Objective To explore the strategies that can improve the nurses ’ compliance of raising the head of a bed for 30 -45 °on mechanical ventilation patients and evaluate the clinical effect .Methods Before implementing “problem solving for better health ( PSBH )”, 78 patients of invasive mechanical ventilation in ICU were included as the control group from January 2012 to July 2012 .After implementing PSBH , 119 patients were included as the experimental group , from October 2012 to May 2013 .By training the nurses , improving the working conditions and putting up posters , the compliance of nurses and the incidence of ventilator associated pneumonia from each group were compared .Results Nurses’ compliance of raising the head of bed for 30-45°was 55.2%in experimental group, which was higher than that of control group (22.0%).The difference was statistically significant (χ2 =237.4, P <0.01).The incidence of ventilator associated pneumonia was 10.1‰ in experimental group, which was lower than that of control group (26.8‰).The difference was statistically significant (χ2 =5.11, P <0.05).Conclusions After the PSBH intervention, the nurses’ compliance of raising the head of bed was increased , and the incidence of ventilator associated pneumonia was reduced.PSBH plays an important role in promoting the patients ’ health.

Objective:To explore the application effect of portable device of airway humidification on patients with head and neck tumor who underwent tracheostomy.Methods:A total of 100 patients with head and neck tumors who underwent tracheostomy at Department of Head and Neck Surgery of Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College from October 2021 to May 2023 were selected as the study subjects.They were randomly divided into the control group and the observation group by using a random number table method,with 50 cases in each group.The control group received conventional nebulization inhalation for airway humidification,and the observation group adopted portable device of airway humidification with 0.45%sodium chloride solution to conduct sustained airway humidification.The effect of airway humidification,occurrence of phlegm scabs,injury and bleeding of airway,tracheal tube obstruction,and comfort level of patients after surgery were observed and compared between the two groups.Results:The satisfaction rates of the patients of observation group at the 1st,2nd,3rd,4th,and 5th day after surgery were 84.0%,88.0%,92.0%,96.0%and 96.0%for humidification of wet sputum,which were better than those of control group,and the differences were statistically significant(x2=46.240,64.103,70.560,67.919,74.227,P<0.05),respectively.The formations of phlegm scabs were respectively 1,5,1 and 1 cases at the 2nd,3rd,4th,5th d after surgery in observation group,which were less than those in control group,and the differences were statistically significant(x2=7.111,23.926,21.760,17.344,P<0.05),respectively.The numbers of airway injury bleeding and overall tracheal tube obstruction at the 2nd d after surgery in the observation group were respectively 2 cases and 1 case,which were significantly less than those in the control group,and the differences were statistically significant(x2=4.000,5.982,P<0.05),respectively.The comfort levels of airway humidification and suction phlegm,and overall comfort evaluation were respectively(17.96±0.75)scores,(16.06±1.05)scores and(34.04±1.63)scores in the observation group,which all were lower than those in the control group,and the differences were statistically significant(t=9.843,17.298,15.792,P<0.05),respectively.Conclusion:The portable device of airway humidification has a significant effect on airway humidification of patients with head and neck tumors who undergo tracheostomy,which can reduce the occurrence of phlegm scabs,and reduce the number of overall tracheal tube obstruction,and improve comfort level of patient with head and neck tumors who undergo tracheostomy.

OBJECTIVE To study the correlation between the early postoperative symptom groups and quality of life in patients with thyroid cancer. METHODS From July 2023 to October 2023,patients after thyroid cancer at 1 to 3 days in Beijing and Shanxi Hospitals were selected,and the general data questionnaire,thyroid cancer quality of life scale(EORTC QLQ-THY 34) and quality of life core questionnaire(EORTC QLQ-C30) were used. Exploration factors were used to extract the early symptom group of thyroid cancer patients,investigate the scores of the quality of life,and conduct Pearson correlation analysis. RESULTS Factor analysis extracted four symptom groups:throat-voice symptom group,limb numbness-emotional symptom group,swallowing related symptom group,physical stress symptom group,The cumulative variance contribution rate was 64.93％. The overall health status score of patients with thyroid cancer in the early postoperative stage was 5.12±1.65,it was below the normal level. In the functional domain,the cognitive function score was 3.74±0.45,emotional function score 3.21±0.43,social function 2.96±0.76,and role function 2.66±0.73. The highest scores in the symptom domain were fatigue 1.77±0.39 and pain 1.75±0.50. The symptom group scores were negatively correlated with the scores of all dimensions of quality of life(P<0.05). Each symptom group and each dimension of the quality of life showed significant correlation. The throat-voice symptom group had the strongest correlation with sleep disturbance and role function(r=0.646,r=-0.561). Limb numbness-emotional symptom group was most associated with social functioning,insomnia,and general health(r=-0.538,r=0.529,r=-0.529). Groups of abnormal swallowing symptoms were most associated with physical function,sleep disturbance,and fatigue(r=-0.491,r=0.491,r=0.476),Groups of physical stress symptoms were most associated with physical function and fatigue(r=-0.523,r=-0.520). Sleep disorder had strong associations with each symptom group(r>0.400). CONCLUSION There are four symptom groups in thyroid cancer patients in the early postoperative period,which affect the quality of life of the patients after surgery. Medical staff should timely evaluate and identify the relevant symptoms of the patients after surgery,and conduct effective management,so as to improve the quality of life of the patients after surgery and promote recovery.