The Psychological Experience of the Nursing Staff of the Medical Oncology Department in Cameroon: Case of the YaoundéGeneral Hospital

Background: The world of cancer care is an emotional place, given the severity of the disease being treated, the heavy workload, the suffering of patients, and the high number of deaths. The nursing staff who work there may be exposed to constant stress from these factors. This study aimed to explore the psychological experience of the nursing staff of the Medical Oncology Department of the Yaoundé General Hospital. Methods: We carried out a cross-sectional study, in June 2017, involving the nursing staff of the Medical Oncology Department of the Yaoundé General Hospital. Results: Sixteen out of 18 nurses were interviewed. All had worked in at least one other department prior to Oncology. The number of years of experience in Oncology ranged from less than one year to 13 years. The choice of the Oncology department was involuntary for 100% of the staff;of these, 62% had intentions of changing departments. Twenty-five percent had applied for a change of department, which was unsuccessful. Stress was expressed by 94% of the staff;93% thought that there was a solution to the stress experienced on a daily basis in the Oncology department. The main solutions proposed to manage this stress were: support for the staff, provision of work materials, and staff training. Conclusion: The nursing staff of the Medical Oncology Department of the Yaoundé General Hospital experiences a high level of stress and are in need of solutions.

Application of early enteral nutrition nursing based on enhanced recovery after surgery theory in patients with digestive surgery

BACKGROUND Postoperative nursing can improve the restlessness and gastrointestinal function of patients with tracheal intubation under general anesthesia in digestive surgery.Wide application of various nursing methods and routine nursing in periop-erative nursing of patients with general anesthesia in digestive surgery.AIM To investigate the impact of early postoperative enteral nutrition nursing based on the enhanced recovery after surgery(ERAS)theory on postoperative agitation and gastrointestinal recovery in patients undergoing general anesthesia that experienced tracheal intubation.METHODS The data of 126 patients with digestive surgery from May 2019 to February 2022 were retrospectively analyzed.According to different nursing methods,they were divided into control group and observation group,with 63 cases in observation group and 63 cases in control group.The patients in the control group had standard perioperative nursing care,whereas those in the observation group got enteral nourishment as soon as possible after surgery in accordance with ERAS theory.Both the rate and quality of gastrointestinal function recovery were compared between the two groups after treatment ended.Postoperative anes-thesia-related adverse events were tallied,patients'nutritional statuses were monitored,and the Riker sedation and agitation score(SAS)was used to measure the incidence of agitation.RESULTS When compared to the control group,the awake duration,spontaneous breathing recovery time,extubation time and postoperative eye-opening time were all considerably shorter(P<0.05).There was no significant difference in the recovery time of orientation force between the two groups(P>0.05);however,the observation group had a lower SAS score than the control group(P<0.05).The recovery time for normal intestinal sounds,the time it took to have the first postoperative exhaust,the time it took to have the first postoperative defecation,and the time it took to have the first postoperative half-fluid feeding were all faster in the observation group than in the control group(P<0.05);Fasting blood glucose was lower in the observation group compared to the control group(P<0.05),while the albumin and hemoglobin levels were higher on the first and third postoperative days;however,there was no statistically significant difference in the incidence of anesthesia-related adverse reactions between the two groups(P>0.05).CONCLUSION The extremely early postoperative enteral nutrition nursing based on ERAS theory can reduce the degree of agitation,improve the quality of recovery,promote the recovery of gastrointestinal function,and improve the nutritional status of patients in the recovery period after tracheal intubation under general anesthesia.

New Progress in the Cause Analysis and Nursing of Respiratory Tract Infection after Abdominal Surgery under General Anesthesia

This article provides a review of the causes of respiratory tract infection after abdominal surgery. These causes include general anesthesia, intubation factors, factors inherent to the patient, surgical factors, the injudicious use of antimicrobial agents, and the environmental factors of the ward. The perioperative management of the respiratory tract should be strengthened. Health education, respiratory function training, oral nursing intervention,atomization inhalation, and personalized expectoration methods should receive more attention to decrease the complications and promote the early rehabilitation of patients after abdominal surgery.

