancer patients. The aim of present study is to evaluate the barriers and facilitators to participation in clinical trials among lymphoma patients in China.From December 2014 to August 2015, the survey was carried out in the Department of Medical Oncology in Sun Yat-sen University Cancer Center. A self-made questionnaire was used among lymphoma patients (N = 331) to evaluate their attitude toward clinical trials. The questionnaire included 2 parts: patients' basic information and whether they were willing to participate in future clinical trials and their reasons.There were 53.5% patients willing to participate in clinical trials. The most common reasons were thirst for new treatments, trust on hospital and doctors, the idea that clinical trials may be more effective than conventional therapy, and to get more management and monitoring. The following patients are more likely to participate in clinical trials: patients who have children (P = .019) or spouse (P = .037), cannot afford treatment cost (P = .019), have tumor relapse (P = .045), and cared about the medical development (P = .032). Patients who have little knowledge of clinical trials are less likely to participate in clinical trials (P = .047).Popularization of knowledge about clinical trial is helpful to improve clinical trial participation in Chinese lymphoma patients.

The prevalence and correlates of symptom distress and quality of life in Chinese oesophageal cancer patients undergoing chemotherapy after radical oesophagectomy.

PURPOSE: The current study was designed to describe the symptom distress and quality of life (QoL) in Chinese oesophageal cancer patients undergoing chemotherapy after radical oesophagectomy and to identify the factors that influenced symptom distress and the relationship between symptom distress and QoL. METHODS: The sample consisted of 102 oesophageal cancer patients undergoing chemotherapy after radical oesophagectomy. The patients completed the Chinese versions of the M.D. Anderson Symptom Inventory (MDASI, an instrument that measures symptom distress), the Hospital Anxiety and Depression Scale (HADS), the Medical Coping Modes Questionnaire (MCMQ) and the Functional Assessment of Cancer Treatment-General (FACT-G, an instrument that measures QoL). RESULTS: The symptoms and symptom interference scores of the patients in the current research were 3.62 (SD 1.66) and 2.94 (SD 1.76), respectively. Occupation after illness, anxiety, types of surgery, whether chemotherapy was on schedule and confrontation coping strategies were factors that influenced symptom distress. There was a negative relationship between symptom distress and QoL scores. CONCLUSION: Oesophageal cancer patients receiving chemotherapy suffer many limitations due to symptom distress and disruptions in their QoL. Oesophageal cancer patients should be assessed regularly and should be supported on an ongoing basis.

Toxicity of concurrent chemoradiotherapy with cetuximab for locoregionally advanced nasopharyngeal carcinoma.

Overexpression of the epidermal growth factor receptor can be found in 80 % of patients with locoregionally advanced nasopharyngeal carcinoma (NPC) and is associated with shorter survival. In this work, we evaluated the feasibility of adding cetuximab to concurrent cisplatin and radiotherapy (RT) in locoregionally advanced NPC. Twenty-eight patients with locoregionally advanced NPC who received the combination therapy were retrospectively reviewed and short-term efficacy was evaluated. Grade 3-4 oral mucositis occurred in 20 (71.4 %) patients. Grade 3 radiotherapy-related dermatitis occurred in seven patients (25 %). Three patients (14.3 %) had grade 3 and one patient (3.6 %) had grade 4 cetuximab-related acneiform rashes. These grade 3-4 skin and mucosal toxic effects were manageable and reversible. At a median follow-up of 33.4 months (95 % CI 29.2-38.1 months), the 2-year progression-free survival was 89.3 % (95 % CI 76.4-98.1 %). In conclusion, concurrent administration of cetuximab, cisplatin and RT is a feasible strategy against locoregionally advanced NPC. Preliminary survival data compare favorably with historic data and further follow-up is warranted.

Prospective analysis of the risk factors for falls in lymphoma patients.

PURPOSE: To explore the risk factors for falls in lymphoma patients receiving chemotherapy. METHODS: Lymphoma patients (203) who received chemotherapy were prospectively recruited and analyzed. Eligible participants were followed up by weekly telephone contact for 6 months or until the time of a fall or death. Risk factors for falling in lymphoma patients were identified using univariate regression analysis and multivariate binary logistic regression analysis. RESULTS: Of the 203 cases, 13.3% (27 cases) had a fall during follow-up. Univariate regression analysis showed the following risk factors for falls in lymphoma patients: gender (P = 0.023), Eastern Cooperative Oncology Group (ECOG) performance status score (P < 0.0001), cancer stage (P < 0.0001), extranodal involvement (P = 0.041), serum lactate dehydrogenase (LDH) level (P < 0.0001), revised International Prognostic Index (R-IPI) (P < 0.0001), history of falls (P < 0.0001), gait (P < 0.0001), cognitive condition (P = 0.029) and intravenous catheter placement (P < 0.0001). Multivariate binary logistic regression analysis found four independent factors significantly associated with the risk of falling in lymphoma patients: female gender (P = 0.042), later stage (P = 0.021), R-IPI (P = 0.030), and intravenous catheter placement (P = 0.001). CONCLUSIONS: Gender, stage, R-IPI, and intravenous catheter placement were independent risk factors for falls in patients with lymphoma. Lymphoma patients with these four risk factors should receive particular attention and fall prevention education to reduce the incidence of falls. The R-IPI may be a new predictor of falling in lymphoma patients and may aid in the management of falls.

