A Qualitative Study on the Negative Emotions of Mothers during Chemotherapy of Their Children with Malignant Brain Tumors

Objective: To explore the negative emotions of mothers during chemotherapy of their children with malignant brain tumors. Methods: The phenomenological method for qualitative studies was adopted;convenience sampling was used to conduct semi-structured interviews to the mothers of 9 children with malignant brain tumors who received chemotherapy from June 2019 to December 2019;the Colaizzi 7-step analytical method was implemented to collate and analyze the original data. Results: The results were summarized into six subjects: stressed, exhausted because of trying to control everything in home care, prone to excessive care, financially burdened, desperate for knowledge of patient care, and desperate for psychosocial support. Conclusions: Understanding the real experiences and inner feelings of mothers during chemotherapy of their children with malignant brain tumors is helpful for medical staff to learn about the psychological distress and needs of mothers of children with malignant brain tumors, so as to give them psychological support and even social support, and help the mothers and the families of children with malignant brain tumors get through a special period.

Application and Care of Two Kinds of Sphenoid Sinus Packing Materials after Pituitary Tumor Resection with the Transnasal Endoscopic Approach

Background: Neuroendoscopic transsphenoidal approach for resection of pituitary adenomas has the advantages of less damage, fewer complications, and a faster recovery than the traditional approach and has beening favored by neurosurgeons. However, there has no standard method of selecting suitable packing materials after the operation to relieve pain in patients and achieve the ideal hemostatic effect. We compared the postoperative complications and treatment effects of two different packing materials in patients with pituitary adenomas. Objective: To investigate the advantages and disadvantages of using a catheter balloon and iodoform gauze for hemostasis in patients undergoing pituitary tumor resection by neuroendoscopic transsphenoidal approach. Materials and Methods: We retrospectively analyzed these data of 48 cases treated with pituitary adenoma resection by the single nasal approach from January 2018 to October 2019 in Sun Yat-sen University Cancer Center. According to the type of sphenoid sinus packing material used, these patients were divided into balloon tamponade oppression group (24 cases) and tela iodoformum oppression group (24 cases), respectively. The balloon tamponade oppression group received catheter balloon tamponade oppression hemostasis, and the tela iodoformum oppression group underwent tela iodoformum oppression hemostasis. The outcomes and complications were compared between the two groups in which two kinds of sphenoid sinus packing materials were used for hemostasis after tumor resection by transnasal endoscopic approach. For the catheter balloon compression hemostasis method, on account of the plasticity of the balloon, the volume of water in the balloon can be adjusted according to the size of the patient’s own sphenoid cavity. The amount of bleeding and several complications in terms of discomfort during placement and removal of the packing material, rebleeding after removal of the packing, cerebrospinal fluid rhinorrhea and electrolyte disturbance are compared between the two groups. Results: 48 patients were enrolled. The two groups’ data of patients were similar in age structure, sex ratio, tumor size at baseline and so on. No complications, such as abscess formation, were found in both groups. The success rate in the compression with catheter balloon group was 100% (24 of 24 patients);and in the iodoform gauze group 83.33% (20 of 24 patients). A catheter balloon was more successful in stopping bleeding at early stage than iodoform gauze. There were no statistically significant differences in the hospitalization stay time, operating day to discharge day and tampon indwelling time (P > 0.05). There were also no significant differences in pairwise comparison between the catheter balloon group and iodoform gauze groups in the incidence of cerebrospinal fluid rhinorrhea or electrolyte disturbance between the two groups (P > 0.05). The incidence of headache in the catheter balloon group was statistically significantly lower than that in the iodoform gauze group (P < 0.05). Conclusion: In patients undergoing endoscopic pituitary tumor resection, compression and hemostasis by means of catheterization expansion lead to lower rates of injury and complications and have a good effect, so this method is worthy of being recommended for clinical practice.

A Study on the Psychological Status of the Caregivers to Patients Out of ICU after Craniocerebral Tumor Surgery and Their Factors

Objective: So as to provide a theoretical basis for the future development of intervention measures to reduce the negative psychological mood of caregivers. To investigate the psychological status of the main caregivers for patients who were transferred out of ICU after craniocerebral tumor surgery and analyze their factors. Methods: 112 patients with cerebral tumor surgery were reviewed from sun yat-sen university cancer hospital. The research object is caregivers. The general data questionnaire, hospital anxiety depression scale and migration of ICU patients’ family members stress questionnaire scale investigation are collected. Multiple linear regression analysis in cerebral tumor patients with postoperative ICU transition out main factors influencing the psychological condition of the caregivers. Results: The anxiety and depression scores were (15.60 ± 5.83) and (38.73 ± 3.23) respectively. The results of multiple regression analysis showed that the gender, education level, relationship with the patient and family monthly income of the primary caregivers of the patients were the influencing factors of anxiety, depression and migration stress psychological state (P < 0.05). Conclusion: The main caregivers of patients who were transferred out of ICU after craniocerebral tumor surgery had relatively severe anxiety, depression and migration stress. Medical staff should pay attention to the psychological status of caregivers and take effective measures to promote their physical and mental health.