The Effects of Humanized Psychological Nursing Model in General Surgery Nursing

Objective:To analyze and comprehensively study the clinical effects of humanized psychological nursing model in general surgery nursing.Methods:The study period was from January 2018 to December 2020.A sample of 200 patients who were admitted to The Second People's Hospital of Taizhou City for general surgery were selected.Random lottery grouping was used to divide the subjects into a study group and a control group.The sample within each group was n=100.The patients in the control group were provided with conventional general surgery nursing plan whereas the patients in the study group received the same nursing plan but with addition of the humanized psychological nursing model.The indicators of the two groups were compared and analyzed.Results:Comparing the scores from Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)after nursing intervention,postoperative visual analog scale(VAS),hospital stay,and patient satisfaction with the nursing services between the two groups,the study group was better(P<0.05).Conclusion:The implementation of humanized psychological nursing model in general surgery nursing had a significant effect in which there were improvements in regard to the patientsJ mental state and their satisfaction with the nursing services.Hence,it is worthy of promotion.

The Department of Otolaryngology Head and Neck Surgery,PLA General Hospital (national key academic unit) The PLA Institute of Otolaryngology (PLA key laboratory for acoustic trauma) The PLA Medical College Department of Deafness Education Key Laboratory

Led by four generations of leadership from late Prof.JIANG Sichang(academician,Chinese Academy of Engineering),Prof.YANG Weiyan(Honorary President,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association),Prof.HAN Dongyi(President Elected,Division of Otolaryngology Head and Neck Surgery,Chinese Medical Association)to now Prof.YANG Shiming(President,Division of Otolaryngologists,

Volvulus of Colon Sigmoide in the General Surgery Department of Chu Gabriel Toure

Introduction: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion, it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion [1]. Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners [2]. Objective: To determine the hospital frequency of sigmoid colon volvulus;to write the clinical and para-clinical aspects of sigmoid colon volvulus;write down the different treatments used for the management of sigmoid colon volvulus. Material and methods: This was a retrospective and prospective study that took place from January 2008 to December 2020 in the General Surgery Department of Gabriel Touré. The retrospective phase ran from January 2008 to December 2019 and the prospective phase from January 2020 to December 2020. Results: From January 2008 to December 2020, we collected 320 cases of patients operated on for sigmoid colon volvulus out of 7989 surgical emergencies over a 12-year period, or 3.64%. In our study, the most represented age group was between 16 and 60 years old, i.e. 81.88%. The mean age was 42.6 ± 17.4 years with extremities of 16 and 90 years. The male sex was the most represented, 89% with a sex ratio of 8.41. The surgical history was found in 13.75% of our patients. The clinic was dominated by abdominal pain (100%), meteorism (100%), and gas and matter arrest (91.3%). The most common radiological image found in the ASP was the double jamb, i.e. 74.69% of cases. We found sigmoid necrosis in 18.13% of cases. We found an absence of necrosis in the majority of cases, i.e. 91.56%. The most performed operative procedure in our patients was the RACR, i.e. 75.63% of cases. The reoperation was performed in only 5.94% of our patients. Complications were grade V in 42.55% according to the Clavin Dindo classification.

Department of Otolaryngology Head and Neck Surgery of Chinese PLA General Hospital (National Key Discipline)

Institute of Otolaryngology of Chinese PLA ( Key Laboratory for the Prevention of Acoustic Trauma,PLA)Key Laboratory of Hearing Impairment Science(Chinese PLA Medical School)Ministry of Education Led by four generations of leadership from late Prof. JIANG Sichang (academician, Chinese Academy of Engineering), Prof.YANG Weiyan (Honorary President, Division of Otolaryngology

Day surgery in strabismus operation under general anesthesia

Background:The purpose of this study is to summarize the application of day surgery combined with fast track program in strabismus operation under general anesthesia.Methods:The clinical data of 2,000 cases of strabismus patients who had underwent surgery in day surgery or traditional hospitalization in the duration from 2015 to 2016 was retrospectively analyzed.The safety and efficacy were assessed by comparing the average length of stay in hospitals,anesthesia recovery time,patient satisfaction and number of adverse events.Results:Compared with the traditional group,the average length of stay in hospital and recovery time in day surgery group were significantly lower(P<0.001)and the satisfaction of patient was improved(P<0.05),which were statistically significant difference.Moreover,no adverse events occurred among these patients.Conclusions:The application of day surgery in strabismus operation under general anesthesia is feasible,which can reduce the recovery time and shorten the hospital stay of patients safely and effectively,and their satisfaction was improved at the same time.

