Objective To investigate the actual cost and benefit of stoma nursing at present as a reference for the improvement of stoma care cost management program. Methods A cross sectional study was carried out in gastrointestinal surgery of a tertiary- level hospital in southwestern China from April 2014 to December 2014. The consumption of intestinal stoma care work, the average monthly income/average monthly working hours ratio and other indicators of stoma care nurse specialist were measured by the step cost allocation method, to investigate the actually cost of a single stoma care service which colostomy patients had received and analyze the gap between actually costs and charge standard of Sichuan Province. Results The directly human cost of stoma care expenses were (22.33 ± 3.66) yuan; working fee expenses were (4.18 ± 0.68) yuan;administrative expenses were (1.87 ± 1.32 ) yuan; research and education expenses were (1.87 ± 1.32 ) yuan; the total cost of investment was (29.14 ± 4.76) yuan, which was much higher than the current charge standard of Chengdu Bureau of Commodity Prices (t=119.50, P <0.05). Conclusions There is a difference between the actual cost and charge standard of stoma care. The situation of low pay to labor is not in line with economic laws, and not conducive to the future development of stoma care speciality.

Objective To study the interactive debridement methods in treatment and nursing of the wound in patients with abdominal surgical incision infection.Methods In May 2010 to December 2013 in West China hospital of Sichuan University,54 patients with postoperative incision infection accompanied with tissue necrosis after gastrointestinal surgery were divided into two groups,23 cases who accepted interactive debridement treatment were set as the observation group,31 cases with traditional dressing hypertonic saline gauze debridement were named as the control group.The wound debridement completion time,wound healing velocity,wound healing time,dressing change frequency and cost were compared between two groups of patients.Results Compared with those of the control group,in the observation group,the wound debridement completion time was shorter,wound healing velocity was faster,dressing change frequency was longer.Although single dressing change cost was higher in the observation group,but the total dressing change cost was lower compared with the control group.Conclusions The interactive debridement methods used in treatment and nursing of patients with abdominal surgical incision infection showed good effect and safety,which is worthy of wide clinical application.

Objective To explore the effect of Contract Learning Methodology in teaching of clinical nursing.Methods 88 nursing students were randomized into the control group(n=46)and experiment group(n=42).The former and the latter adopted the Contract Learning Methodology and conventional teaching methodology,respectively.The two groups were assessed and compared in terms of their scores of clinical nursing theory and manipulation.Results The students in the experiment group were comprehensively better then those in the control group in terms of theoretical and manipulative exams,writing of nursing histories, writing of reading reports,basic nursing,communicating ability and comprehensive achievements(P<0.01).Conclusion The Contract Learning Methodology may fortify the sense of discipline in nursing students,enhance the sense of teaching in teachers and therefore propel the quality of teaching and learning.

Objective To observe the effects of rehabilitation training combined with health education on quality of life and psychological state of elderly patients with chronic obstructive pulmonary disease (COPD).Methods A total of 108 elderly inpatients with moderate to severe COPD in stable conditions were randomly divided into an intervention group and a control group,with 54 patients in each group.The patients in both groups received general respiratory medical therapy.The patients in intervention group also received additional comprehensive rehabilitation training consisting of individualized exercise instructions and health education,while the patients in control group only received online telephone health education and rehabilitation training instruction.Patients in both groups were assessed by using St.George's respiratory questionnaire (SGRQ) and symptom checklist 90 (SCL-90) before and after one year of treatment.Results After treatment,the control group's scores for various SGRQ items were similar to the scores within the group before treatment (P ＞ 0.05).The intervention group's SGRQ scores for symptoms,mobility and impact on life and the total score were (42.12 ± 11.32),(45.17 ± 10.23),(29.98 ± 6.54) and (41.02±9.92),respectively,significantly different from their baseline values and those of the control group after treatment (P ＜ 0.01).After treatment,the intervention group's SCL-90 scores were significantly improved from baseline values and were also significantly different from the control group (P ＜ 0.05).Comparison between the two groups showed that throughout the treatment period,the number of patients with acute attacks and the number of patients' hospitalization due to acute attacks were statistically significantly lower in the intervention group (P ＜ 0.05).Conclusions Rehabilitation training combined with health education can significantly improve quality of life and psychological health of COPD patients.

Bariatric surgery is a type of surgery to reconstruct the anatomical structure of gastrointestinal tract in order to reduce body mass, improve metabolic disorders and long-term health. Metabolic surgery developed late in China. Less attention was paid to the quality of life of postoperative patients. This paper introduces the predictors of quality of life, assessment tools and intervention measures, aiming to develop assessment tools fitting China's cultural background, to explore the quality of life of patients with bariatric surgery in China, and to establish a multidisciplinary team and long-term follow-up mechanism.

