BACKGROUND Acute pancreatitis(AP),as a common acute abdomen disease,has a high incidence rate worldwide and is often accompanied by severe complications.Negative emotions lead to increased secretion of stress hormones...BACKGROUND Acute pancreatitis(AP),as a common acute abdomen disease,has a high incidence rate worldwide and is often accompanied by severe complications.Negative emotions lead to increased secretion of stress hormones,elevated blood sugar levels,and enhanced insulin resistance,which in turn increases the risk of AP and significantly affects the patient's quality of life.Therefore,exploring the intervention effects of narrative nursing programs on the negative emotions of patients with AP is not only helpful in alleviating psychological stress and improving quality of life but also has significant implications for improving disease outcomes and prognosis.AIM To construct a narrative nursing model for negative emotions in patients with AP and verify its efficacy in application.METHODS Through Delphi expert consultation,a narrative nursing model for negative emotions in patients with AP was constructed.A non-randomized quasi-experimental study design was used in this study.A total of 92 patients with AP with negative emotions admitted to a tertiary hospital in Nantong City of Jiangsu Province,China from September 2022 to August 2023 were recruited by convenience sampling,among whom 46 patients admitted from September 2022 to February 2023 were included in the observation group,and 46 patients from March to August 2023 were selected as control group.The observation group received narrative nursing plan,while the control group was given with routine nursing.Self-rating anxiety scale(SAS),self-rating depression scale(SDS),positive and negative affect scale(PANAS),caring behavior scale,patient satisfaction scale and 36-item short form health survey questionnaire(SF-36)were used to evaluate their emotions,satisfaction and caring behaviors in the two groups on the day of discharge,1-and 3-month following discharge.RESULTS According to the inclusion and exclusion criteria,a total of 45 cases in the intervention group and 44 cases in the control group eventually recruited and completed in the study.On the day of discharge,the intervention group showed significantly lower scores of SAS,SDS and negative emotion(28.57±4.52 vs 17.4±4.44,P<0.001),whereas evidently higher outcomes in the positive emotion score,Caring behavior scale score and satisfaction score compared to the control group(P<0.05).Repeated measurement analysis of variance showed that significant between-group differences were found in time effect,inter-group effect and interaction effect of SAS and PANAS scores as well as in time effect and inter-group effect of SF-36 scores(P<0.05);the SF-36 scores of two groups at 3 months after discharge were higher than those at 1 month after discharge(P<0.05).CONCLUSION The application of narrative nursing protocols has demonstrated significant effectiveness in alleviating anxiety,ameliorating negative emotions,and enhancing satisfaction among patients with AP.展开更多
BACKGROUND Severe acute pancreatitis(SAP)is a familiar critical disease in the intensive care unit(ICU)patients.Nursing staff are important spiritual pillars during the treatment of patients,and in addition to routine...BACKGROUND Severe acute pancreatitis(SAP)is a familiar critical disease in the intensive care unit(ICU)patients.Nursing staff are important spiritual pillars during the treatment of patients,and in addition to routine nursing,more attention needs be paid to the patient’s psychological changes.AIM To investigate the effects of psychological intervention in ICU patients with SAP.METHODS One hundred ICU patients with SAP were hospitalized in the authors’hospital between 2020 and 2023 were selected,and divided into observation and control groups per the hospitalization order.The control and observation groups received routine nursing and psychological interventions,respectively.Two groups are being compared,using the Self-rating Anxiety Scale(SAS),Self-Determination Scale(SDS),Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ,and 36-item Short Form Health Survey(SF-36)scores;nursing satisfaction of patients;ICU care duration;length of stay;hospitalization expenses;and the incidence of complications.RESULTS After nursing,the SDS,SAS,and APACHEⅡ scores in the experimental group were significantly lower than in the control group(P<0.05).The SF-36 scores in the observation group were significantly higher than those in the control group(P<0.05).The nursing satisfaction of patients in the experimental group was 94.5%,considerably higher than that of 75.6% in the control group(P<0.05).The ICU care duration,length of stay,and hospitalization expenses in the observation group were significantly lower than those in the control group,and the incidence of complications was lower(P<0.05).CONCLUSION For patients with SAP,the implementation of standardized psychological intervention measures can effectively alleviate adverse psychological conditions.展开更多
Objective:To study the role of nursing risk management in the prevention of post-ERCP pancreatitis.Methods:80 patients who underwent ERCP in our hospital from December 2023 to April 2024 were selected and randomly div...Objective:To study the role of nursing risk management in the prevention of post-ERCP pancreatitis.Methods:80 patients who underwent ERCP in our hospital from December 2023 to April 2024 were selected and randomly divided into an observation group and a control group using the random number table method,with 40 cases in each group.The observation group was given nursing risk management interventions and patients in the control group were given routine nursing interventions,and the patients in the two groups were compared in the incidence rate of pancreatitis and the satisfaction of nursing care.Results:The incidence of postoperative pancreatitis in the observation group was significantly lower than in the control group(P<0.05).The patient satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Nursing risk management after ERCP can reduce the incidence of postoperative pancreatitis and improve patient satisfaction.展开更多
Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis....Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis. Patients with severe acute pancreatitis who received treatment in our hospital were selected, from which 80 cases were chosen for detailed analysis. The patients were randomly grouped into a control group (conventional nursing care) and a study group (evidence-based nursing care), with 40 patients each. Relevant research data were recorded during the nursing process, analyzed, and used as research indicators. Results: The hospitalization time and morbidity and mortality rate of the research group were shorter than those of the control group, and the recovery rate was higher than that of the control group (P < 0.05). Patient satisfaction with nursing care in the observation group was higher than in the control group (P < 0.05). Conclusion: For patients with severe acute pancreatitis, the use of evidence-based nursing methods effectively reduced the patient’s mortality rate, improved its curative effect, and also shortened the patient’s hospitalization time.展开更多