A randomised, controlled trial comparing the long-term effects of peripherally inserted central catheter placement in chemotherapy patients using B-mode ultrasound with modified Seldinger technique versus blind puncture.

OBJECTIVE: To compare the effects of peripherally inserted central venous catheter (PICC) placement using B-mode ultrasound with the modified Seldinger technique (BUMST) versus the blind puncture. METHODS: One hundred chemotherapy patients were recruited to participate in a randomised, controlled trial in Guangzhou, China. Fifty were assigned to the experimental group (using BUMST), and 50 were assigned to the control group (blind puncture). Demographic and background data, data related to PICC placement, complications after PICC placement, the patients' degree of comfort (determined via a questionnaire), and patients' costs for PICC maintenance were collected to compare the effects of the two methods. T-tests and chi-square tests were used to analyse the data; p < 0.05 was accepted as statistically significant. RESULTS: Nighty-eight of the 100 PICCs were successfully inserted (50 in the experimental group and 48 in the control group). Compared with the control group, the experimental group had a lower rate of unplanned catheter removal (4.0% vs. 18.7%; p = 0.02), a lower incidence of mechanical phlebitis (0% vs. 22.9%; p < 0.001), a lower incidence of venous thrombosis (0% vs. 8.3%; p = 0.037), and a higher incidence of catheter migration (32% vs. 2.1%; p < 0.001). Compared with the control group, the experimental group experienced significantly less severe contact dermatitis (p = 0.038), had improved comfort at 1 week, 1 month, 2 months, and 3 months after PICC placement (p < 0.001), and had lower costs for PICC maintenance at 2 months, 3 months and when the catheter was removed (p < 0.05). CONCLUSIONS: Using B-mode ultrasound with MST for PICC placement reduced complications and patients' costs for PICC maintenance and improved patients' degree of comfort; thus, this procedure should be more widely used. The clinical trial registration number: ChiCTR-TRC-12002749.

Telephone follow-up for patients returning home with colostomies: views and experiences of patients and enterostomal nurses.

PURPOSE: To explore the views of patients and enterostomal nurses regarding a telephone follow-up program for patients returning home with colostomies. METHODS AND SAMPLE: Semi-structured interviews were conducted with eleven patients who accepted a telephone intervention and seven enterostomal nurses who conducted telephone follow-ups. Qualitative data were analyzed using content analysis. KEY RESULTS: The enterostomal nurses indicated that the telephone follow-up was appreciated and well accepted by the patients. Both the patients and the enterostomal nurses perceived the telephone follow-up as efficient at solving stoma care problems in a timely manner, shortening the process of resuming normal life, and most importantly, providing psychological support. The enterostomal nurses found that telephone follow-up after a patient's hospital discharge was meaningful work. Additional nurse training and measures to overcome communication barriers are required. CONCLUSIONS: All of the patients benefited from the nurse-led telephone follow-up program as part of the continuity of nursing care. The sustainability of the service requires hospital support. Further dissemination of telephone follow-up to other discharged surgical patients might be warranted.

[Affecting factors of quality of life of colostomy patients].

BACKGROUND & OBJECTIVE: This study was to identify the factors that affect the quality of life (QOL) and bring forward methods of improving the QOL of colostomy patients, so as to offer evidences for practical nurses. METHODS: A descriptive, correlative design was employed in this study. From October, 2002 to February, 2004, 86 colostomy patients who discharged from Tumor Hospital of Sun Yat-sen University were recruited to complete a series of questionnaires, including EORTC QLQ-C30, Symptom Check List(SCL-90), Perceived Social Support Scale(PSSS). The SPSS11.0 was used for data analysis. RESULTS: The QOL of colostomy patients was relatively low. The mean score of EORTC QLQ-C30 was 49.13+/-17.20. The score of QOL was negatively correlated with the score of SCL-90 and positively correlated with the score of social support. The score of SCL-90 was the most important factor that affected the QOL, followed by the income of the patients. CONCLUSION: The major factors affecting the QOL were mental health status, financial status and social support of the patients. The results point out practical nurses should keep an eye on these factors.