Individualized Sellar Floor Reconstruction Method and Nursing Strategy for the Intraoperative Cerebrospinal Fluid Leakage Caused by Neuroendoscopic Transsphenoidal Pituitary Adenoma Resection

Objective: To explore the clinical effect of and the method and nursing strategy for sellar reconstruction for intraoperative cerebrospinal fluid (CSF) leakage in pituitary adenoma resection under neuroendoscopy. Methods: The data from 20 cases of intraoperative CSF leak caused by transsphenoidal pituitary adenoma resection were retrospectively analyzed. Six patients were treated with mucosal flap and artificial dural reconstruction of sellar (simple sellar floor reconstruction). In 45 patients, autologous fat, fascia lata, and artificial dura were used to repair and reconstruct the sellar floor (multilayer sellar floor reconstruction). After the operation, all patients underwent follow-up for 6 - 24 months. Results: Fifty patients were followed up without CSF leakage. One patient was cured after leakage of CSF through the lumbar cistern 1 month after discharge. Conclusion: For patients with CSF leakage during neuroendoscopic transsphenoidal pituitary adenoma resection, individualized sellar floor reconstruction should be adopted according to the degree of CSF leakage and the size of the sellar floor defect. Strict nursing measures can effectively prevent CSF leakage and reduce postoperative complications.

Evaluation of the Effect of Chemotherapeutic Drug Training on Mobile Terminal for Neuro-Oncology Nurses Based on Kirkpatrick’s Model

Background: Since there has been training, there has been discussion about the effect of training. But training evaluation is not systematic until Kirkpatrick came up with the training evaluation model in 1959. At present, the prevailing model in the systematic summary of training evaluation is still The Kirkpatrick’s model. This model was further improved in 1994, more responsive to contemporary needs, and thus widely used all over the world. At the beginning, it was widely used in human resource management of enterprises. In recent years, this model has been gradually used in the medical field to evaluate the effect of medical training. The Kirkpatrick’s model has a systematic, integrated and persuasive evaluation system for trainees. It has good effects in the pre-service nurse training, the professional image and code of conduct nurses training, and the geriatric nurse training. At present, there are few studies on the chemotherapeutic drug training of neurologist nurses in China. In clinical work, nurses’ cognitive and practical behaviors of chemotherapeutic drug protection and drug extravasation prevention and treatment are insufficient. It directly harms the health of nursing staff and increases the complications of chemotherapy, increases pain of tumor patients, delays or interrupts chemotherapy, and aggravates the economic burden of patients. Especially, Chemotherapeutic drugs for neuro-oncology have particularity and necessity of urgent training. Objective: To investigate the effect of chemotherapeutic drug training through mobile terminal for neuro-oncology nurses based on the Kirkpatrick’s model. Methods: The training content and evaluation questionnaire for chemotherapeutic drugs were designed by nursing management personnel and senior nurses in our department according to the guidelines and common diseases requiring chemotherapy in the department. The content includes the basic knowledge of neuro-oncology chemotherapy, pharmacological knowledge, toxic and side effect of chemotherapy, etc., which are regularly pushed through the mobile terminal-WeChat. Forty nurses participated in the training and the effect is evaluated by Kirkpatrick’s model. Result: After the training, 100% of nurses were satisfied with the training content and 97.5% with the training form. The scores of nurses in learning level such as basic pharmacological knowledge, drug configuration and exposure, drug treatment and infusion, observation of toxic and side effects, and treatment of drug extravasation were significantly higher than those before the training (P < 0.01). The scores of nurses in the behavior level such as drug allocation, health education, toxic and side effect observation and prediction, treatment of exosmosis, occupational protection were significantly higher than those before the training. After the training, the satisfaction of managers, chemotherapy physicians and chemotherapy patients on the behavior of nurses was significantly higher than that before the training (P < 0.01). Conclusion: The chemotherapeutic drug training through mobile terminal based on Kirkpatrick’s model can improve the ability of neuro-oncology nurses, so as to improve the satisfaction of physicians and patients.

Analysis of Present Situation and Influencing Factors of Coping Methods by Parents of Children with Central Nervous System Tumors

Background: Central nervous system (CNS) tumors are the most common solid tumors among children. Due to the severity of the tumors and the complexity of therapeutic regimes, it is very important to examine whether parents of the children with CNS tumors have positive coping methods against the disease. This study aims to analyze the coping methods of the parents and the factors influencing the methods. Methods: A total of 108 parents of brain cancer children admitted from January 2019 to September 2020 were selected as subjects. After collecting the general information of the parents, they were studied using the Coping Health Inventory for Parents (CHIP, Chinese version). Additionally, their coping pattern and the influencing factors were analyzed. Results: The average scores of the three subscales of the CHIP were (4.25 ± 0.939), (3.11 ± 1.205) and (3.60 ± 1.187), respectively. Univariate analysis showed that parents’ education, medical payment methods, places of residence and economic concerns were the main factors influencing the coping methods (all P < 0.05). Conclusions: Healthcare staff should fully evaluate the coping methods adopted by the parents having children with CNS tumors, take targeted nursing measures accordingly, and assist the parents in seeking social support and learning disease-related knowledge. In addition, public education on disease is equally important.

Perioperative Nursing of a Case of Right Temporal Lobe Brain Abscess Ruptured into the Ventricle

Objective: To explore the perioperative nursing method of brain abscess breaking into the ventricle. Methods: By reviewing the clinical data of 1 case of right temporal lobe brain abscess into the ventricle, the effective nursing methods were summarized. Results: The patient’s condition was advanced quickly, and the diagnosis was treated in time to avoid brain hernia, but the treatment was difficult because of the critical condition. Conclusion: Brain abscess is a very serious intracranial infectious disease. It is of great significance to observe the changes in patients’ condition and take effective nursing measures.