Analysis of Perioperative Respiratory Care Methods and their Application Value in Children with Congenital Heart Disease

Objective:To analyze the perioperative respiratory care methods and application value in children with congenital heart disease.Methods:60 children with congenital heart disease(treated from January 2021 to October 2023)were screened and divided into two groups randomly.Each group consisted of 30 cases.The perioperative routine was used in the control group.The observation group underwent the perioperative routine along with better respiratory care.Oxygenation indicators,surgical complications,and family satisfaction levels of the groups were compared.Results:There was no significant difference in the oxygenation index between the two groups of children at admission(P>0.05).At discharge,the oxygenation indicators in the observation group were better than those of the control group,and the incidence of surgical complications was lower than that of the control group.The total satisfaction of family members in the observation group was higher than that of the control group(P<0.05).Conclusion:During the perioperative period for children with congenital heart disease,the implementation of respiratory care,which mainly involves symptomatic care,catheter care,sputum suction care,etc.,can actively improve the oxygenation indicators,reduce surgical complications,and promote faster and better recovery,of children with congenital heart disease.

Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.

Information Needs and Self-Care Practices of Diabetic Patients in Mbala, Northern Province, Zambia

Introduction: Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. It is “a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both” manifested by carbohydrates, fat and protein metabolism abnormality. If untreated high blood sugar can damage the nerves, eyes, kidneys, and other organs. The purpose of this study was to assess the information needs and self-care practice of Diabetic Patients in Mbala, Northern Province Zambia. Methods: This was an analytical cross-sectional study where 105 respondents aged 18 years and above participated in the study. Participants were randomly selected. A structured interview schedule and a check list were used to collect data. Statistics Package for Social Sciences computer software package version 23.0 was used to analyze data. Chi square and fisher’s exact tests were used to test the significance of the association between Knowledge of Diabetes Mellitus, attitude towards self-care practices, self-care practices among Diabetic patients and the need for information among Diabetic patients. A 95% confidence interval and P value of 0.05 were used to ascertain the degree of significance. Multi-variate binary logistic regression model to determine predictors of self-care practices and need for information was also used. Result: On analyzing the dependent variables, more than half (61.9%), had high need for information and three quarters (85.7%) of respondents had poor self-care practices. Slightly more than half (58.1%) had high knowledge levels majority (78.1%), had a negative attitude. Significant associations were found P Conclusion: Negative attitudes and lack of information among Diabetic patients were the main reasons associated with poor self-care practices. Particular attention should therefore be given to ensuring that Diabetic patients are given adequate information on Diabetes self-care in order to improve the quality of life.

Application of Flipped Classroom Combined with PBL Teaching Method in the Teaching of Respiratory Intensive Care Unit Nursing

Objective:The aim is to investigate the application effect of flipped classroom combined with problem-based learning(PBL)teaching method in the teaching of respiratory intensive care unit nursing.Methods:100 fresh nursing students who were interned in the respiratory intensive care unit of our hospital from June 2020 to May 2022 were selected and randomly divided into 50 students in the control group and 50 students in the experimental group.The students in the control group were taught by PBL teaching method,and the students in the experimental group were taught by flipped classroom combined with PBL teaching method.After the completion of the teaching,the teachers combined the performance of the two groups of students,and scored them comprehensively in terms of their professional theoretical knowledge,clinical operation skills,independent learning ability,and teamwork ability,and carried out a survey of the experimental group’s students in terms of their satisfaction with the understanding of theoretical knowledge,clinical operation,independent learning ability,teamwork ability,and other dimensions.Results:There was no statistical significance in the specialized theoretical knowledge scores of the two groups of students(P>0.05).The scores of clinical operation,independent learning ability,and teamwork ability of the two groups of students were statistically significant(P<0.05),and all the scores of the students in the experimental group were higher than that of the control group.More than 90%of the students believed that the flipped classroom combined with PBL teaching method could assist in the comprehension of theoretical knowledge,improve the clinical operation skills,enhance the ability of independent learning and teamwork;there were 92%of the students supported the use of flipped classroom combined with PBL teaching in respiratory intensive care unit nursing teaching.Conclusion:In the teaching of respiratory intensive care unit nursing,the use of flipped classroom combined with PBL teaching method can improve the learning effect of students,and has certain value in teaching.

