1.Research progress on the status and management of diabetes mellitus after acute pancreatitis
Chen WU ; Xingmei MAO ; Shengxiao XIANG ; Ping XIE ; Can ZHANG ; Jing WANG
Chinese Journal of Practical Nursing 2024;40(2):157-161
Post-acute pancreatitis diabetes is one of the most common distant complications of acute pancreatitis. However, its incidence has been underestimated for a long time, indicating that it has not been taken seriously by healthcare professionals in clinical practice. This article provides a review of the urgent need for healthcare professionals to focus on the current status, adverse outcomes, screening and management aspects of diabetes after acute pancreatitis, and aims to provide a reference for healthcare professionals in their relevant clinical work.
2.The nursing intervention of ultrasound drug penetration in the application of the digestive tract cancer patients′ postoperative rapid recovery
Chinese Journal of Practical Nursing 2024;40(3):161-166
Objective:To explore the impact of nursing intervention in strengthening the implementation of ultrasound drug penetration therapy on postoperative rapid recovery of patients with digestive tract tumors after surgery, and to provide reference for the formulation of intervention plans for postoperative rapid recovery of digestive tract tumor patients.Methods:A randomized controlled trial was used. From April to July 2021, 120 postoperative patients with digestive tract tumors admitted to the Second Affiliated Hospital of Dalian Medical University were selected and divided into a control group, a dispersed treatment group, and a concentrated treatment group according to the random number table method, with 40 patients in each group. The control group mainly received routine accelerated rehabilitation surgical care, supplemented by early rehabilitation training; the dispersed treatment group received nursing intervention with ultrasound drug penetration therapy on the basis of the control group, once a day in the morning and once in the afternoon, lasting for 30 min each time; on the basis of the control group, the concentrated treatment group received nursing intervention of one-time concentrated ultrasound drug penetration therapy for 60 min. The gastrointestinal reactions, intestinal function recovery, hospitalization, postoperative complications, and nursing satisfaction of each group of patients were observed and compared using one-way ANOVA, LSD- t test, and χ2 test. Results:There were 27 males and 13 females in the control group, aged (61.85 ± 16.85) years old. while 23 males and 17 females in the dispersed treatment group aged (60.90 ± 16.88) years old, and 23 males and 17 females in the concentrated treatment group aged (59.80 ± 13.58) years old. The duration of postoperative nausea, vomiting, and abdominal distension symptoms, recovery time of bowel sounds, recovery time of exhaust, and first meal time in the dispersed treatment group and concentrated treatment group were (38.58 ± 2.74), (17.45 ± 1.92), (38.76 ± 3.34), (50.04 ± 2.57) h and (36.79 ± 2.58), (16.48 ± 1.85), (36.98 ± 2.28), (48.25 ± 3.07) h, respectively, which were lower than those in the control group (43.13 ± 3.56), (21.24 ± 2.50) (42.65 ± 3.78), (52.21 ± 3.15) h, the differences were statistically significant ( t values were 3.38-9.68, all P<0.05). The duration of postoperative nausea, vomiting, and abdominal distension symptoms, recovery time of bowel sounds, recovery time of exhaust, and first meal time in the concentrated treatment group were shorter than those in the dispersed treatment group, and the differences were statistically significant ( t values were 2.31-3.01, all P<0.05). The time to get out of bed activity and hospitalization of patients in the dispersed treatment group and the concentrated treatment group were (5.83 ± 1.20) h, (9.90 ± 2.12) d and (7.35 ± 2.13) h, (8.30 ± 1.42) d, respectively. The control group was (4.39 ± 1.53) h and (14.93 ± 2.56) d, respectively. The time to get out of bed activity and hospitalization of patients in the dispersed treatment group and the concentrated treatment group were better than those in the control group, while the time to get out of bed activity and hospitalization of patients in the concentrated treatment group were better than those in the dispersed treatment group, the differences were statistically significant ( t values were -7.14-14.34, all P<0.05). The incidence of intestinal obstruction was 15.0% (6/40) in the control group, 5.0% (2/40) in the dispersed treatment group, and 0 in the concentrated treatment group, with a statistically significant difference ( χ2=7.50, P<0.05). The nursing satisfaction of patients in the concentrated treatment group reached 100.00% (40/40), which was 92.5% (37/40) and 85.0% (34/40) in the dispersed treatment group and control group, with a statistically significant difference ( χ2=6.49, P<0.05). Conclusions:Nursing intervention through ultrasound drug penetration therapy, especially centralized treatment, can significantly improve postoperative intestinal function, reduce postoperative gastrointestinal reactions, shorten hospitalization time, reduce postoperative complications, accelerate patient recovery, and provide effective nursing intervention plans for clinical practice. It is worth promoting and applying.
