With the development of medical technology, the survival rate of cancer patients continues to improve, and the number of stoma patients is increasing day by day. Self-management refers to patients monitoring and managing their own diseases to maintain and improve physical health. Good self-management ability can enhance patient treatment compliance, reduce the incidence of stoma and surrounding complications, improve health outcomes, and raise patient quality of life. This article reviews the research progress on self-management of stoma patients, with the aim of providing reference for research on self-management of stoma patients.

Objective:To explore the current status and influencing factors of self-care ability in patients with cystostomy and ileal conduit.Methods:Using the convenient sampling method, a total of 160 patients with cystostomy and ileal conduit who visited the Urostomy Clinic of Peking University First Hospital from October 2021 to March 2022 were selected as the research objects. Patients were surveyed using a general information survey questionnaire, Social Support Rating Scale (SSRS) and Urostomy Education Scale. Spearman correlation analysis was used to explore the correlation between social support and self-care in patients with cystostomy and ileal conduit, and multiple linear regression analysis was used to explore the influencing factors of self-care ability in patients with cystostomy and ileal conduit. A total of 160 questionnaires were sent out, and 157 were effectively collected, with an effective recovery rate of 98.13% (157/160) .Results:The total score of Urostomy Education Scale of 157 patients with cystostomy and ileal conduit was [20.00 (4.00, 21.00) ]. The results of multiple linear regression analysis showed that marital status, comorbidities, stoma and peristomal complications, frequency of follow up in urostomy clinic and objective support were the influenting factors for self-care of patients with cystostomy and ileal conduit ( P<0.05) . Conclusions:Self-care of patients with cystostomy and ileal conduit is related to many factors. Medical staff should strengthen the intervention and management of patients with cystostomy and ileal conduit from multiple aspects such as individual and social function, so as to improve their self-care ability.

Objective:To explore the efficacy and safety of Ganhai Weikang capsule (GWC) in the treatment of functional dyspepsia (FD).Methods:A randomized, double-blind, placebo-controlled parallel, multi-center, superiority clinical trial was conducted. From March 2018 to April 2020, totally 324 patients with dyspepsia symptoms, who were diagnosed as chronic non-atrophic gastritis by endoscopy and pathology and met the Rome Ⅳ diagnostic criteria for FD from 7 top hospitals were enrolled, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Heilongjiang Hospital of Traditional Chinese Medicine, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Qilu Hospital of Shandong University, the First Affiliated Hospital of Zhejiang University, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University and the Third Xiangya Hospital of Central South University. The patients were randomly divided into the GWC group and the placebo group according to the ratio of 1∶1. The patients of GWC group were given GWC and the patients of placebo group were given GWC capsule simulant. The patients of both groups orally took capsules before meals, 2.4 g each time and 3 times per day, and the course of treatment was 4 weeks. The main efficacy index was the total clinical effective rate after 4 weeks, and the secondary efficacy index was the changes of clinical symptom scores of upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety. The safety index included laboratory tests and adverse events. Chi-square test and Wilcoxon rank sum test were used for statistical analysis.Results:A total of 320 FD patients were enrolled in the full analysis set (FAS), which included 161 cases in GWC group and 159 cases in placebo group. A total of 298 cases were in the per-protocol set (PPS), 149 cases each in GWC group and placebo group. The results of FAS and PPS both showed that the total clinical effective rates of the GWC group were higher than those of the placebo group (84.5%, 136/161 vs. 44.0%, 70/159 and 83.9%, 125/149 vs. 46.3%, 69/149), and the differences were statistically significant ( χ2=57.07 and 46.32, both P<0.001). In addition, the differences of the total score of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (FAS: 10 (7, 14) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 3); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs. 1 (0, 3). PPS: 10 (7, 13) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 2); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs.1 (0, 3)), and the differences were statistically significant (FAS: Z=5.80, 5.91, 3.19, 3.72 and 3.30; PPS: Z=5.14, 5.11, 2.86, 3.21 and 2.84; all P<0.01). The results of FAS and PPS indicated that the improvement rates of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) of GWC group were all higher than those of the placebo group (FAS: 77.8% (54.6%, 91.3%) vs. 42.9% (28.6%, 61.5%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 60.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 41.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%). PPS: 77.8% (54.2%, 89.5%) vs. 44.0% (28.6%, 65.0%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 46.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%)), and the differences were statistically significant (FAS: Z=8.60, 7.72, 4.98, 4.24 and 5.61; PPS: Z=7.90, 7.03, 4.49, 3.88 and 4.83; all P<0.001). After 2 weeks of treatment, the differences of the total score of main symptoms and score of each symptom (upper abdominal pain, upper abdominal burning and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (5.0 (3.0, 8.0) vs. 4.0 (2.0, 6.0); 2.0 (1.0, 2.0) vs. 2.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0)), and the differences were statistically significant ( Z=2.95, 3.44, 2.43 and 2.79, all P<0.05). There was no significant difference in the incidence of adverse events between the GWC group and the placebo group (0.6%, 1/163 vs. 0, 0/159). Conclusion:The clinical total effective rate of GWC in the treatment of FD is superior to that of placebo and it has good safety.

