1.Examining core symptoms and influencing factors of patients with gastric cancer undergoing chemotherapy:the role of Traditional Chinese Medicine constitutional traits
Yanling ZOU ; Yi LI ; Ziyan ZHANG ; Xun LI ; Lihua YANG ; Xiaoqing WANG ; Juan GAO ; Huiyun GUAN ; Peibei DUAN
Chinese Journal of Nursing 2024;59(18):2238-2243
Objective To investigate the incidence and severity of symptoms in patients with gastric cancer who received chemotherapy,we constructed a symptom network to explore core symptoms and bridge symptoms.Furthermore,the study explores the association between core symptoms and Traditional Chinese Medicine(TCM)constitutions.Methods Patients with gastric cancer who received chemotherapy in the medical oncology and surgical oncology department from March to August 2023 were selected for the study using a convenience sampling method.The MD Anderson Symptom Inventory Gastrointestinal Cancer was used for evaluating gastrointestinal symptoms and their severity among patients receiving chemotherapy for gastric cancer,as well as assessing the classification of TCM constitution among patients.The symptom network model was constructed using the R programming language,and the central index was analyzed to determine the core symptoms and bridge symptoms.Binary logistic regression analysis was employed to assess the association between different physical conditions and the occurrence of core symptoms.Results A total of 346 electronic questionnaires were collected,with 340 valid ones,and the effective recovery rate was 98.3%.The 3 most prevalent and severe symptoms among the 340 patients with gastric cancer were fatigue(85.59%),lack of appetite(82.35%),and taste alteration(81.18%).The centrality index results indicated that grief exhibited the highest intensity,medium,and compactness centrality values(rs=8.23,rb=2.00,rc=0.03),making it the core symptom of this condition.Sleep disorders,lack of appetite,drowsiness,and taste alteration were identified as bridging symptoms with bridge intensities of 0.74,0.76,0.99,and 0.94 respectively.The results of Spearman correlation analysis showed that there was a positive correlation between sadness and qi-deficiency constitution,phlegm-dampness constitution(P<0.05).The phlegm-dampness constitution was positively correlated with the taste alterations(P<0.05).Conclusion In patients with gastric cancer,fatigue emerges as the most prominent symptom,while sadness assumes the core symptom.Additionally,sleep disorder,lack of appetite,drowsiness,and taste alteration are bridge symptoms.According to the principles of TCM constitution,qi-deficiency and phlegm-dampness are constitutions associated with a higher risk of experiencing sadness,and phlegm-dampness is a constitution associated with a higher risk of taste changes.Nurses can integrate core symptoms and TCM constitutions characteristics to optimize the strategies for symptom intervention.
2. Identification of subtypes of symptom cluster in patients with gastric cancer undergoing chemotherapy: a cluster analysis
Xiao WANG ; Peibei DUAN ; Aqin WANG ; Chao XIA
Chinese Journal of Practical Nursing 2019;35(17):1281-1286
Objective:
To explore the possible types of patients with gastric cancer undergoing chemotherapy based on their experience with the symptom cluster of pain, fatigue, sleep disturbance.
Methods:
Totally 161 gastric cancer patients were investigated by the demographic and clinical characteristics questionnaire, the Numeric Rating Scale (NRS), the Brief Fatigue Inventory (BFI), the Pittsburgh Sleep Quality Index (PSQI), Quality of Life Questionnaires (QLICP-ST). Cluster analysis using SPSS 22.0 version was performed to categorize patients.