Health-Related Internet Information Both Strengthens and Weakens Parents’ Potential for Self-Care—A Mixed-Methods Study on Parents’ Search Patterns

Background: Today’s parents belong to the digital generation and regularly use the Internet as a source of information. Parents’ quests for health-related online information comprise an effort to manage symptoms of illness or address questions about child development which may be an expression of self-management or self-care. Purpose: This study aims to describe health and child development related Internet search patterns used by parents of children ages zero to six, and further, how the obtained information was used in contacts with Child Health Care. Design and Methods: A two-step mixed- method approach is used in this study, comprising both a quantitative and a qualitative approach. First, a questionnaire was distributed to parents (n = 800) at 13 health centers in a medium sized county in Sweden. Second, one narrative interview with two parents total was conducted. Descriptive and non-parametric statistics were calculated, and qualitative manifest content analyses were performed. Results: A total of 687 completed the questionnaire, which corresponds to a response rate of 86%. The results show that 97% used the Internet for health-related and developmental child issues. The results show that parents often look at basic tips and the Internet is seen as a fast and accessible forum to obtain information. Parents often initiated their Internet searches using Google search for the specific subject, but the most common and most used website (used by 95% of parents), was the Swedish health site 1177.se. 98.4% of parents evaluated the general information searches they made on the Internet as reliable despite only 31% of the parents checking to see if the websites they used were scientifically based. Parents (81.7%) stated that they wanted their Child Health Nurses (CHN) to give them recommendations for valid websites. Conclusions: The results in this study show that, on the one hand, the Internet could strengthen parental knowledge (support self-care capacity), but, on the other hand, the found information could worry them and increase their anxiety—negatively affected self-care capacity. The parents suggested that the information should be double-checked to establish trust and develop self-care knowledge. Having a good resource to rely on, such as personal contact with a CHN, or using reliable websites seems to strengthen and reassure parents.

Diabetes self-care in primary health facilities in India-challenges and the way forward

India has approximately 73 million people living with diabetes and another 37 million with prediabetes while nearly 47% of the diabetes cases are undiagnosed. The high burden of poor glycemic control and early onset of complications with associated economic costs indicates a high prevalence of poor self-management practices. It is well-established that achieving patient-centered primary care consistent with a chronic care model ensures optimum diabetes self-management support and improves long-term clinical and health outcomes in diabetes patients. The public sector primary care system in India provides services free of cost to beneficiaries but lacks patient-centered care that undermines diabetes selfmanagement education and support. Furthermore, factors like poor patient knowledge of diabetes, suboptimal medication adherence, persistent clinical inertia, lack of data for monitoring and evaluation through clinical audit worsens the standards of diabetes care in primary care settings of India. There is a need for government initiatives to be directed towards the provision of comprehensive outpatient care that is inclusive of uninterrupted supply of drugs, provision of essential laboratory investigators, training and availability of qualified diabetes educators and availability of specialist support when required. Furthermore, the integration of depression screening and smoking cessation services at the primary care level is warranted.

Application of self-care based on full-course individualized health education in patients with chronic heart failure and its influencing factors

BACKGROUND The treatment of heart failure not only needs to relieve the clinical symptoms and improve the quality of life for patients but also needs to select scientific and reasonable ways to prevent or delay the progression of the disease,thus reducing the mortality and hospitalization rate.Although the previous regimen can effectively relieve symptoms in the early stage of treatment,long-term use may cause adverse events,such as arrhythmia,and even increase mortality.Therefore,conventional treatment cannot meet the actual health needs of patients,and scientific nursing intervention is very necessary.AIM To investigate the application of self-care based on full-course individualized health education (FCIHE) and its influencing factors in patients with chronic heart failure (CHF).METHODS We enrolled CHF patients who were admitted to our center between September 2015 and June 2016 and divided them into an intervention group (n = 50) and control group (n = 50) using a random number table.Routine nursing care was applied to the control group,and FCIHE was offered to the intervention group.The self-care behavior,6-min walking distance (6MWD),and 36-item short form health survey (SF-36) scores were compared between the two groups.The influencing factors of the self-care were also analyzed.RESULTS The 6MWD was not significantly different between the two groups at admission (P > 0.05);however,at 3 and 6 mo after discharge,6MWD was significantly increased,and it was significantly longer in the intervention group (P < 0.05).The scores for self-care behavior showed no significant difference at admission between the two groups (P > 0.05);however,at 3 and 6 mo after discharge,the total scores for self-care maintenance,management,confidence,and behavior of the intervention group were significantly higher than those of the control group (P < 0.05).There were no significant differences in the SF-36 scores at admission (P > 0.05);however,at 3 mo and 6 mo after discharge,the scores for all eight subscales,including physical functioning,role limitations due to physical problems,bodily pain,general health perceptions,vitality,social functioning,role-limitations due to emotional problems,and mental health,were significantly higher in the intervention group (P < 0.05).As shown by logistic regression analysis,the influencing factors of self-care mainly included age,cardiac function class,and education background (odds ratio > 1;all P < 0.05).CONCLUSION FCIHE improved self-care behavior and cardiac function in CHF patients.Age,cardiac function,and education level affected the implementation of self-care among CHF patients.