BACKGROUND Acute pancreatitis(AP)is a common inflammatory disease of the pancreas with high mortality rates.It is of great significance to take scientific intervention measures for patients with AP in time.AIM To expl...BACKGROUND Acute pancreatitis(AP)is a common inflammatory disease of the pancreas with high mortality rates.It is of great significance to take scientific intervention measures for patients with AP in time.AIM To explore the effect of standardized nursing combined with mindfulness stress reduction training on the curative effect,negative emotion,and quality of life in patients with acute pancreatitis.METHODS A total of 80 patients with acute pancreatitis admitted to The First People's Hospital of Jiangxia District Hospital from May 2021 to May 2023 were randomly divided into control group and observation group(n=40).Patients in control group were given the standardized nursing intervention,and the observation group were given standardized nursing plus mindfulness stress reduction training intervention.The time of clinical symptom disappeared or improved,complication occurrence rate,emotional state,and quality of life score of the two groups were observed and compared.RESULTS In comparison with the control group,the bowel sound recovery time,ventosity and abdominal pain improvement time,and venting and cacation time in observation group were shorter,and the total incidence rate of complications was reduced,showing statistically significant difference(P<0.05).The scores of anxiety and depression in observation group were lower than those in control group(P<0.05).Serum levels of tumour necrosis factor alpha,interleukin(IL)-6,IL-1βand IL-8 in observation group were lower than those in control group(P<0.05).The scores of life quality in physiology,psychology,environment and social relations in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).CONCLUSION The application of standardized nursing intervention combined with mindfulness stress reduction training in patients with acute pancreatitis has a definite effect,which can help to ameliorate the clinical symptoms,anxiety and depression of patients,reduce the incidence rate of complications,and improve the prognosis of patients.展开更多
Objective:To explore and analyze the application value of nursing intervention for patients with pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP).Methods:From May 2022 to May 2023,100 patients w...Objective:To explore and analyze the application value of nursing intervention for patients with pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP).Methods:From May 2022 to May 2023,100 patients with pancreatitis after ERCP who were admitted to the General Surgery Department of our hospital were selected as the research objects,they were divided into a research group and a general group by flipping coins,with 50 cases in each group.The research group received nursing intervention,and the general group received general nursing.The postoperative index recovery time,quality of life,and emotional performance were compared between the two groups.Results:The blood amylase recovery time,abdominal pain recovery time,white blood cell recovery time,and hospitalization time in the research group were significantly lower than those in the general group(P<0.05).Before intervention,the physical function,social factors,physiological performance,emotional state,and other quality of life indicators were compared between the groups,and there was no statistically significant difference(P>0.05);after intervention,the mentioned quality of life indicators were significantly better than that of the general group(P<0.05).Before intervention,the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores between the groups were compared,and there was no statistically significant difference(P>0.05);after intervention,the SAS and SDS scores of the research group were significantly better than those of the general group(P<0.05).Conclusion:The application of nursing intervention in patients with pancreatitis after ERCP has high clinical value and specific practical significance.展开更多
Severe gallstone pancreatitis(GSP)refractory to maximum conservative therapy has wide clinical variations,and its pathophysiology remains controversial.This Editorial aimed to investigate the pathophysiology of severe...Severe gallstone pancreatitis(GSP)refractory to maximum conservative therapy has wide clinical variations,and its pathophysiology remains controversial.This Editorial aimed to investigate the pathophysiology of severe disease based on Opie’s theories of obstruction,the common channel,and duodenal reflux and describe its types.Severe GSP might be a hybrid disease with pathology polarized between acute cholangitis with mild pancreatitis(biliary type)and necrotizing pancreatitis uncomplicated with biliary tract disease(pancreatic type),in which hepatobiliary and pancreatic lesion severity is inversely related to the presence or absence of impacted ampullary stones.Severe GSP is caused by stones that are persistently impacted at the ampulla with biliopancreatic obstruction(biliary type),and probably,stones that are either temporarily lodged at the duodenal orifice or passed into the duodenum,thereby permitting reflux of bile or possible duodenal contents into the pancreas(pancreas type).When the status of the stones and the presence or absence of impacted ampullary stones with biliopancreatic obstruction are determined,the clinical course and outcome can be predicted.Gallstones represent the main cause of acute pancreatitis globally,and clinicians are expected to encounter GSP more often.Awareness of the etiology and pathogenesis of severe disease is mandatory.展开更多