Factors associated with refractory pain in emergency patients admitted to emergency general surgery

BACKGROUND: Oligoanalgesia in emergency departments (EDs) is multifactorial. A previousstudy reported that emergency providers did not adequately manage patients with severe paindespite objective findings for surgical pathologies. Our study aims to investigate clinical andlaboratory factors, in addition to providers’ interventions, that might have been associated witholigoanalgesia in a group of ED patients with moderate and severe pains due to surgical pathologies.METHODS: We conducted a retrospective study of adult patients who were transferred directlyfrom referring EDs to the emergency general surgery (EGS) service at a quaternary academic centerbetween January 2014 and December 2016. Patients who were intubated, did not have adequaterecords, or had mild pain were excluded. The primary outcome was refractory pain, which wasdefi ned as pain reduction <2 units on the 0–10 pain scale between triage and ED departure.RESULTS: We analyzed 200 patients, and 58 (29%) had refractory pain. Patients with refractory painhad signifi cantly higher disease severity, serum lactate (3.4±2.0 mg/dL vs. 1.4±0.9 mg/dL, P=0.001), and lessfrequent pain medication administration (median [interquartile range], 3 [3–5] vs. 4 [3–7], P=0.001), whencompared to patients with no refractory pain. Multivariable logistic regression showed that the number of painmedication administration (odds ratio [OR] 0.80, 95% confi dence interval [95% CI] 0.68–0.98) and ED serumlactate levels (OR 3.80, 95% CI 2.10–6.80) were signifi cantly associated with the likelihood of refractory pain.CONCLUSIONS: In ED patients transferring to EGS service, elevated serum lactate levelswere associated with a higher likelihood of refractory pain.

Developing an evidence-based and theory informed intervention to involve families in patients care after surgery: A quality improvement project

Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical patients.Methods: We used a quality improvement project following a multi-phase design.In Phase 1,an iterative method was used to combine evidence from a narrative review and professionals' preferences.In Phase 2,the logic model underlying the program was developed guided by four steps: (1) confirm situation,intervention aim,and target population;(2) documented expected outcomes,and outputs of the intervention;(3) identify and describe assumptions,external factors and inputs;and (4) confirm intervention components.Results: Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative review.In Phase 2,the logic model was developed and includes (1) the inputs (e.g.educational-and environmental support),(2) the ultimate outcomes (e.g.reduction of postoperative complications),(3) the intermediate outcomes (e.g.behavioural changes),and (4) immediate outcomes (e.g.improved knowledge,skills and attitude).Conclusions: We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards,and how we took different factors into account.The description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.

思维导图联合Mini-CEX在胸外科健康评估教学中的应用

目的探讨思维导图联合迷你临床演练评估在胸外科实习护生健康评估教学中的应用效果。方法方便取样法选取在胸外科实习的大专护生59人,按时间段分为对照组30人、观察组29人。对照组按常规实施临床带教;观察组采取思维导图联合迷你临床演练评估教学法实施临床带教。连续6周后评价效果。结果观察组批判性思维能力、健康评估能力及学习效果自我评价得分显著优于对照组(均P<0.05)。结论思维导图联合迷你临床演练评估教学法用于胸外科大专实习护生健康评估能力教学,可培养护生的批判性思维能力,提高健康评估的教学效果。

Implementation and evaluation of a pain management core competency education program for surgical nurses

Objective:To investigate the effect of a pain management core competency education program on surgical nurses’pain knowledge and pain management nursing practice behaviors.Methods:An 8-h education program focused on pain management core competency was provided twice in two weeks including the multidimensional nature of pain,pain assessment,pharmacological and nonpharmacological management,and knowledge application was developed and implemented for surgical nurses by a multidisciplinary team.Multimodal teaching approaches such as didactic teaching and vignettes of cases for nurses to discuss were used.The Clinical Pain Knowledge Test(CPKT)was completed by 135 and 107 nurses from 17 surgical wards pre and post-program,respectively.Two hundred and three patients’medical records were randomly sampled according to the number of operations in each ward one week before and in the fifth week after the intervention,respectively.Documentation of patients’postoperative pain management nursing practice behaviors and pain intensity scores were collected.Results:After the intervention,the CPKT scores of nurses significantly increased from 45.6%±12.3%to 54.2%±10.2%(t=5.786,P<0.001).Nurses’postoperative pain management nursing practice improved,with proportion of pain assessment documentation increased from 59.6%(121/203)to 74.9%(152/203)(χ^(2)=10.746,P=0.001),those using pain intensity assessment tools increased from 81.8%(99/121)to 95.4%(145/152)(χ^(2)=13.079,P<0.001),and intramuscular injection of nonopioids decreased from 12.6%(13/103)to 2.7%(3/111)(χ^(2)=7.598,P=0.006).Patients’average worst pain score on the operation day significantly decreased(Z=-2.486,P=0.013),and scores from the first to the third postoperative day also decreased(Z=-2.172,P=0.030).Conclusions:Implementation of a pain management core competency education program for surgical nurses can increase their knowledge of core competencies of pain management,improve selected pain management practices,and decrease patients’postoperative pain intensity.