The effect of self-employment on health, access to care, and health behavior

The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, who are either selfemployed or salaried workers. Outcomes include physical and mental health perception, validated indexes of physical and mental health, and medical conditions;access-to-care measures such as a barrier to obtaining necessary health care;and health behaviors such as smoking, physical activity and body mass index. Instrumental variables methods are used to correct for selection into self-employment. We find that self-employment is positively associated with perceived physical health, and is negatively associated with having diabetes, high blood pressure, high cholesterol and arthritis. No mental health outcome is significantly associated with self-employment. There is no significant difference between self-employed and wage-earning individuals with regard to access to care. Self-employed individuals are less likely to smoke, and are more likely to participate in physical activity and have normal-weight. We conclude that despite lack of health insurance, self-employed persons in the US are as healthy as wage-earners, do not experience a greater barrier to access to care, and are more likely to engage in healthy behavior.

Microstructure characteristics and solidification behavior of wrought aluminum alloy 2024 rheo-diecast with self-inoculation method

One important problem in casting wrought aluminum alloys is the high tendency to the formation of hot tears in the solidification process.By using semi-solid metal(SSM) processing,the hot tearing tendency of alloys can be minimized during casting.In the present research,the semi-solid slurry of wrought aluminum alloy 2024 was firstly prepared with a novel self-inoculation method(SIM),and then the microstructure characteristics of the semi-solid slurry and the rheo-diecastings cast with the semi-solid slurry were investigated.The results indicate that finer and more uniform globular primary α-Al particles can be obtained when the semi-solid slurry are isothermally held for a short period within the semi-solid temperature range,and the primary α-Al particles without entrapped liquid are uniformly fine,globular grains in the rheo-diecastings.The holding temperature and time affect the solid fraction,particle size,and shape factor.After the semi-solid slurry is held at 625 ℃ for 3 min and 5 min,the optimal values for the average equivalent diameter are 70.80 μm and 74.15 μm,and for the shape factor are 1.32 and 1.42,respectively.The solidification process of the rheo-diecastings is composed of the following two distinct stages:primary solidification process and secondary solidification process.The secondary solidification process consists further of the following three stages:(1) direct growth of secondary primary(α 2) phase from the surface of the primary α-Al phase particles without re-nucleation,(2) independent nucleation and growth of α 3 phase from the residual liquid,and(3) eutectic reaction at the end.

The Process of Compliance with Self-Care among Patients with Hypertension: A Grounded Theory Study

Introduction: Controlling hypertension across world continues to be challenging. Managing hypertension is not only concerned with lowering blood pressure by using antihypertensive medications;it also aims to minimize its consequences through adopting self-care practices. Compliance with self-care practices among patients with hypertension is considered a multidimensional phenomenon. The phenomenon of hypertension has been studied quantitatively, however;little qualitative studies were conducted to understand the compliance with self-care among patients with hypertension. Aim: To understand the process that patients with hypertension go through to comply with self-care practices. Methods: This study used a qualitative design that followed constructivist grounded theory approach;purposive sampling was used to recruit participants from cardiac clinics;semi structured, in-depth and face-to-face interview was used as a major method for data collection. Findings: Four participants with hypertension participated in this study;the phenomena of self-care was identified as the central phenomena;the start of the disease was identified as a casual condition;beliefs toward hypertension disease, beliefs toward self-care practices, knowledge and awareness regarding hypertension disease and self-care practices were identified as strategies;experiencing self-care practices was identified as consequence and being patients with hypertension in a social context. Conclusions: The process of compliance with self-care has a path of actions and interactions. The process started from the moment of diagnosis where the patients start to think about self-care. The absence of health care context leads to varying level of compliance with self-care among patients with hypertension. This indicated the need for more effective patient and health care provider relationship, education and awareness campaign.