3.Effects of mindfulness-based stress reduction therapy on fear of the disease progression, sleep and quality of life in patients with acute ischemic stroke
Xiongpo LIN ; Yunxiao LIU ; Jinghua MA ; Jing ZHAO ; Zilan HAO
Chinese Journal of Practical Nursing 2024;40(3):167-173
Objective:To explore the effects of mindfulness-based decompression therapy on fear of disease progression, quality of life and sleep quality in patients with acute ischemic stroke, in order to provide intervention measures to alleviate fear of the disease progression degree and improve sleep and quality of life in patients with acute ischemic stroke.Methods:This study was a randomized controlled study. Using the convenience sampling method, 98 patients with acute ischemic stroke who attended the Department of Neurology at the Third Hospital of Hebei Medical University from November 2021 to September 2022 were selected for the study, and the study population was divided into experimental group ( n=49) and control group ( n=49) using the random number table method. The control group received conventional care, and the experimental group received mindfulness-based stress reduction therapy for 8 weeks in addition to conventional care. Compared the scores of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Stroke-Specific Quality of Life Scale (SS-QOL), and Pittsburgh Sleep Quality Index (PSQI) between the two groups of patients before and after intervention using two independent sample t-tests, and further compared the score spread of each scale before and after intervention between the two groups of patients using Mann-Whitney U test. Results:In the experimental group, 4 cases fell off and 3 cases had imperfect questionnaire information, while in the control group, 2 cases fell off and 5 cases had imperfect questionnaire information. Finally, 42 cases were included in each group. The 23 males and 19 females in the control group aged (48.31 ± 7.61) years old, while 25 males and 17 females in the experimental group aged (50.19 ± 8.64) years old. There was no significant difference in FoP-Q-SF, SS-QOL and PSQI scores between the two groups before intervention (all P>0.05). After intervention, the scores of FoP-Q-SF and PSQI in the experimental group (35.79 ± 7.04, 7.19 ± 2.58) were lower than those in the control group (38.52 ± 4.02, 9.45 ± 2.28), while the SS-QOL score (200.36 ± 21.75) was higher than that in the control group (185.41 ± 15.90), the differences were statistically significant ( t=2.19, -4.26, 3.60, all P<0.05). After intervention, the scores of FoP-Q-SF and PSQI in the experimental group were lower than those before intervention (39.69 ± 4.15, 10.00 ± 2.85), while the SS-QOL score was higher than that before intervention (176.93 ± 23.54), the differences were statistically significant ( t=4.80, 10.45, -11.43, all P<0.05). The score spreads of FoP-Q-SF, SS-QOL, and PSQI in the experimental group before and after intervention were 1.00 (0.00, 9.25), 20.00 (12.75, 32.75), 3 (1, 4), which were higher than 1.00 (-1.25, 2.00), 5.50 (1.00, 10.25), 0 (-1, 2) in the control group, the differences were statistically significant ( Z=-2.30, -5.74, -5.53, all P<0.05). Conclusions:Mindfulness-based decompression therapy can effectively relieve the fear of disease progression and improve the quality of sleep and life in patients with acute ischemic stroke.
4.Development and reliability and validity test of the Scale of Pain-Relevant Responses from Spouse for Chronic Pain Patients
Wen SI ; Qiao LIU ; Dandan SUO ; Qing YANG ; Na WANG
Chinese Journal of Practical Nursing 2024;40(3):174-180
Objective:To develop the Scale of Pain-Relevant Responses from Spouse for Chronic Pain Patients and to test its reliability and validity, so as to provide a reliable tool for the scientific assessment of the pain-relevant responses from spouses for chronic pain patients.Methods:Based on the interpersonal process model of intimacy, the first draft of the scale was formed through literature analysis, semi-structured interview, Delphi expert consultation and pre-investigation. A questionnaire survey was conducted on 388 patients with chronic pain who visited the Second Affiliated Hospital of Air Force Military Medical University from April 2022 to April 2023 using convenience sampling method to test the reliability and validity of the scale.Results:The Scale of Pain-Relevant Responses from Spouse for Chronic Pain Patients included 21 items in 4 dimensions: emotional support pain-relevant responses, behavioral support pain-relevant responses, distractive pain-relevant responses and negative pain-relevant responses. The range of I-CVI was 0.850-1.000. The results of structural validity analysis showed that four qualified common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 71.173%. The confirmatory factor analysis model fit indicators were within the acceptable range. The correlation validity coefficient was 0.692 ( P<0.01). The Cronbach α coefficient of the total table was 0.894, the half reliability was 0.906, and the retest reliability was 0.927. Conclusions:The Scale of Pain-Relevant Responses from Spouse for Chronic Pain Patients has good reliability and validity, and is suitable for the evaluation of pain-relevant responses from spouse of chronic pain patients.
