RESUMO
AIMS AND OBJECTIVES: This study aimed to clinically validate the nursing outcome "Swallowing status: pharyngeal phase" (1013). METHODS: A two-stage study was designed: (1) Chinese translation and cultural adaptation and (2) clinical validation. Internal consistency and interrater reliability tests were performed on 285 patients with laryngeal cancer, and an additional 130 patients were randomly selected from the 285 patients as an independent sample. Criterion-related validity tests were performed using the standardized swallowing assessment (SSA). Nursing outcome sensitivity was detected by scoring two time points. RESULTS: The Cronbach's alpha coefficients were 0.951 for the nursing outcome and 0.942-0.965 for each indicator. The interclass correlation coefficient (ICC) values for each indicator ranged from 0.73 to 0.929. The scores of the nursing outcome were negatively correlated with the SSA scores (r = -0.555, p < 0.01). With the exception of two indicators, there was a significant difference (p < 0.05) between the total scores of the scale and its 11 indicator scores for the two time points. The results indicated that the nursing outcome "Swallowing status: pharyngeal phase" (1013) exhibited satisfactory psychometric properties and high sensitivity to change. CONCLUSIONS: The nursing outcome "Swallowing status: pharyngeal phase" (1013) demonstrated good reliability, validity, and sensitivity in patients with laryngeal cancer. IMPLICATIONS FOR NURSING PRACTICE: The nursing outcome "Swallowing status: pharyngeal phase" (1013) can be used to assess swallowing function in patients with laryngeal cancer and provide guidance for the development of rehabilitation intervention plans and nursing care.
RESUMO
Objective: To investigate the views of health care professionals in a head and neck surgical department toward the implementation of advance care planning prior to surgery for older patients with head and neck cancer. Method: Q methodology was used to explore and analyze participants' views by combining quantitative and qualitative methods. Participants were asked to rank 35 Q statements generated via semi-structured interviews and a literature review and to explain the reasons for their ranking in subsequent interviews. The data was then analyzed and used to develop a factor series to illustrate participants' views. Results: This study surveyed 15 health care professionals, including eight doctors and seven nurses. The views of health care professionals toward preoperative implementation of advance care planning discussions were varied and could be categorized into three types: defending the autonomy of patients, patients' knowledge and the Chinese traditional cultural context hinder the implementation of preoperative advance care planning, and lack of confidence in performing preoperative advance care planning. Conclusions: Although the health care professionals in the head and neck surgical department in this study recognized the benefits of preoperative discussions regarding advance care planning, patients' knowledge level, traditional Chinese values, inadequate capacity among health care professionals, and unsound legal policies have caused these professionals to have misgivings about preoperative counseling and discussing advance care planning with patients. Further studies should be conducted, and strategies to overcome barriers to discussions of preoperative advance care planning should be developed.
RESUMO
In this paper, a DNA-PEI microcapsule with novel nuclease-responsive controlled release properties was demonstrated. This microcapsule was constructed by the self-assembly of native DNA and PEI, and can work as a dual carrier for both DNA in the capsule shell and drugs inside the capsule. The controlled release behavior of the model drug BSA-FITC was studied using fluorescence microscopy and UV spectroscopy, and the results show that the synergetic controlled release can be triggered very well by a bio-stimulus, DNA nuclease recognition capsule decomposition, as well as the pH value and salt concentration. The therapeutic effects of the drug are enhanced due to the bio-stimuli responsive properties and the synergetic release of DNA and the drug together.