Interaction between Locomotion and Self-Care for Patients with Stroke in Severity Classification Based on the Motor Functional Independence Measure upon Admission to the Recovery Ward

Background: A correlation between self-care and gait in stroke patients has been shown. However, there are few reports suggesting an interaction between self-care and gait. Purpose: To investigate the interaction between locomotion and improvements in self-care. Participants and Methods: We retrospectively analyzed 3034 stroke patients who were registered in the Japanese Rehabilitation Database. Using their data, patients were classified into three groups (severe, moderate, slight) based on the motor functional independence measure upon admission, and data were modified as mean-centered values. We performed a correlation analysis to evaluate the relationship among all the collected data. Subsequently, a hierarchical multiple regression analysis was performed to evaluate interaction using the self-care motor score from the Functional Independent Measure (FIM) as the dependent variable. Model 1 used two independent variables (National Institutes of Health Stroke Scale and cognitive FIM score), model 2 used two independent variables (locomotion gain and gain of an item with the strongest correlation coefficient to the de-pendent variable), and model 3 used a mean-centering value, which was added to model 2. The simple slope was used for further analysis. Results: Locomotion showed an interaction with self-care, except in the slight group. The R2 changes in models 1 and 2 were significant in the following: grooming, dressing lower body, and bladder management in the severe group (p < 0.01), and only dressing upper body in the moderate group (p < 0.01). Results of the simple slope analysis were significant for grooming, bowel management, and dressing lower body in the severe group and for dressing upper body in the moderate group. Conclusion: Locomotion demonstrated interaction with improving self-care, mainly in the severe group. Therefore, for moderate and slight cases, an intervention that not only involves locomotion training but also focuses on improving activities of daily living should be considered.

Microstructure of partially remelted billet of AM60 alloy prepared with self-inoculation method

The billets of AM60 alloy, prepared with self-inoculation method, were partially remelted into semisolid state.Effects of process parameters on remelting microstructure of semisolid billet were investigated.Experimental results show that the solid particles obtained with self-inoculation method are in smaller grain size and globular shape after partial remelting, compared with those prepared with other casting methods.In the optimized process conditions, the average size of solid particles of partially remelted billet is 65 μm, and the shape factor is 1.12.The process parameters, i.e.pouring temperature, addition amount of self-inoculants, and the slope angle of multi-stream mixing cooling channel have influence on the microstructure of partially remelted billet.The optimized temperature is from 680 °C to 700 °C, addition amount of self-inoculants is between 5% and 7% (mass fraction), slope angle of multi-stream mixing cooling channel is between 30° and 45°, with which the dendritic microstructure of as-cast billet can be avoided, and the size of solid particles of remelted billet is reduced.

The Effect of Anemia on Quality of Life and Self-Care Agency in Turkey Hemodialysis Patients

Objective: Anemia is an important complication which affects quality of life and self-care agency in hemodialysis patients. The aim of this study was to determine the effects of anemia on quality of life and self-care agency in adult patients who receive chronic hemodialysis treatment. Methods: In this cross-sectional study, the Quality of Life Scale, the Self Care Agency Scale, and a data form were administered to 136 hemodialysis patients who were receiving treatment three hospital-based dialysis units in Istanbul. Results: The health perception of cases whose hemoglobin level was 12 mg/dl and above was significantly better than those whose hemoglobin level was lower than 12 mg/dl. Hemoglobin levels were significantly and positively correlated to physical role function, general health, and health from the previous year (p < 0.05). As the hemoglobin levels of the cases increased, quality of life pertaining to the mentioned domains increased. Conclusion: It was concluded that the quality of life in chronic dialysis patients was affected by anemia.