Objective:To explore the application effect of "connections, concepts, concrete practice and conclusions (4C)" teaching method combined with two-way evaluation method in nursing teaching of gastrointestinal surgery, so as to provide reference for personnel training and quality control of practice.Methods:A historical controlled study was conducted to prospectively include the nursing interns received by the Department of Gastrointestinal Surgery of the hospital from May 2020 to May 2022 as the subjects of this study. The interns were divided into the control group (64 interns from May 2020 to May 2021) and the research group (93 interns from June 2021 to May 2022) according to the order of admission of nursing interns. The control group was taught by traditional nursing teaching method, while the research group was taught by "4C" teaching method combined with two-way evaluation method. The scores of theoretical knowledge and operation of nursing students in the two groups were compared after 6 weeks of practice. The self-directed learning ability of nursing students in the two groups was compared before and after 6 weeks of practice [Chinese version of self-rating scale of self-directed learning (SRSSDL)]. The evaluation of teaching quality between two groups of nursing students were compared. SPSS 25.0 was used for t-test and Chi-square test. Results:One person in the control group voluntarily quit the internship, and two in the observation group voluntarily quit the internship. Finally, 63 people in the control group and 91 people in the research group entered the study. There was no statistical significant difference between the two groups in baseline data ( P>0.05). At 6 weeks of practice, the scores of theoretical knowledge (87.96±4.62) and operation (92.60±4.25) in the study group were higher than those in the control group [(86.02±4.53) and (88.27±4.31)] ( P<0.05). At 6 weeks of practice, the total scores of learning awareness, learning behavior, learning strategies, learning evaluation, interpersonal skills and self-directed learning ability of the two groups were higher than those before practice, and the study group was higher than the control group ( P<0.05). After 2 weeks, 4 weeks and 6 weeks of practice, the scores of the two groups of nursing students in evaluating the teaching quality of the teachers increased gradually compared with that of the first week of practice ( P<0.05). Conclusion:The "4C" teaching method combined with the two-way evaluation method in the nursing teaching of gastrointestinal surgery can improve the nursing students' theoretical knowledge, practical operation ability and self-directed learning ability, and is conducive to the improvement of teaching quality.

Objective:To explore the application of understanding teaching mode combined with hierarchical training in the standardized training of nurses in gastrointestinal surgery department.Methods:Sixty-three nurses who had standardized training in gastrointestinal surgery department in West China Hospital, Sichuan University from January 2018 to January 2022 were selected as the study objects, among which, 32 nurses from January 2018 to July 2020 were set as the control group, taking regular training method, and 31 nurses from August 2020 to January 2022 were set as the observation group, taking the understanding teaching mode combined with hierarchical training method. The core competence scores of the two groups after training were compared, the scores of basic theory and practical skills of the two groups were compared, and the satisfaction degree of nurses during training was compared between the two groups. SPSS 22.0 was used to perform t-test. Results:After the training, the scores of core competence in the observation group were higher than that in the control group, and the difference was statistically significant ( P < 0.05). The scores of theoretical assessment (96.59±3.22) and practical skills (97.09±2.88) in the observation group were significantly higher than those in the control group (91.52±2.45)(91.14±2.85) ( P < 0.05). The total satisfaction scores of the observation group (93.48 ± 2.52) was higher than that of the control group (86.80 ± 2.22), and the difference was statistically significant ( P < 0.05). Conclusion:It is suggested that understanding teaching mode and joint hierarchical training can improve the core ability and assessment score of nurses in gastrointestinal surgery department, and improve the satisfaction of nurses.

Objective To investigate the effect of moist healing mode in the wound care of patients with perianal abscess to necrotizing fasciitis .Methods The wound treatment and care experience of three patients with perianal abscess to necrotizing fasciitis from January 2010 to May 2013 was retrospectively analyzed and summarized.Results Through the methods of open drainage , scientific fistula treatment, effective debridement , infection control , bloodstream infections prevention and reasonable fixation to improve patients ’ quality of life.And the scientific nutritional support could promote the growth of granulation wound healing . Besides, humane care multidisciplinary collaboration , promotion of rehabilitation and other moist wound healing care made all patients healed without death and disability .Conclusions The moist healing wound care in acute necrotizing fasciitis treatment can help patients promote wound healing and reduce medical risks .

At this stage, there are few assessment scales for excess skin after bariatric metabolic surgery in China. This review summarizes the main contents, characteristics and limitations of the excess skin assessment scale after bariatric metabolic surgery in foreign countries, aiming to provide reference for the development and application of the excess skin assessment tool after bariatric metabolic surgery in China.

Objective:To systematically review the life experience of patients after bariatric and metabolic surgery.Methods:We searched PubMed, Web of Science, Embase, China National Knowledge Infrastructure, WanFang Data, and VIP by computer, and included qualitative research on the life experience of patients after bariatric and metabolic surgery. The retrieval time was from the establishment of the database to July 31, 2020. The quality of the included article was assessed using the quality evaluation criteria for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center (2017) . Meta-synthesis was performed using a pooled integration approach.Results:A total of 17 articles were included.A total of 38 themes were refined and grouped into 14 categories, resulting in four research results, namely return to normality, negative experience, control, and fear of isolation.Conclusions:The life experience of patients after bariatric surgery is complex and individual, and various experiences interact with each other, not a single existence. It is suggested that medical and nursing staff should pay attention to patients from multiple angles after surgery, establish a multidisciplinary follow-up team and diversified follow-up methods, and solve the multi-level needs of patients.