Results:
Four different types of patients were got through cluster analysis. Type Ⅰ patients showed all low symptoms (23 cases accounted for 14.3%), Type Ⅱ patients showed low pain and moderate fatigue (43 cases accounted for 26.7%), Type Ⅲ patients showed low pain and high fatigue (62 cases accounted for 38.5%), Type Ⅳ patients performed moderate-to-high on all symptoms (33 cases accounted for 20.5%). Their education status, chemotherapy cycle sand KPS score were the main factor influencing the classification of pain-fatigue-sleep disorder symptoms in patients with gastric cancer undergoing chemotherapy after operation (
3.Meta-analysis of auricular-plaster therapy intervening with anxiety in adults
Lihua YANG ; Peibei DUAN ; Qingmei HOU ; Shizheng DU ; Sijuan MEI ; Xiaoqing WANG
Chinese Journal of Modern Nursing 2019;25(26):3337-3342
Objective? To review the intervention effects of auricular-plaster therapy on adults with anxiety systematically. Methods? Data about random controlled trails of auricular-plaster therapy in treating anxiety were collected from Cochrane, PubMed, Embase, CBMdisc, CNKI and Wanfang databases. The quality of literatures were assessed and the data were collected by two persons independently. Multiple-time-point Meta-analysis was used for anxiety, while endpoint Meta-analysis was used for quality of sleep and life. RevMan 5.3 was used for statistical analysis. Results? Totally 15 literatures were included in this study, involving 890 subjects. Meta-analysis showed that auricular-plaster therapy could ameliorate anxiety continuously with high degrees within 2 months (P< 0.01), but there were no notable effects yet beyond 2 months (P> 0.05). Auricular-plaster therapy could improve the quality of sleep effectively (P<0.001). There was no evidence that auricular-plaster therapy could improve the quality of life (P>0.05). Conclusions? Auricular-plaster therapy can ameliorate patients' anxiety and improve their quality of sleep, but considering the limited quality and quantity of studies included, the findings of our study will need to be tested by multicenter and high-quality random controlled trails with large samples, especially its long-term intervention effects.
4.Effect of artificial airway cuff pressure at different monitoring intervals on ventilator associated pneumonia in critical patients
Xiaowei GUO ; Zhimin LIU ; Xiuqin GONG ; Xingxin XU ; Peibei DUAN
Modern Clinical Nursing 2017;16(6):22-25
Objective To investigate the effects of artificial airway cuff pressure at different monitoring intervals on ventilator associated pneumonia (VAP) in critical patients. Methods About 56 patients treated with mechanical ventilation from January 2015 to December were grouped by ward numbers:32 patients in the south ward were in the experiment group and 24 in the north ward were in the control group. The two groups were given the same routine care, e.g., mechanical ventilation by endotracheal intubation. In the experiment group, the cuff pressure was controlled to 30cm H2O every six hours and the control group was every 4h. The two groups were compared in terms of the incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation and mortality. Result The incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation, and mortality showed no significant differences between the two groups (P>0.05). Conclusions For mechanically ventilated patients, the cuff pressure controlled to 30cm H2O every 6h can not increase the incidence of VAP, duration of mechanical ventilation and mortality. It can reduce the nursing workload.
5.Effect of herbal plaster on appetite loss of patients with gastrointestinal cancer undergoing chemotherapy
Xiaoqing WANG ; Peibei DUAN ; Xiaoqin ZHANG ; Lihong WU
Chinese Journal of Modern Nursing 2017;23(11):1549-1551
Objective To investigate the intervention effect of herbal plaster on appetite loss of patients with gastrointestinal cancer undergoing chemotherapy.Methods Sixty-six patients treated in Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine from August 2015 to August 2016 were selected by convenient sampling, and were divided randomly into two groups. Patients in the control group were given conventional nursing, while patients in the observation group were given extra application of herbal plaster. The effect of intervention was evaluated by change of the patients' appetite and BMI.Results After completion of the treatment, appetite scores of patients in the observation group were (4.55±1.32) points, with that in the control group (2.22±1.43) (t=5.48,P<0.05); difference of BMI between the two groups showed no statistic significance (t=0.89,P>0.05).Conclusions Herbal plaster, as a characteristic technique in external treatment of traditional medicine, can help the patients regain their appetite to a certain extent and thus improve clinical outcomes. Still, clinical quantity-effect researches need to be strengthened in the future, so as to make the results more stringent, to better popularize and promote traditional Chinese nursing technology, and to provide new ideas and complementary therapy for clinical application of appetite loss caused by chemotherapy.