This article summarized the overview of diagnosis related groups (DRGs), the necessity of comprehensively popularizing and applying DRGs in specialized hospitals and general hospitals, the different methods and effects of nursing human resource allocation based on DRGs in specialized hospitals and general hospitals at home and abroad, and analyzed the different challenges and opportunities faced by DRGs in the implementation of human resource allocation in two types of hospitals. According to the types and characteristics of hospitals, this paper put forward some corresponding suggestions and prospects for the future, such as intelligent human resource prediction system and the construction of information sharing platform, so as to provide reference for the comprehensive promotion of DRGs in different types of hospitals in China.

Objective:To build a comprehensive clinical management of outpatient with orthotopic neobladder based on doctor-nurse cooperation to provide overall service to patients.Methods:The comprehensive clinical management was established in October 2018, 32 patients were collected retrospectively from January 2009 to before the establishment of the clinic, and 14 patients were collected from the establishment of the clinic to January 2020. After the establishment of the clinic, the comprehensive management mode was adopted, including the medical team implementing management from the aspects of implementing doctor-patient joint decision-making, guiding patients to carry out pelvic floor muscle rehabilitation training, teaching family members to carry out new bladder irrigation, and establishing patients′ records. Before the establishment of the clinic, there was no specialized personnel for unified management, and the doctor for new bladder irrigation and so on.Results:The rate of complete urinary control in the 46 patients with orthotopic neobladder was 82.6%(38/46) in the day and 71.7%(33/46) in the night. The rates of complete urine control of patients in the day and night were 12/14 and 9/14 after the establishment of the clinic. The length of stay which was (13.36 ± 9.44) d, and feeding time which was (5.00 ± 2.11) d of the patients after the establishment of the clinic were both less than those of the patients before the establishment of the clinic, which were (17.28 ± 9.98) d and (5.78 ± 2.90) d, but the differences were not statistically significant ( t values were -1.247 and -0.905 respectively, both P>0.05). However, for diurnal and night-time urine control, the proportion of people with more than one diaper was better after the establishment of outpatient clinic than before. Conclusions:The establishment of the comprehensive clinical management meets the needs of patients with orthotopic neobladder, enables patients to get the function of continence and urination sooner, and contributes to improve the clinical outcome of patients.

Objective:To retrieve, evaluate and summarize the relevant evidence of mechanical prevention of venous thromboembolism (VTE) in adult patients undergoing abdominal and pelvic surgery, so as to provide a scientific basis for clinical practice.Methods:We systematically retrieved and screened the guide network and database for evidence on mechanical prevention of VTE in adult patients undergoing abdominal and pelvic surgery, including guidelines, evidence summary, clinical decision-making, systematic review, and expert consensus. The search time limit was to build the database until January 19, 2020. Two researchers who had undergone evidence-based training selected appropriate evaluation tools according to different types of literature to evaluate the quality of the literature, and to extract, translate and integrate recommendations.Results:A total of 24 articles were included, including 7 guidelines, 2 evidence summaries, 1 recommended practice, 12 systematic reviews, and 2 expert consensus. The evidence was summarized from 6 aspects, namely admission assessment, contraindications, applicable population, starting time, duration and patient education, and a total of 10 recommendations were formed.Conclusions:This study summarizes the best evidence for mechanical prevention of VTE in adult patients undergoing abdominal and pelvic surgery, and provides evidence-based evidence for standardizing clinical mechanical prevention.