Autoimmune pancreatitis(AIP)is an autoimmune subtype of chronic pancreatitis resulting from the aberrant immune response against the pancreas,leading to inflammation and fibrosis.Although AIP is rare,its incidence is ...Autoimmune pancreatitis(AIP)is an autoimmune subtype of chronic pancreatitis resulting from the aberrant immune response against the pancreas,leading to inflammation and fibrosis.Although AIP is rare,its incidence is increasing and is often misdiagnosed as other pancreatic diseases.AIP is commonly classified into two types.Type 1 AIP(AIP-1)is typically associated with elevated serum immunoglobulin G4(IgG4)levels and systemic manifestations,while type 2 AIP is typically a more localized form of the disease,and may coexist with other autoimmune disorders,especially inflammatory bowel diseases.Additionally,there is emerging recognition of a third type(type 3 AIP),which refers to immunotherapy-triggered AIP,although this classification is still gaining acceptance in medical literature.The clinical manifestations of AIP mainly include painless jaundice and weight loss.Elevated serum IgG4 levels are particularly characteristic of AIP-1.Diagnosis relies on a combination of clinical,laboratory,radiological,and histological findings,given the similarity of AIP symptoms to other pancreatic disorders.The mainstay of treatment for AIP is steroid therapy,which is effective in most cases.Severe cases might require additional imm-unosuppressive agents.This review aims to summarize the current knowledge of AIP,encompassing its epidemiology,etiology,clinical presentation,diagnosis,and treatment options.We also address the challenges and controversies in diagnosing and treating AIP,such as distinguishing it from pancreatic cancer and managing long-term treatment,highlighting the need for increased awareness and knowledge of this complex disease.展开更多
Acute pancreatitis is a common systemic inflammatory disease, manifested by a spectrum of severity, ranging from mild in the majority of patients to severe acute pancreatitis. Patients with severe acute pancreatitis s...Acute pancreatitis is a common systemic inflammatory disease, manifested by a spectrum of severity, ranging from mild in the majority of patients to severe acute pancreatitis. Patients with severe acute pancreatitis suffer from severe local and systemic complications and organ failure, leading to a poor prognosis. The early recognition of the severe condition is important to improve prognosis. Obesity has risen in tandem with an increase in the severity of acute pancreatitis in recent years. Studies have revealed that adipose tissue, particularly visceral adipose tissue is associated with the prognosis of acute pancreatitis. This review discussed the role of visceral adipose tissue in obese patients with acute pancreatitis and explored the possible mechanism involved.展开更多
Background:A high prevalence of diabetes mellitus(DM)coexisting with autoimmune pancreatitis(AIP)is observed.However,evidence on the circumstances under which corticosteroid therapy(CST)for AIP improves or worsens DM ...Background:A high prevalence of diabetes mellitus(DM)coexisting with autoimmune pancreatitis(AIP)is observed.However,evidence on the circumstances under which corticosteroid therapy(CST)for AIP improves or worsens DM is scarce.This study aimed to demonstrate and identify predictors of DM control under the influence of CST.Methods:Patients diagnosed with type 1 AIP were enrolled from a prospectively maintained cohort and were classified into three groups according to the chronology in which AIP and DM were diagnosed:pre-existing DM(pDM),concurrent DM(cDM),and non-DM(nDM).The responses of DM to CST were assessed when corticosteroid was ceased or tapered to a maintenance dose and classified as‘improvement’and‘non-improvement’(including‘no change’and‘exacerbation’).Results:Among 101 patients with type 1 AIP,52(51.5%)patients were complicated with DM at the time of AIP diagnosis,with 36 patients in the cDM group and 16 patients in the pDM group.The incidences of diffuse pancreatic swelling(72.2%)and pancreatic body/tail involvement(91.7%)were significantly higher in the cDM group than in both the pDM and nDM groups.Of the 52 patients with DM,CST was administered in 48 cases.Multivariate logistic analysis identified that elevated serum gamma-glutamyl transferase(GGT)level at AIP diagnosis[odds ratio(OR)=0.032,95%confidence interval(CI):0.003-0.412,P=0.008]and pancreatic atrophy after CST(OR=0.027,95%CI:0.003-0.295,P=0.003)were negatively associated with DM control improvement.Conclusions:Patients with diffuse pancreatic swelling and pancreatic body/tail involvement in pancreatitis tended to be complicated with cDM at AIP diagnosis.CST exerted a beneficial effect on the clinical course of DM in nearly half of the AIP patients complicated with DM at diagnosis,particularly in those without elevated serum GGT levels at diagnosis and who did not experience pancreatic atrophy after CST.展开更多
In this editorial we comment on the article by Jaber et al.Autoimmune pancreatitis(AIP)represents a distinct form of pancreatitis,categorized into AIP-1 and AIP-2,characterized by obstructive jaundice,lymphoplasmacyti...In this editorial we comment on the article by Jaber et al.Autoimmune pancreatitis(AIP)represents a distinct form of pancreatitis,categorized into AIP-1 and AIP-2,characterized by obstructive jaundice,lymphoplasmacytic infiltrate,and fibrosis.AIP-1,associated with elevated immunoglobulin G4(IgG4)levels,exhibits higher relapse rates,affecting older males,while AIP-2 is less common and linked to inflammatory bowel disease.AIP is considered a manifestation of IgG4-related systemic disease,sharing characteristic histological findings.Steroids are the primary treatment,with emerging biomarkers like interferon alpha and inter-leukin-33.AIP poses an increased risk of various malignancies,and the assoc-iation with pancreatic cancer is debated.Surgery is reserved for severe cases,necessitating careful evaluation due to diagnostic challenges.AIP patients may have concurrent PanINs but display favorable long-term outcomes compared to pancreatic cancer patients.Thorough diagnostic assessment,including biopsy and steroid response,is crucial for informed surgical decisions in AIP.展开更多
Severe acute pancreatitis(SAP)is a serious systemic disease associated with strong local inflammatory reactions and serious systemic pathophysiological disorders caused by trypsin spillover.Patients with SAP are prone...Severe acute pancreatitis(SAP)is a serious systemic disease associated with strong local inflammatory reactions and serious systemic pathophysiological disorders caused by trypsin spillover.Patients with SAP are prone to exhibit gastrointestinal dysfunction.Meanwhile,gastrointestinal dysfunction further aggravates the systemic inflammatory response and metabolic abnormalities,resulting in a more critical condition of SAP.Gastrointestinal dysfunction is considered to be the“trigger”of multiple organ dysfunction syndrome[1].Thus,it is important to maintain gastrointestinal homeostasis in the treatment of SAP.展开更多
Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes...Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes is unknown.This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients.Methods:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were screened.The primary outcome was 90-day readmission after discharge.Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission.Results:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did not.Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,P<0.01]and lower 90-day readmission with an RR of 0.61(95%CI:0.41-0.91,P=0.02)than those who did not.For the quality of life,patients who received early SAC had a significantly higher score in the subscale of vitality(P=0.03)while the other subscales were all comparable between the two groups.Multivariable Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjusting for potential confounders with a hazard ratio of 0.57(95%CI:0.34-0.96,P=0.04).Mediation analysis showed that SVT mediated 37.0%of the early SAC-90-day readmission causality.Conclusions:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.展开更多
BACKGROUND Hypertensive cerebral hemorrhage(HCH),the most common chronic diseases,has become a topic of global public health discussions.AIM To investigate the role of rehabilitative nursing interventions in optimizin...BACKGROUND Hypertensive cerebral hemorrhage(HCH),the most common chronic diseases,has become a topic of global public health discussions.AIM To investigate the role of rehabilitative nursing interventions in optimizing the postoperative mental status recovery phase and to provide clinical value for future rehabilitation of patients with HCH.METHODS This randomized controlled study included 120 patients with cerebral HCH who were contained to our neurosurgery department between May 2021–May 2023 as the participants.The participants have randomly sampled and grouped into the observation and control groups.The observation group received the rehabilitation nursing model,whereas the control group have given conventional nursing.The conscious state of the patients was assessed at 7,14,21,and 30 d postoperatively.After one month of care,sleep quality,anxiety,and depression were compared between the two groups.Patient and family satisfaction were assessed using a nursing care model.RESULTS The results showed that the state of consciousness scores of the patients in both groups significantly increased(P<0.05)after surgical treatment.From the 14th day onwards,differences in the state of consciousness scores between the two groups of patients began to appear(P<0.05).After one month of care,the sleep quality,anxiety state,and depression state of patients were significantly better in the observation group than in the control group(P<0.05).Satisfaction with nursing care was higher in the observation group than in the control group(P<0.05).CONCLUSION The rehabilitation nursing model has a more complete system compared to conventional nursing,which can effectively improve the postoperative quality of life of patients with cerebral hemorrhage and improve the efficiency of mental state recovery;however,further analysis and research are needed to provide more scientific evidence.展开更多
BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,th...BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.展开更多
BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglect...BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.展开更多
BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stro...BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stroke cases.AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021.The participants were divided into two groups,namely the control group(n=80)receiving routine care and the research group(n=92)receiving comprehensive care.Various assessment scales,including the standard swallowing function assessment scale(SSA),National Institutes of Health Stroke scale(NIHSS),European stroke scale(ESS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Barthel index(BI),and the motor func-tion assessment scale(MAS),were employed to evaluate the improvement in swallowing function,neurological deficits,clinical outcomes,anxiety,depression,daily living activities,and motor function before and after care.Furthermore,the study compared the occurrence of adverse reactions during the nursing period,life quality before and after the intervention,rehabilitation compliance,and nursing satisfaction between the two groups.RESULTS After the nursing intervention,the research group exhibited significantly improved SSA and NIHSS scores compared to the control group(P<0.05).Moreover,both groups demonstrated significant reductions in SAS and SDS scores(P<0.05),with the research group showing more obvious advantages(P<0.05).Compared to the control group,the research group displayed significantly better ESS,BI,and MAS scores(P<0.05),coupled with a lower incidence of adverse reactions(P<0.05).Additionally,the research group demonstrated markedly higher levels of life quality,rehabilitation compliance,and nursing satisfaction compared to the control group(P<0.05).CONCLUSION Comprehensive nursing effectively improved swallowing function,quality of life,and patient satisfaction,high-lighting its clinical significance.展开更多
BACKGROUND Radical surgery is a preferred treatment for colorectal carcinoma,wherein nursing intervention is essential for postoperative recovery and prevention of complications.Recently,the application of humanistic ...BACKGROUND Radical surgery is a preferred treatment for colorectal carcinoma,wherein nursing intervention is essential for postoperative recovery and prevention of complications.Recently,the application of humanistic care in medical care has attracted attention.Humanistic care emphasizes comprehensive care,with importance attached to patients’physical needs as well as psychological and emotional support to provide more humane and personalized care services.However,no clinical reports have examined the use of humanistic care in patients undergoing radical surgery for colorectal carcinoma.AIM To investigate the influence of humanistic care-based operating room nursing on the safety,postoperative recovery,and nursing satisfaction of patients who have undergone radical surgery for colorectal carcinoma.METHODS In total,120 patients with rectal cancer who underwent surgery in Zhongnan Hospital of Wuhan University between August 2023 and March 2024 were selected and grouped based on the nursing methods employed.Of these patients,55 were treated with routine nursing intervention(control group)and 65 were provided humanistic care-based operating room nursing(research group).The patients’vital signs were recorded,including systolic/diastolic blood pressure(SBP/DBP)and heart beats per minute(BPM),as well as serum stress indices,including norepinephrine(NE),adrenal hormone(AD),and cortisol(Cor).Postoperative recovery and complications were also recorded.Patients’negative emotions,life hope,and nursing satisfaction were evaluated using the Self-rating Depression/Anxiety Scale(SDS/SAS),Herth Hope Index(HHI),and self-deve-loped nursing satisfaction questionnaire,respectively.RESULTS During emergence from anesthesia,SBP,DBP,and BPM levels were found to be lower in the research group than those in the control group,also serum Cor,AD,and NE levels were lower.In addition,the research group had shorter operative,awakening,anal exhaust,first postoperative ambulation,drainage tube removal,intestinal recovery,and hospital times.The total complication rate and the SDS and SAS scores were lower in the research group than those in the control group.The HHI and nursing satisfaction scores were higher in the research group.CONCLUSION Humanistic care-based operating room nursing can mitigate physiological stress responses,reduce postoperative complications,promote postoperative recovery,relieve adverse psychological emotions,and enhance life hope and nursing satisfaction in patients undergoing radical surgery for colorectal carcinoma,which can be popularized in clinical practice.展开更多
BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to impr...BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.展开更多
Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 ...Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.展开更多
文摘BACKGROUND Acute pancreatitis(AP),as a common acute abdomen disease,has a high incidence rate worldwide and is often accompanied by severe complications.Negative emotions lead to increased secretion of stress hormones,elevated blood sugar levels,and enhanced insulin resistance,which in turn increases the risk of AP and significantly affects the patient's quality of life.Therefore,exploring the intervention effects of narrative nursing programs on the negative emotions of patients with AP is not only helpful in alleviating psychological stress and improving quality of life but also has significant implications for improving disease outcomes and prognosis.AIM To construct a narrative nursing model for negative emotions in patients with AP and verify its efficacy in application.METHODS Through Delphi expert consultation,a narrative nursing model for negative emotions in patients with AP was constructed.A non-randomized quasi-experimental study design was used in this study.A total of 92 patients with AP with negative emotions admitted to a tertiary hospital in Nantong City of Jiangsu Province,China from September 2022 to August 2023 were recruited by convenience sampling,among whom 46 patients admitted from September 2022 to February 2023 were included in the observation group,and 46 patients from March to August 2023 were selected as control group.The observation group received narrative nursing plan,while the control group was given with routine nursing.Self-rating anxiety scale(SAS),self-rating depression scale(SDS),positive and negative affect scale(PANAS),caring behavior scale,patient satisfaction scale and 36-item short form health survey questionnaire(SF-36)were used to evaluate their emotions,satisfaction and caring behaviors in the two groups on the day of discharge,1-and 3-month following discharge.RESULTS According to the inclusion and exclusion criteria,a total of 45 cases in the intervention group and 44 cases in the control group eventually recruited and completed in the study.On the day of discharge,the intervention group showed significantly lower scores of SAS,SDS and negative emotion(28.57±4.52 vs 17.4±4.44,P<0.001),whereas evidently higher outcomes in the positive emotion score,Caring behavior scale score and satisfaction score compared to the control group(P<0.05).Repeated measurement analysis of variance showed that significant between-group differences were found in time effect,inter-group effect and interaction effect of SAS and PANAS scores as well as in time effect and inter-group effect of SF-36 scores(P<0.05);the SF-36 scores of two groups at 3 months after discharge were higher than those at 1 month after discharge(P<0.05).CONCLUSION The application of narrative nursing protocols has demonstrated significant effectiveness in alleviating anxiety,ameliorating negative emotions,and enhancing satisfaction among patients with AP.
文摘BACKGROUND Severe acute pancreatitis(SAP)is a familiar critical disease in the intensive care unit(ICU)patients.Nursing staff are important spiritual pillars during the treatment of patients,and in addition to routine nursing,more attention needs be paid to the patient’s psychological changes.AIM To investigate the effects of psychological intervention in ICU patients with SAP.METHODS One hundred ICU patients with SAP were hospitalized in the authors’hospital between 2020 and 2023 were selected,and divided into observation and control groups per the hospitalization order.The control and observation groups received routine nursing and psychological interventions,respectively.Two groups are being compared,using the Self-rating Anxiety Scale(SAS),Self-Determination Scale(SDS),Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ,and 36-item Short Form Health Survey(SF-36)scores;nursing satisfaction of patients;ICU care duration;length of stay;hospitalization expenses;and the incidence of complications.RESULTS After nursing,the SDS,SAS,and APACHEⅡ scores in the experimental group were significantly lower than in the control group(P<0.05).The SF-36 scores in the observation group were significantly higher than those in the control group(P<0.05).The nursing satisfaction of patients in the experimental group was 94.5%,considerably higher than that of 75.6% in the control group(P<0.05).The ICU care duration,length of stay,and hospitalization expenses in the observation group were significantly lower than those in the control group,and the incidence of complications was lower(P<0.05).CONCLUSION For patients with SAP,the implementation of standardized psychological intervention measures can effectively alleviate adverse psychological conditions.
文摘Objective:To study the role of nursing risk management in the prevention of post-ERCP pancreatitis.Methods:80 patients who underwent ERCP in our hospital from December 2023 to April 2024 were selected and randomly divided into an observation group and a control group using the random number table method,with 40 cases in each group.The observation group was given nursing risk management interventions and patients in the control group were given routine nursing interventions,and the patients in the two groups were compared in the incidence rate of pancreatitis and the satisfaction of nursing care.Results:The incidence of postoperative pancreatitis in the observation group was significantly lower than in the control group(P<0.05).The patient satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Nursing risk management after ERCP can reduce the incidence of postoperative pancreatitis and improve patient satisfaction.