6.Analysis of risk factors for contact dermatitis in patients with PICC catheterization
Sijuan MEI ; Peibei DUAN ; Xiaoqing WANG ; Lihua YANG ; Li SUN
Chinese Journal of Modern Nursing 2017;23(23):2997-3001
Objective To investigate the risk factors for contact dermatitis in patients with peripherally inserted central catheter (PICC) catheterization.Methods A total of 244 patients with PICC catheterization admitted in the Venous Catheter Nursing Outpatient of Affiliated Hospital of Nanjing University of TCM from June to August 2016 were selected using convenience sampling. A prospective study was performed on those patients for general information, PICC catheter information, PICC care information and contact dermatitis development information. SPSS 21.0 was used to analyze the date.Results A number of 24 patients were observed to have contact dermatitis with an incidence of 9.84%. Single factor analysis showed that gender, age, allergy, dressing type and catheter material correlated to the development of contact dermatitis with PICC. The differences were statistically significant (P<0.05). Multiple factor logistic regression analysis showed that the gender[OR=2.721, 95%CI (1.059-6.994),P=0.038], allergy[OR=5.846, 95%CI (2.030-16.833),P=0.001] and dressing type[OR=4.055, 95%CI (1.472-11.169),P=0.007]were risk factors of contact dermatitis in patients with PICC catheterization.Conclusions For PICC catheterization patients, effective preventive measures aiming at risk factors can reduce the occurrence of contact dermatitis with PICC.
7.Development of Quality of Life Questionnaire with traditional Chinese medicine characteristics for patients with ulcerative colitis
Qiong WANG ; Yiqing WANG ; Peibei DUAN ; Jun LI ; Lihua YANG ; Long SUN
Chinese Journal of Practical Nursing 2016;32(8):612-616
Objective To develop the Quality of Life Questionnaire with traditional Chinese medicine characteristics for patients with ulcerative colitis.Methods The pool of entries were initially formed by using literature review,theoretical analysis and interviews.Delphi technique was used to formulate.quality of life questionnaire for patients with ulcerative colitis through a two-round expert consultation among 22 experts in 9 provinces.Results In two-round surveys,the rates of questionnaire retrieve were 95.7% and 100.0%,respectively.The authoritative coefficients was 0.85,the coordination coefficients were 0.288 and 0.290,respectively,P< 0.01.The preparation of the primary scale consisted of physical,psychological,independence and social function of 4 dimensions and 48 items.Conclusions A reliable and valid questionnaire with traditional Chinese medicine characteristics for evaluation of quality of life for patients with ulcerative colitis was developed.It can be used to provide reference for the evaluation of the quality of life for patients with ulcerative colitis in China.
8.Scrapping therapy combined withDecoction for perimenopausal syndrome with pattern of fire excess fromdeficiency.
Fang MENG ; Peibei DUAN ; Qian HU ; Yiqing WANG ; Qiong WANG ; Min ZHANG ; Yue HU
Chinese Acupuncture & Moxibustion 2016;36(8):821-826
OBJECTIVETo observe the efficacy difference between scrapping therapy combined withDecoction and the single application ofDecoction for perimenopausal syndrome (PMS) with pattern of fire excess fromdeficiency.
METHODSEighty patients were assinged into an observation group and a control group, 40 cases in each one. Patients in the control group were treated with oral administration ofDecoction to clear heart heat and nourish kidney. One dose of the decoction was taken by two times within one day. Based on the treatment of the control group, patients in the observation group were additionally treated with scrapping therapy along the urinary bladder meridian of foot-, heart meridian of hand-and kidney meridian of foot-; the scrapping therapy was performed at Back-points, Shenmen (HT 7), Yongquan (KI 1), Taixi (KI 3), Zhaohai (KI 6), Sanyinjiao (SP 6), Zusanli (ST 36), etc.; the treatment was given once every week. Four weeks of treatment were taken as one course in two groups, and totally 2 courses were given. The modified Kupperman score, menopausal quality of life (MENQOL), level of serum estrogen (E), follicle stimulating hormone (FSH) and luteinizing hormone (LH) before and after treatment as well as the clinical efficacy were valuated between the two groups.
RESULTSAfter treatment, each item score and total score of modified Kupperman were reduced apparently in the two groups (<0.01,<0.05) except dyspareunia score in the control group. The score of hot flash and sweating, paresthesia, depression, fatigue, arthralgia, palpitation, formication, urinary symptoms and total score in the observation group were superior to those in the control group (<0.01,<0.05). After treatment, the total score and each dimension score of MENQOL were obviously decreased in the two groups (all<0.01), and the scores of vasomotor symptoms, psychosocial condition and physical condition in the observation group were significantly lower than those in the control group (<0.01,<0.05). There were no significant differences of serum hormone levels before and after treatment between the two groups (all>0.05), however, after treatment, the serum Elevel had the tendency to raise and serum LH, FSH levels had the tendency to decrease in the observation group. The total effective rate was 97.4% (37/38) in the observation group, which was higher apparently than 81.1% (30/37) in the control group (<0.01).