5.Establishment and evaluation of a nomogram model for predicting postoperative frailty in elderly patients with gastrointestinal tumors
Jiajia LI ; Mei ZHAO ; Mei WANG ; Chao ZHANG
Chinese Journal of Practical Nursing 2024;40(3):181-188
Objective:To analyze the influencing factors of postoperative frailty in elderly patients with gastrointestinal tumors, establish a nomogram model for predicting postoperative frailty and evaluate its efficacy, so as to provide reference basis for formulating perioperative frailty management plans for elderly gastrointestinal tumor patients in the later stage.Methods:Convenience sampling method was used to select 376 elderly patients with gastrointestinal tumors who underwent surgical treatment in the First Affiliated Hospital of Anhui Medical University from December 2021 to August 2022 as the study objects. On the 5th day after surgery according to Tilburg Frailty Indicator, the patients were diagnosed whether they developed postoperative frailty and were divided into postoperative frailty group and postoperative non-frailty group. General data, laboratory indicators and clinical data of patients were collected. Univariate analysis and multivariate Logistic regression analysis were used to screen the independent influencing factors of postoperative frailty in elderly patients with gastrointestinal tumors. R software was used to establish a nomogram prediction model and conduct internal validation to evaluate the differentiation, calibration and clinical applicability of the model.Results:A total of 265 males and 111 females included aged (70.04 ± 5.89) years old, with 222 (59.0%) patients experienced postoperative frailty in this study. Multivariate analysis showed that low Barthel Index score ( OR=0.941, 95% CI 0.903-0.980), low hemoglobin ( OR=0.976, 95% CI 0.963-0.989), high Charison Comorbid Index score ( OR=1.457, 95% CI 1.128-1.882), preoperative frailty ( OR=4.369, 95% CI 1.486-12.841), and pathological stage Ⅲ-Ⅳ ( OR=2.053, 95% CI 1.253-3.364) were independent influencing factors for postoperative frailty of elderly gastrointestinal tumors (all P<0.05). The AUC before and after internal validation of the nomogram model was 0.811 (95% CI 0.768-0.854) and 0.803 (95% CI 0.762-0.856) respectively. The results of Hosmer-Lemeshow test showed good goodness of fit ( χ2=4.09, P>0.05). Decision curve analysis showed that the model had certain clinical applicability. Conclusions:Based on the risk factors of postoperative frailty in elderly patients with gastrointestinal tumors, the nomogram prediction model was established, which has good differentiation, consistency and clinical applicability, and can provide reference for clinical staff to make perioperative frailty management plan.
6.Best evidence summary of nutrition management in patients of acoustic neuroma during the perioperative period
Jie MA ; Yingpu FENG ; Jian XU ; Lin WANG
Chinese Journal of Practical Nursing 2024;40(3):189-196
Objective:To summarize and evaluate the best evidence of perioperative nutrition management for patients with acoustic neuroma, and to provide evidence-based basis for clinical nurses.Methods:BMJ best clinical practice, UpToDate, Cochrane Library, Guidelines International Network, Scottish Intercollegiate Guidelines Network, the official website of Ontario Registered Nurses Association, JBI Australian evidence-based health care center, PubMed, Embase, CINAHL, Yimaitong, Chinese biomedical literature database, CNKI, Wanfang database and other domestic and foreign databases related to clinical practice guidelines, expert consensus, evidence summary, systematic evaluation, sysmtem analysis, clinical randomized scientific control were seached. The retrieval time was limited from June 1st, 2013 to June 1st, 2023. Evaluated the quality of the included literatures, and conduct evidence extraction, grade evaluation and summary analysis.Results:A total of 17 literatures were included, including 5 guidelines, 6 expert consensus, 2 best practices and evidence summary, 2 system evaluation and 2 randomized scientific control. A total 27 of best evidence was formed, covering five aspects: nutrition management team construction, screening and evaluation of nutrition and dysphagia, timing and implementation of nutrition support, specific measures of nutrition management, continuous nutrition management after discharge.Conclusions:This study summarized the best evidence of perioperative nutritional management of acoustic neuroma, and provides evidence-based basis for clinical nurses. However, its recommendations are not specialized, some of them are controversial, and come from many countries. In clinical practice, we should make a comprehensive analysis in combination with the actual clinical situation and other relevant factors, and make some choices, so as to promote the improvement of clinical nursing quality.