情景模拟法在心内科护士心肺复苏教学中的应用效果

目的探讨在心内科护士心肺复苏(CPR)教学中采用情景模拟法的应用效果。方法选取2022年9月至2023年3月赣南医学院第一附属医院50名心内科护士作为研究对象,按照随机数字表法分为对照组(25例)与观察组(25例)。对照组采用常规培训方法,观察组采用情景模拟法。比较两组CPR能力、培训前后理论成绩、技能指标、复苏效率指标、对培训方式的评价情况。结果观察组CPR各项能力、理论成绩和各项操作技能指标、学习主动性、评判性以及发散性思维能力、独立解决问题能力、团队合作以及人际意识、表达以及沟通能力均高于对照组,差异有统计学意义(P<0.05);观察组复苏效率指标应用时间短于对照组,差异有统计学意义(P<0.05)。结论在心内科护士CPR教学中采用情景模拟法,能够提高护士的CPR能力和各项理论成绩与技能操作指标能力,具有良好的教学效果,值得临床推广。

自主教学模式在普外科护生肠造口护理中的教学效果评估分析

为评估与分析自主教学模式在普外科护生肠造口护理教学中的应用效果,选择于2022年10月到2023年3月在中国医科大学附属盛京医院普外科实习的92名护生作为研究对象,分为对照组和研究组,对照组采用传统教学模式,研究组采用自主教学模式,两组教学时间为3个月。教学实践表明,自主教学模式在普外科护生肠造口护理教学中应用能提高护生的学习成绩和批判性思维能力,促进其职业发展,并提高教学满意度。

门诊手术室护理干预手段应用于颌面外伤清创缝合术中的价值

目的探究门诊手术室护理在颌面外伤清创缝合术中的应用价值。方法单纯随机选取2021年7月—2023年7月滕州市中医医院收治的100例颌面外伤患者为研究对象,依据不同护理方法分为研究组和对照组,每组50例,研究组使用门诊手术室护理,对照组使用常规护理,分析两组患者情绪评分、视觉模拟疼痛评分(Visual Analogu Scale,VAS)、自我感受负担量表(Self-percrived Burden Scale,SPBS)评分、护理满意度等。结果研究组情绪评分低于对照组,差异有统计学意义(P<0.05)。研究组VAS评分低于对照组,差异有统计学意义(P<0.05)。研究组SPBS评分低于对照组,差异有统计学意义(P<0.05)。研究组护理满意度(98.00%)高于对照组(82.00%),差异有统计学意义(χ^(2)=7.111,P<0.05)。结论在临床进行颌面外伤清创缝合术治疗期间采用门诊手术室护理干预效果显著,能缓解患者颌面瘢痕程度,减少负性情绪状态。

观察复方雪药修复液对甲沟炎门诊拔甲术后患者临床疗效及睡眠质量的效果

目的:分析在甲沟炎门诊拔甲术患者护理过程中运用复方雪药修复液对术后愈合以及睡眠质量的影响。方法:选取2022年2月至2023年10月福建中医药大学附属第二人民医院普外科收治的门诊拔甲术患者76例作为研究对象,按照随机数字表法分为对照组和观察组,每组38例。对照组给予常规护理干预,观察组给予复方雪药修复液辅助护理干预。采用匹兹堡睡眠质量指数(PSQI)比较2组患者睡眠质量的差异,并比较2组患者的夜间觉醒次数、日平均睡眠时间、夜间最长连续睡眠时间,并比较2组患者的创面恢复情况,包括换药次数、结痂厚度、结痂时间、结痂脱落时间。结果:干预后,观察组PSQI评分显著低于对照组,观察组日平均睡眠时间、夜间最长连续睡眠时间显著长于对照组,观察组夜间觉醒次数显著低于对照组,观察组患者换药次数、结痂厚度、结痂时间均显著低于对照组,差异均有统计学意义(均P<0.05)。结论:对门诊拔甲术患者进行术后护理过程中,辅助使用复方雪药修复液可以降低换药次数、结痂厚度、结痂时间,提升患者术后睡眠质量,值得临床推广应用。