Objective:To retrieve, evaluate and summarize relevant evidence of parastomal hernia prevention and management, so as to provide a reference for clinical nursing.Methods:We used computer systems to search and screen the related guidelines, evidence summary, recommended practices, expert consensus and systematic reviews on the prevention and management of parastomal hernia in the official websites of ostomy-related associations, guide networks, and databases. The research time limit was from the establishment of the database to July 2, 2020. Two systematically trained researchers evaluated the quality of the articles, and extracted data and evidence from the articles that met the quality standards.Results:A total of 9 articles were included, involving 6 guidelines, 1 recommended practice and 2 systematic reviews. A total of 15 best pieces of evidence were summarized, including 5 aspects, namely diagnostic standards, classification, risk factors, prevention and management.Conclusions:If medical personnel can accurately identify the risk factors of parastomal hernia, and carry out early prevention and management, it can reduce the incidence of parastomal hernia and/or alleviate the discomfort caused by parastomal hernia, thereby improving the patient's quality of life. It is suggested that clinical nursing staff can transform in a targeted manner according to specific clinical situations to improve the quality of clinical nursing.

Objective:To find out the obstacle factors in its clinical application according to the clinical situation of the application of urinary catheter fixation device.Methods:From September 2018 to October 2018, 19 nurses working in the urology ward of Peking University First Hospital were selected for a semi-structured interview. Based on the theoretical domain framework, the interview outline was formulated and the content was analyzed, and the topic was extracted again.Results:This study identified obstacle factors related to 5 areas of the theoretical domain framework, namely "knowledge, social or professional role and identity, motivation and goals, environmental factors and social influence". The themes were extracted again, respectively: "the system level of evidence implementation (organizational factors, training, product categories) needs to be optimized, the level of willingness of users (patients) for evidence implementation needs to be improved and the sustainability of evidence application needs to be strengthened".Conclusions:The factors that affect the clinical application of urinary catheter fixation devices are multiple, and future research needs to formulate targeted intervention plans based on evidence according to obstacles identified.

Objective? To understand the situation of urinary incontinence and quality of life among patients with post-laparoscopic radical prostatectomy and to analyze the correlation between them. Methods? From September 2015 to October 2016, we selected 115 patients with post-laparoscopic radical prostatectomy at a ClassⅢ Grade A hospital in Beijing for survey by questionnaire with the method of convenience sampling. We collected patients' general information as well as disease information, and evaluated the situation of urinary incontinence (incidence and severity of urinary incontinence) with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and influence of urinary incontinence on quality of life with the Incontinence Impact Questionnaire (IIQ-7) to analyze the correlation between severity of urinary incontinence and quality of life. Results? Among 115 patients with post-laparoscopic radical prostatectomy, there were 95 (82.6%) urinary incontinence patients including 41 cases (43.1%) with mild urinary incontinence, 47 cases (49.5%) with medium urinary incontinence and 7 cases (7.4%) with severe urinary incontinence. The score of severity of urinary incontinence ranged from 0 to 19.0 with 8.0 for the median and 5.0 for the interquartile range. Spearman correlation analysis showed that the score of IIQ-7 had a positive correlation with the severity of urinary incontinence (r=0.674, P＜0.01), and had a negative correlation with the postoperative time (r=-0.215, P＜0.05). Multiple linear regression analysis showed that the main influencing factor of quality of life was severity of urinary incontinence (P＜0.01). Conclusions? Urinary incontinence is common among patients with post-laparoscopic radical prostatectomy mainly in mild and medium urinary incontinence. The more serious the urinary incontinence is,the greater the influence on quality of life is which points out that the scientific and effective management by medical staff for urinary incontinence can improve patients' quality of life.

Objective To explore the barriers in the clinical use of evidence-based urethral catheter cleaning. MethodsThe interview outline was developed based on the Theoretical Domains Framework (TDF) from September to October 2018. Totally 19 nurses working in the Department of Urinary Surgery at Peking University First Hospital was selected for semi-structural interview by convenient sampling, and content analysis was conducted based on the results. ResultsA total of 4 barriers related to 4 domains under the TDF were found in this study, namely, social / professional roles and identities, confidence in results, environmental factors and resources, and social impact. The subjects were extracted on this basis, which were lack of knowledge conversion process and norms in the department, poor self-management ability in the patients, and insufficient catheter cleaning resources. ConclusionsThe clinical use of evidence-based urethral catheter cleaning is affected by multiple factors, including systems, patients and resource availability. Departments need to explore and develop the norms for knowledge transformation, improve the self-management ability of postoperative patients, provide sufficient resources for catheter cleaning, and promote the clinical use of evidence-based urethral catheter cleaning.