文摘Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis. Patients with severe acute pancreatitis who received treatment in our hospital were selected, from which 80 cases were chosen for detailed analysis. The patients were randomly grouped into a control group (conventional nursing care) and a study group (evidence-based nursing care), with 40 patients each. Relevant research data were recorded during the nursing process, analyzed, and used as research indicators. Results: The hospitalization time and morbidity and mortality rate of the research group were shorter than those of the control group, and the recovery rate was higher than that of the control group (P < 0.05). Patient satisfaction with nursing care in the observation group was higher than in the control group (P < 0.05). Conclusion: For patients with severe acute pancreatitis, the use of evidence-based nursing methods effectively reduced the patient’s mortality rate, improved its curative effect, and also shortened the patient’s hospitalization time.
文摘BACKGROUND Acute pancreatitis(AP)is a common inflammatory disease of the pancreas with high mortality rates.It is of great significance to take scientific intervention measures for patients with AP in time.AIM To explore the effect of standardized nursing combined with mindfulness stress reduction training on the curative effect,negative emotion,and quality of life in patients with acute pancreatitis.METHODS A total of 80 patients with acute pancreatitis admitted to The First People's Hospital of Jiangxia District Hospital from May 2021 to May 2023 were randomly divided into control group and observation group(n=40).Patients in control group were given the standardized nursing intervention,and the observation group were given standardized nursing plus mindfulness stress reduction training intervention.The time of clinical symptom disappeared or improved,complication occurrence rate,emotional state,and quality of life score of the two groups were observed and compared.RESULTS In comparison with the control group,the bowel sound recovery time,ventosity and abdominal pain improvement time,and venting and cacation time in observation group were shorter,and the total incidence rate of complications was reduced,showing statistically significant difference(P<0.05).The scores of anxiety and depression in observation group were lower than those in control group(P<0.05).Serum levels of tumour necrosis factor alpha,interleukin(IL)-6,IL-1βand IL-8 in observation group were lower than those in control group(P<0.05).The scores of life quality in physiology,psychology,environment and social relations in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).CONCLUSION The application of standardized nursing intervention combined with mindfulness stress reduction training in patients with acute pancreatitis has a definite effect,which can help to ameliorate the clinical symptoms,anxiety and depression of patients,reduce the incidence rate of complications,and improve the prognosis of patients.
文摘Objective:To explore and analyze the application value of nursing intervention for patients with pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP).Methods:From May 2022 to May 2023,100 patients with pancreatitis after ERCP who were admitted to the General Surgery Department of our hospital were selected as the research objects,they were divided into a research group and a general group by flipping coins,with 50 cases in each group.The research group received nursing intervention,and the general group received general nursing.The postoperative index recovery time,quality of life,and emotional performance were compared between the two groups.Results:The blood amylase recovery time,abdominal pain recovery time,white blood cell recovery time,and hospitalization time in the research group were significantly lower than those in the general group(P<0.05).Before intervention,the physical function,social factors,physiological performance,emotional state,and other quality of life indicators were compared between the groups,and there was no statistically significant difference(P>0.05);after intervention,the mentioned quality of life indicators were significantly better than that of the general group(P<0.05).Before intervention,the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores between the groups were compared,and there was no statistically significant difference(P>0.05);after intervention,the SAS and SDS scores of the research group were significantly better than those of the general group(P<0.05).Conclusion:The application of nursing intervention in patients with pancreatitis after ERCP has high clinical value and specific practical significance.
文摘Severe gallstone pancreatitis(GSP)refractory to maximum conservative therapy has wide clinical variations,and its pathophysiology remains controversial.This Editorial aimed to investigate the pathophysiology of severe disease based on Opie’s theories of obstruction,the common channel,and duodenal reflux and describe its types.Severe GSP might be a hybrid disease with pathology polarized between acute cholangitis with mild pancreatitis(biliary type)and necrotizing pancreatitis uncomplicated with biliary tract disease(pancreatic type),in which hepatobiliary and pancreatic lesion severity is inversely related to the presence or absence of impacted ampullary stones.Severe GSP is caused by stones that are persistently impacted at the ampulla with biliopancreatic obstruction(biliary type),and probably,stones that are either temporarily lodged at the duodenal orifice or passed into the duodenum,thereby permitting reflux of bile or possible duodenal contents into the pancreas(pancreas type).When the status of the stones and the presence or absence of impacted ampullary stones with biliopancreatic obstruction are determined,the clinical course and outcome can be predicted.Gallstones represent the main cause of acute pancreatitis globally,and clinicians are expected to encounter GSP more often.Awareness of the etiology and pathogenesis of severe disease is mandatory.
文摘Autoimmune pancreatitis(AIP)is an autoimmune subtype of chronic pancreatitis resulting from the aberrant immune response against the pancreas,leading to inflammation and fibrosis.Although AIP is rare,its incidence is increasing and is often misdiagnosed as other pancreatic diseases.AIP is commonly classified into two types.Type 1 AIP(AIP-1)is typically associated with elevated serum immunoglobulin G4(IgG4)levels and systemic manifestations,while type 2 AIP is typically a more localized form of the disease,and may coexist with other autoimmune disorders,especially inflammatory bowel diseases.Additionally,there is emerging recognition of a third type(type 3 AIP),which refers to immunotherapy-triggered AIP,although this classification is still gaining acceptance in medical literature.The clinical manifestations of AIP mainly include painless jaundice and weight loss.Elevated serum IgG4 levels are particularly characteristic of AIP-1.Diagnosis relies on a combination of clinical,laboratory,radiological,and histological findings,given the similarity of AIP symptoms to other pancreatic disorders.The mainstay of treatment for AIP is steroid therapy,which is effective in most cases.Severe cases might require additional imm-unosuppressive agents.This review aims to summarize the current knowledge of AIP,encompassing its epidemiology,etiology,clinical presentation,diagnosis,and treatment options.We also address the challenges and controversies in diagnosing and treating AIP,such as distinguishing it from pancreatic cancer and managing long-term treatment,highlighting the need for increased awareness and knowledge of this complex disease.
