1.A qualitative study on psychological experience of Stanford Type A aortic dissection patients during hospitalization
Jin ZHU ; Rong ZHANG ; Lili ZHANG ; Wenxuan TAN
Chinese Journal of Nursing 2024;59(19):2369-2374
Objective This study aims to explore the psychological experiences of patients with Stanford Type A aortic dissection during different stages of their hospital stay.Methods Using purposive sampling,10 patients treated for Stanford Type A aortic dissection from May to August 2022 at a tertiary A general hospital in Guangdong Province were selected as study subjects.Semi-structured interviews were conducted,and the data were analyzed using interpretative phenomenological analysis to extract themes.Results 3 primary themes and 14 sub-themes were identified.1.During the diagnosis phase,patients experienced increased uncertainty,with a strong need for information and emotional support.This included fear of the emergency environment,enhanced sense of the unknown,a desire for attention from medical staff,and hope to have surgery soon.2.During the treatment phase,patients had cognitive bias and low treatment compliance,including fear of monitor alarms,rejection of medical devices and tubes,a sense of lost dignity during treatment,feelings of helplessness due to physical restrictions,and despair over prolonged ICU stays.3.In the recovery phase,patients anticipated and were worried about significant life changes,including a shift in mindset to actively face future life,feelings of guilt towards family members,concerns about artificial blood vessel implants,anxiety about social participation,and worries about disease self-management and prognosis.Conclusion The psychological experiences and needs of patients with Stanford Type A aortic dissection vary during different stages of their hospital stay.During the diagnosis phase,medical staff should strengthen information and emotional support;during the treatment phase,they should enhance communication and psychological counseling;and during the recovery phase,medical staff should improve patients'disease self-management skills,enhance their level of social support,and guide the awakening of positive psychological experiences.
2."Two-pronged approach"to construct a new model for progressive training of nursing assistants
Wenxuan TAN ; Rong ZHANG ; Jin ZHU ; Yunling ZHONG ; Jiehui YANG
Modern Hospital 2024;24(10):1632-1635,1640
Objective To construct a new model for the progressive training of nursing assistants using a"two-pronged approach,"providing references for management departments to formulate training strategies for nursing assistants.Methods Guided by the core competencies of nursing assistants,the Delphi expert consultation method was employed to solicit opinions from 18 experts across 7 provinces to develop the new training model.Results A total of two rounds of consultations were con-ducted,achieving a 100.00%response rate.The experts'authority coefficients were 0.935,and the Kendall harmony coeffi-cients for the two rounds were 0.240 and 0.256(P<0.001),respectively.Ultimately,nursing assistants were categorized into five levels,which include stratified competency standards,training plans,and promotion requirements.Conclusion The new model for the progressive training of nursing assistants is scientifically rigorous and aligns with professional demands.It offers guiding sig-nificance for the training of nursing assistants and can be appropriately adjusted based on the actual situation of hospitals.
3.Effect of Dahuang Xiezhuo Prescription on Renal Interstitial Fibrosis of Rats with 5/6 Nephrectomy by Regulating ROS/TXNIP/NLRP3 Pathway
Wenxuan CAO ; Xin XIN ; Miao TAN ; Fei GAO ; Fengwen YANG ; Suzhi CHEN ; Meifang REN ; Jinchuan TAN
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(21):81-89
ObjectiveTo observe the effect of Dahuang Xiezhuo prescription on the changes in renal pathology and reactive oxygen species (ROS)/thioredoxin-interacting protein (TXNIP)/NOD-like receptor protein 3 (NLRP3) pathway expression in the kidney tissues of rats with 5/6 nephrectomy, and to explore the mechanism of Dahuang Xiezhuo prescription in protecting renal function and delaying renal interstitial fibrosis and the possibility. MethodNinety healthy male SD rats were randomly divided into a sham operation group, a model group, low, medium, and high-dose (6.825, 13.65, 27.30 g·kg-1) Dahuang Xiezhuo prescription groups, and a Niaoduqing granule group (2.60 g·kg-1). Except the sham operation group, 5/6 nephrectomy was used to replicate the rat model of chronic renal failure (CRF). After modeling, each administration group was given the corresponding dose of drug suspension by intragastric administration, once a day for consecutive 8 weeks. After administration, serum creatinine (SCr) and urea nitrogen (BUN) levels and 24 h urinary protein quantification (UTP) levels were detected. Western blot assay was used to detect the protein expressions of thioredoxin (TRX), TXNIP, and NLRP3. The protein expressions of TRX, TXNIP, NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), transformation growth factor-β (TGF-β), Collagen Ⅳ, α-smooth muscle actin (α-SMA), and fibronectin (FN) were detected by immunohistochemistry. ResultAs compared with the sham operation group, serum levels of SCr, BUN, and UTP in the model group were increased (P<0.05), TRX, TXNIP, NLRP3, ASC, TGF-β, Collagen Ⅳ, α-SMA, and FN proteins were increased (P<0.01), and renal interstitial fibrosis significantly occurred. As compared with the model group, the levels of SCr, 24 h BUN, and UTP in the low, medium, and high-dose Dahuang Xiezhuo prescription groups and the Niaoduqing granule group were decreased to varying degrees (P<0.05), TRX, TXNIP, NLRP3, ASC, TGF-β, Collagen Ⅳ, α-SMA, and FN were decreased (P<0.01), and renal interstitial fibrosis was improved to varying degrees. ConclusionDahuang Xiezhuo prescription can protect renal function and delay renal interstitial fibrosis in rats with CRF.