CONCLUSIONSThe scrapping therapy combined withDecoction or the simple application ofDecoction can both improve PMS symptoms and the quality of life, delay the ovary recession; the combination of scrapping therapy andDecoction achieve superior efficacy on PMS syndrome to the simple application ofDecoction.
9.Clinical observation of post-infectious cough differentiated as wind-cold retention in the lung treated with scraping therapy anddecoction.
Qian HU ; Qiuqin WANG ; Peibei DUAN ; Fang MENG ; Xiuqin GONG ; Shufeng HU ; Xiaozhen ZHU
Chinese Acupuncture & Moxibustion 2016;36(12):1257-1262
OBJECTIVETo compare the difference in the therapeutic effect on post-infectious cough differentiated as wind-cold retention in the lung between the combined therapy of scraping anddecoction and the simple application ofdecoction.
METHODSEighty patients were randomized into a combined therapy group and a Chinese herbal medicine group, 40 cases in each one. In the Chinese herbal medicine group, the oral administration ofdecoction was used. The main ingredients included,,,,,,,, etc., one dose a day, twice a day. In the combined therapy group, on the basis of the treatment as the Chinese herbal medicine group, scraping therapy was added and applied to the bladder meridian of foot-, the lung meridian of hand-, the conception vessel and the governor vessel, focusing on Tiantu (CV 22), Baihui (GV 20), Dazhui (GV 14), Feishu (BL 13), Fengmen (BL 12), Taiyuan (LU 9), Lieque (LU 7) and Fengchi (GB 20), once a week and one-week treatment as one session. Totally, the continuous two sessions were required in the two groups. The cough symptom score, cough remission time, relapse, TCM syndrome score, the score of Leicester cough questionnaire (LCQ), SP concentration in the supernatant of the induced sputum before and after treatment as well as clinical efficacy were observed in the two groups.
RESULTSThe cough symptom score, TCM symptom score and SP concentration in the supernatant of the induced sputum were all apparently reduced after treatment in the patients of the two groups (all<0.01). The scores in the combined therapy group were reduced in the higher amplitude as compared with those in the Chinese herbal medicine group (all<0.01). The total effective rate was 95.0% (38/40) in the combined therapy group, better than 87.5% (35/40) in the Chinese herbal medicine group (<0.05). Regarding the cough remission time and relapse rate, the results in the combined therapy group were better than those in the Chinese herbal medicine group[(5.3±1.2) d vs (7.4±1.5) d,<0.01; 0% (0/19) vs 62.5% (5/8),<0.01]. The scoreo of LCQ was all apparently improved in the patients of the two groups (both<0.01), and the score in the combined therapy group was higher than that in the Chinese herbal medicine group (<0.01).
CONCLUSIONSScraping therapy combined withdecoction and the simple application ofdecoction all relieve the symptoms of post-infectious cough and improves the living quality. The therapeutic effects of the combined therapy are superior to the oral administration ofdecoction.
10.Literatures analysis on intervention of caner-related fatigue in CNKI
Xiaoqing WANG ; Peibei DUAN ; Sijuan MEI ; Lihua YANG
Chinese Journal of Modern Nursing 2016;22(15):2106-2109
Objective To probe into the current status quo and issues of intervention research about cancer-related fatigue in cancer patients.Methods The key words were “cancer-related fatigue”,“fatigue”,“tumor”that searched literatures from CKNI and statistically analyzed by excel and other software.Results A total of 1 53 intervention research literatures were found out which involved excise therapy,psychological nursing, health education,Chinese medicine nursing,self care,etc.The quality of literatures were low,including 5 literatures with Jadad assessment score-3 points,1 7 literatures having 2 points,and the others with 2 points below.Conclusions There are too many intervention studies on cancer-related fatigue of patients with cancer chemotherapy,but the quality of literatures are unsatisfied.Therefore,the methodology should be strengthened for intervention studies of cancer-related fatigue,so as to improve research quality and satisfy evidence-based demands.

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