文摘Acute pancreatitis is a common systemic inflammatory disease, manifested by a spectrum of severity, ranging from mild in the majority of patients to severe acute pancreatitis. Patients with severe acute pancreatitis suffer from severe local and systemic complications and organ failure, leading to a poor prognosis. The early recognition of the severe condition is important to improve prognosis. Obesity has risen in tandem with an increase in the severity of acute pancreatitis in recent years. Studies have revealed that adipose tissue, particularly visceral adipose tissue is associated with the prognosis of acute pancreatitis. This review discussed the role of visceral adipose tissue in obese patients with acute pancreatitis and explored the possible mechanism involved.
基金from CAMS Innovation Fund for Medical Sciences(CIFMS)(2021-I2M-1-002)National Key Clinical Specialty Construction Project(ZK108000)+1 种基金National High-Level Hospital Clinical Research Funding(2022-PUMCH-B-024)National Natural Science Foundation of China,Joint Fund Project(U20A600).
文摘Background:A high prevalence of diabetes mellitus(DM)coexisting with autoimmune pancreatitis(AIP)is observed.However,evidence on the circumstances under which corticosteroid therapy(CST)for AIP improves or worsens DM is scarce.This study aimed to demonstrate and identify predictors of DM control under the influence of CST.Methods:Patients diagnosed with type 1 AIP were enrolled from a prospectively maintained cohort and were classified into three groups according to the chronology in which AIP and DM were diagnosed:pre-existing DM(pDM),concurrent DM(cDM),and non-DM(nDM).The responses of DM to CST were assessed when corticosteroid was ceased or tapered to a maintenance dose and classified as‘improvement’and‘non-improvement’(including‘no change’and‘exacerbation’).Results:Among 101 patients with type 1 AIP,52(51.5%)patients were complicated with DM at the time of AIP diagnosis,with 36 patients in the cDM group and 16 patients in the pDM group.The incidences of diffuse pancreatic swelling(72.2%)and pancreatic body/tail involvement(91.7%)were significantly higher in the cDM group than in both the pDM and nDM groups.Of the 52 patients with DM,CST was administered in 48 cases.Multivariate logistic analysis identified that elevated serum gamma-glutamyl transferase(GGT)level at AIP diagnosis[odds ratio(OR)=0.032,95%confidence interval(CI):0.003-0.412,P=0.008]and pancreatic atrophy after CST(OR=0.027,95%CI:0.003-0.295,P=0.003)were negatively associated with DM control improvement.Conclusions:Patients with diffuse pancreatic swelling and pancreatic body/tail involvement in pancreatitis tended to be complicated with cDM at AIP diagnosis.CST exerted a beneficial effect on the clinical course of DM in nearly half of the AIP patients complicated with DM at diagnosis,particularly in those without elevated serum GGT levels at diagnosis and who did not experience pancreatic atrophy after CST.
文摘In this editorial we comment on the article by Jaber et al.Autoimmune pancreatitis(AIP)represents a distinct form of pancreatitis,categorized into AIP-1 and AIP-2,characterized by obstructive jaundice,lymphoplasmacytic infiltrate,and fibrosis.AIP-1,associated with elevated immunoglobulin G4(IgG4)levels,exhibits higher relapse rates,affecting older males,while AIP-2 is less common and linked to inflammatory bowel disease.AIP is considered a manifestation of IgG4-related systemic disease,sharing characteristic histological findings.Steroids are the primary treatment,with emerging biomarkers like interferon alpha and inter-leukin-33.AIP poses an increased risk of various malignancies,and the assoc-iation with pancreatic cancer is debated.Surgery is reserved for severe cases,necessitating careful evaluation due to diagnostic challenges.AIP patients may have concurrent PanINs but display favorable long-term outcomes compared to pancreatic cancer patients.Thorough diagnostic assessment,including biopsy and steroid response,is crucial for informed surgical decisions in AIP.
文摘Severe acute pancreatitis(SAP)is a serious systemic disease associated with strong local inflammatory reactions and serious systemic pathophysiological disorders caused by trypsin spillover.Patients with SAP are prone to exhibit gastrointestinal dysfunction.Meanwhile,gastrointestinal dysfunction further aggravates the systemic inflammatory response and metabolic abnormalities,resulting in a more critical condition of SAP.Gastrointestinal dysfunction is considered to be the“trigger”of multiple organ dysfunction syndrome[1].Thus,it is important to maintain gastrointestinal homeostasis in the treatment of SAP.
基金supported by grants from the National Natural Science Foundation of China (82070665 and 81900592)
文摘Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes is unknown.This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients.Methods:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were screened.The primary outcome was 90-day readmission after discharge.Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission.Results:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did not.Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,P<0.01]and lower 90-day readmission with an RR of 0.61(95%CI:0.41-0.91,P=0.02)than those who did not.For the quality of life,patients who received early SAC had a significantly higher score in the subscale of vitality(P=0.03)while the other subscales were all comparable between the two groups.Multivariable Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjusting for potential confounders with a hazard ratio of 0.57(95%CI:0.34-0.96,P=0.04).Mediation analysis showed that SVT mediated 37.0%of the early SAC-90-day readmission causality.Conclusions:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.