7.A qualitative research on the adherence of long dialysis duration hemodialysis patients to exercise training
Lan MA ; Qiong XIAO ; Yanhong HU ; Yuefei GUO
Chinese Journal of Practical Nursing 2024;40(3):197-202
Objective:To explore the factors that promote and hinder exercise adherence in long dialysis duration hemodialysis patients, and to provide a reference for improving their exercise levels.Methods:From March to May 2023, a qualitative research method using phenomenon approach was conducted and 15 patients with peritoneal dialysis for at least 10 years at the People′s Liberation Army Central Command Headquarters Hospital (Hankou Hospital) were selected for in-depth interviews using purposive sampling method. The data were analyzed using Colaizzi 7-step method and the main themes were extracted.Results:Among the 15 interviewers, there were 5 males and 10 females, aged 39-76 years old.Conclusions:The exercise level of long dialysis duration hemodialysis patients is influenced by multiple factors. Medical staff should correct their cognitive biases and change their behavioral attitudes, strengthen external supportive environments and reduce subjective normative pressures, gradually provide more objective support, thereby promoting the exercise training of long dialysis duration hemodialysis patients.
8.Visualization analysis on implementation science in translation of clinical practice guidelines based on knowledge graph
Tingting PENG ; Xun DENG ; Ying WU ; Shan ZHANG
Chinese Journal of Practical Nursing 2024;40(3):203-210
Objective:To investigate the hot topics and trends of implementation science in the transformation of clinical practice guidelines, in order to provide ideas and references for clinical managers to reasonably apply and implement scientific promotion guidelines.Methods:CiteSpace6.2.R3 software was used to visualize the literature, which retrieved from the core database of Web of Science, including the number of articles, countries and high-frequency keywords and keyword clustering and emergence for visual analysis, etc.Results:A total of 4 593 articles were included in the final analysis. Since 1993, the number of published papers had increased year by year. The hot topics focused on primary care, attitudes, knowledge translation, clinical trials, risk factors and machine learning. The research trends included older adults and artificial intelligence.Conclusions:The rapid development of implementation science in guideline translation research suggests that scholars from various countries, especially hospital administrators should reasonably apply implementation science framework to integrate evidence into clinical practice, and promote the implementation of clinical practice guidelines.
9.Summary of the best evidence for screening and management of patients with post-stroke fatigue
Saisai ZHANG ; Xinzhai DONG ; Nali ZHANG ; Junping ZHANG ; Fang ZHAO
Chinese Journal of Practical Nursing 2024;40(3):211-217
Objective:To search, screen and summarize the best evidence of screening and management of patients with post-stroke fatigue, and to provide basis for early identification of clinical staff.Methods:According to the "6S" pyramid model, the system searches for relevant evidence on post stroke fatigue screening and management from UpToDate, BMJ Best Practice, International Guidelines Collaboration Network, New Zealand Guidelines Collaboration Group, Ontario Registered Nurses Association website, Scottish Interhospital Guidelines Network, Joanna Briggs Institute Evidence Based Health Care Center database, and Yimaitong, National Stroke Foundation, Stroke Association, National Stroke Center, Cochrane Library, PubMed, Embase, CINAHL, CNKI, WanFang Datebase, VIP and CBM from January 2013 to March 2023 regarding screening and management of post stroke fatigue patients. Researchers screen literature, evaluate quality, and summarize evidence.Results:Fifteen articles were selected, including 1 clinical decision, 3 guidelines, 3 expert consensus, 2 evidence summary, 5 systematic review and 1 randomized controlled trial. A total of 22 best evidence items were summarized from seven aspects of screening assessment, risk factors, psychosocial intervention, activity and rest, health education, complementary therapy, and follow-up.Conclusions:The study summarized the best evidence for the screening and management of patients with post-stroke fatigue, so as to provide a more scientific and systematic approach to the management of post-stroke fatigue and provide a reference for improving the long-term quality of life of stroke patients.
10.First aid and nursing care of a patient with upper gastrointestinal bleeding induced by Dieulafoy disease after liver transplantation
Ying LIU ; Yajuan CUI ; Jing LI ; Xuexue LEI ; Xue GUAN ; Ying YU
Chinese Journal of Practical Nursing 2024;40(3):218-221
Objective:To summarize the first aid and nursing experience of a patient with upper gastrointestinal bleeding induced by Dieulafoy disease after liver transplantation.Methods:One case with upper gastrointestinal bleeding induced by Dieulafoy disease after liver transplantation was given a series of treatment and nursing measures, including identify bleeding manifestations, providing emergency nursing measures, nutritional support treatment, establishing infection prevention and control system, implementing prone ventilation and pulmonary function rehabilitation, precise immunosuppressive therapy, various forms of psychological care in the First Hospital of Jilin University in November 22, 2021.Results:After 58 d of careful treatment and nursing, the patient recovered and was discharged.Conclusions:Dieulafoy disease is a critical disease, and early diagnosis and targeted first aid and predictive care for liver transplant patients with such diseases are the key to promoting recovery.

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