外科责任护士出院计划能力的潜在剖面分析及影响因素研究

目的探讨外科责任护士出院计划能力现状,分析其类别及人群特征。方法便利选取3所三级甲等医院的516名外科责任护士作为调查对象,采用一般资料调查表、责任护士出院计划能力量表、自我效能量表及职业认同感量表进行调查,对其出院计划能力进行潜在剖面分析,并通过单因素分析和logistic回归分析识别各类别的影响因素。结果外科责任护士出院计划能力分为3个类别:低能力组(24.23%)、中等能力组(49.22%)和高能力-达成共识组(26.55%)。logistic回归分析结果显示,外科责任护士年龄、工作年限、学历、是否参加过出院计划培训、自我效能感及职业认同感是出院计划能力潜在剖面类别的影响因素(均P<0.05)。结论外科责任护士出院计划能力存在异质性。护理管理者可根据不同类别的影响因素对外科责任护士进行个体化干预,以提高其整体出院计划能力。

手外科血管危象预防护理质量评价指标的构建及应用

目的构建手外科血管危象预防护理质量评价指标,并评价应用效果。方法以三维质量结构模式为理论框架,通过文献分析、半结构访谈及专家函询构建手外科血管危象预防护理质量评价指标。将200例单指断指再植或皮瓣移植患者按照入院时间分为对照组和观察组各100例,对照组给予常规护理,观察组根据构建的手外科血管危象预防护理质量评价指标进行护理。结果构建的手外科血管危象预防护理质量评价指标体系包含结构质量、过程质量、结果质量3项一级指标,10项二级指标及47项三级指标。质量评价指标应用后,观察组血管危象及时发现率、断指再植或移植皮瓣成活率及患者满意度评分显著高于对照组,患者血管危象发生率显著低于对照组(均P<0.05)。结论构建并应用手外科血管危象预防护理质量指标有利于及时发现血管危象,降低血管危象发生率,提高再植手指或移植皮瓣成活率及患者满意度。

弹性工作制联合带组护士管理模式在眼科日间手术中的应用效果

目的探讨弹性工作制联合带组护士管理模式在眼科日间手术中的应用效果。方法于2022年9月-2023年3月在某三甲医院眼科日间手术室实施弹性工作制联合带组护士管理模式,比较模式实施前后患者出院指导质量、手术取消率、不良事件发生率及护士职业认同感。结果实施弹性工作制联合带组护士管理模式后,患者出院指导质量总分和护士职业认同感总分均较实施前提升(P<0.05),患者手术取消率和不良事件发生率均较实施前有所下降(P<0.05)。结论弹性工作制联合带组护士管理模式能够提升患者出院指导质量,助力日间手术管理,提升护士职业认同感。

泌尿外科日间手术患者护理安全管理质量评价指标体系的构建

目的 构建基于Vincent患者安全因素框架的泌尿外科日间手术患者护理安全管理指标。方法 于2023年3-5月,采用Vincent患者安全因素框架作为结构框架,着重对泌尿外科日间手术护理安全进行研究。通过文献回顾法系统地收集、分类和汇总影响日间手术护理安全的各种因素。在确定指标的过程中采用层次分析法,对各个指标进行筛选并确定权重,建立泌尿外科日间手术护理安全管理指标体系。结果 本研究中2轮的权威系数(Cr)分别为0.863和0.895,说明专家具有较高的权威性;2轮专家协调系数表明专家意见的协调性较一致(P<0.001);对各指标进行权重赋值后,初步构建了包含组织管理因素、团队因素、环境因素、个人及工作任务因素、患者因素5个方面的泌尿外科日间手术护理安全管理指标体系,其包含5个一级指标、13个二级指标、42个三级指标。结论 构建的泌尿外科日间手术患者护理安全管理指标体系,明确影响患者安全的各级因素,并体现了以预防为主的护理安全管理理念,为保障泌尿外科日间手术患者安全和护理安全管理提供了量化评价标准和可靠的参考依据,值得在临床实践中推广和应用。