文摘BACKGROUND Hypertensive cerebral hemorrhage(HCH),the most common chronic diseases,has become a topic of global public health discussions.AIM To investigate the role of rehabilitative nursing interventions in optimizing the postoperative mental status recovery phase and to provide clinical value for future rehabilitation of patients with HCH.METHODS This randomized controlled study included 120 patients with cerebral HCH who were contained to our neurosurgery department between May 2021–May 2023 as the participants.The participants have randomly sampled and grouped into the observation and control groups.The observation group received the rehabilitation nursing model,whereas the control group have given conventional nursing.The conscious state of the patients was assessed at 7,14,21,and 30 d postoperatively.After one month of care,sleep quality,anxiety,and depression were compared between the two groups.Patient and family satisfaction were assessed using a nursing care model.RESULTS The results showed that the state of consciousness scores of the patients in both groups significantly increased(P<0.05)after surgical treatment.From the 14th day onwards,differences in the state of consciousness scores between the two groups of patients began to appear(P<0.05).After one month of care,the sleep quality,anxiety state,and depression state of patients were significantly better in the observation group than in the control group(P<0.05).Satisfaction with nursing care was higher in the observation group than in the control group(P<0.05).CONCLUSION The rehabilitation nursing model has a more complete system compared to conventional nursing,which can effectively improve the postoperative quality of life of patients with cerebral hemorrhage and improve the efficiency of mental state recovery;however,further analysis and research are needed to provide more scientific evidence.
基金the Research Project of the Jiangyin Municipal Health Commission,No.G202008。
文摘BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.
文摘BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.
基金This study was approved by the Ethics Committee of Hengyang Maternal and Child Health Hospital(No.202001151).
文摘BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stroke cases.AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021.The participants were divided into two groups,namely the control group(n=80)receiving routine care and the research group(n=92)receiving comprehensive care.Various assessment scales,including the standard swallowing function assessment scale(SSA),National Institutes of Health Stroke scale(NIHSS),European stroke scale(ESS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Barthel index(BI),and the motor func-tion assessment scale(MAS),were employed to evaluate the improvement in swallowing function,neurological deficits,clinical outcomes,anxiety,depression,daily living activities,and motor function before and after care.Furthermore,the study compared the occurrence of adverse reactions during the nursing period,life quality before and after the intervention,rehabilitation compliance,and nursing satisfaction between the two groups.RESULTS After the nursing intervention,the research group exhibited significantly improved SSA and NIHSS scores compared to the control group(P<0.05).Moreover,both groups demonstrated significant reductions in SAS and SDS scores(P<0.05),with the research group showing more obvious advantages(P<0.05).Compared to the control group,the research group displayed significantly better ESS,BI,and MAS scores(P<0.05),coupled with a lower incidence of adverse reactions(P<0.05).Additionally,the research group demonstrated markedly higher levels of life quality,rehabilitation compliance,and nursing satisfaction compared to the control group(P<0.05).CONCLUSION Comprehensive nursing effectively improved swallowing function,quality of life,and patient satisfaction,high-lighting its clinical significance.
文摘BACKGROUND Radical surgery is a preferred treatment for colorectal carcinoma,wherein nursing intervention is essential for postoperative recovery and prevention of complications.Recently,the application of humanistic care in medical care has attracted attention.Humanistic care emphasizes comprehensive care,with importance attached to patients’physical needs as well as psychological and emotional support to provide more humane and personalized care services.However,no clinical reports have examined the use of humanistic care in patients undergoing radical surgery for colorectal carcinoma.AIM To investigate the influence of humanistic care-based operating room nursing on the safety,postoperative recovery,and nursing satisfaction of patients who have undergone radical surgery for colorectal carcinoma.METHODS In total,120 patients with rectal cancer who underwent surgery in Zhongnan Hospital of Wuhan University between August 2023 and March 2024 were selected and grouped based on the nursing methods employed.Of these patients,55 were treated with routine nursing intervention(control group)and 65 were provided humanistic care-based operating room nursing(research group).The patients’vital signs were recorded,including systolic/diastolic blood pressure(SBP/DBP)and heart beats per minute(BPM),as well as serum stress indices,including norepinephrine(NE),adrenal hormone(AD),and cortisol(Cor).Postoperative recovery and complications were also recorded.Patients’negative emotions,life hope,and nursing satisfaction were evaluated using the Self-rating Depression/Anxiety Scale(SDS/SAS),Herth Hope Index(HHI),and self-deve-loped nursing satisfaction questionnaire,respectively.RESULTS During emergence from anesthesia,SBP,DBP,and BPM levels were found to be lower in the research group than those in the control group,also serum Cor,AD,and NE levels were lower.In addition,the research group had shorter operative,awakening,anal exhaust,first postoperative ambulation,drainage tube removal,intestinal recovery,and hospital times.The total complication rate and the SDS and SAS scores were lower in the research group than those in the control group.The HHI and nursing satisfaction scores were higher in the research group.CONCLUSION Humanistic care-based operating room nursing can mitigate physiological stress responses,reduce postoperative complications,promote postoperative recovery,relieve adverse psychological emotions,and enhance life hope and nursing satisfaction in patients undergoing radical surgery for colorectal carcinoma,which can be popularized in clinical practice.
基金Supported by 2022 Fujian Medical University Qihang Fund General Project Plan,No.2022QH1120。
文摘BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.
基金supported by a key Program of the Chongqing Scientific and Technological Commission(Grant Number.CSTB2022TIAD-KPX0165).
文摘Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.