Automated Telephone Calls in the Follow-Up of Self-Care in Outpatients with Type 2 Diabetes: A Feasibility Study

Aims and objectives: To test an automated telephone service as a follow-up and support strategy for self-care in a population of adult Mexican patients with type 2 diabetes. Methods: The design was a two-group comparative design, with pre and post-intervention measurements. Patients were assigned into intervention (n = 31), or comparison (n = 33) groups. Over 12 weeks, each participant in the intervention group received automated phone calls with instructions to facilitate accomplishment of the treatment, and self-care activities. Two focus groups helped to appreciate patients’ follow-up experience. Randomized grouping was performed by selecting numbers from an urn;the final sample comprised 31 (48%) patients in the intervention group, and 33 (52%) in the comparison group;these procedures were performed by the case nurse management. The study was approved by the Ethics Committee of the Autonomous University of Nuevo Leon and the University of Michigan;all of the participants signed informed consent. Results: Of the 372 programmed phone calls made to the participants, 234 were completed, representing a 62.9% response rate. Phone calls may be associated to a 0.82% decrease in the HbA1c values and to lower depression scores. HbA1c measurements decreased 0.82% (M = 7.41 - 6.69;t = 25;4.11;p = ?0.001) from the baseline values over the 12-week study in the intervention group and 0.49% (M = 7.24 - 6.75;t = 26;2.11;p = 0.044) in the comparison group. Variables related to medication intake did not exhibit differences between the baseline and second measurements, except with respect to the scale of depression.

Research Progress on Self-Care Ability of Hemodialysis Patients

Good self-management can help hemodialysis patients improve their quality of life and survival rate. This article reviews the status quo of self-care ability of maintenance hemodialysis patients, the influencing factors of self-care ability and the intervention measures. To improve the self-care ability and quality of life of patients, coordinated nursing intervention, self-efficacy intervention, psychological intervention and health education were proposed. To provide a reference for the self-management of hemodialysis patients.

Impact of Pharmaceutical Care on Self-Administration of Outpatient Low-Molecular-Weight Heparin Therapy

Outpatient subcutaneous (s.c.) therapies are becoming more and more common in the treatment of different diseases. The effectiveness of community-pharmacy-based interventions in preventing problems that arise during s.c. self-injections of low-molecular-weight heparins (LMWH) is unknown. Our objective was to provide a standard operating procedure (SOP) for community pharmacists and to compare pharmaceutical vs. standard care in both clinical and daily life settings. We hypothesized that: pharmaceutical care results in improved adherence, safety, and satisfaction, and in fewer complications;the interventions used are feasible in daily life;and the results achieved in clinical and daily life settings are comparable. In the clinical setting (randomized controlled trial), patients were recruited sequentially in hospital wards;in the daily life setting (quasi-experimental design with a comparison group), recruitment took place in community pharmacies by pharmacists and trained master students during their internship. Interventions were offered according to patient needs. Data were collected by means of a monitored self-injection at home and structured questionnaire-based telephone interviews at the beginning and the end of the LMWH treatment. The main outcome measures were: scores to assess patient’s skills;syringe count to assess adherence;and frequency, effectiveness, and patient’s assessment of received interventions. The results show a median age of the 139 patients of 54 years. Interventions resulted in improved application quality (p p = 0.03). Oral instructions were pivotal for improving patients’ application quality. We found no significant score differences between the intervention groups in the clinical and daily life settings. Patients’ baseline skills were high, with the lowest score being 0.86 (score range ?2.00 to +2.00). Adherence rate was high (95.8%). In conclusion, our SOP for pharmacist interventions was of good quality, adequate, appreciated, and feasible in daily life. Patients are capable of managing s.c. injection therapies if adequate assistance is provided.

Effects of novel self-inoculation method on microstructure of AM60 alloy

A novel cast processing method,self-inoculation method (SIM),was proposed.The process involves the addition of self-inoculant to melt,then pouring the melt to a mould through a multi-stream mixing cooling channel.In this paper,the process parameters were investigated.Results indicate that the melt treatment temperature,the amount of self-inoculant added,and the slope angle of the cooling channel are the key factors for SIM process.The optimized parameters are that the melt treatment temperature is between 680 and 700°C;the addition of self-inoculant is between 5wt.% and 7wt.%;and the slope angle of the cooling channel is between 30° and 45°.Further analysis reveals that SIM changes the solidification microstructure of slurry by controlling the nucleation and growth of the primary phase in the melt.

Applicability of the Welch method for examining self-noise level parameters for broadband seismometers

Seismometer self-noise levels were determined using Sleeman’s three-sensor method in combination with the Welch method for different parameter combinations. The self-noise levels decreased with the increasing segment window length, which is equivalent to the subwindow length, and with the increasing segment overlap rate for different frequency points at a fixed band. After the statistical examination of 9800 different parameter combinations, a zone of reasonable self-noise calculation parameter combinations was identified. Reasons for the unsuitability of certain parameter combinations were explored with respect to their distortion of the seismometer’s self-noise levels.