Analysis of Humanistic Nursing Care in Regulating the Emotion, Satisfaction, and Sleep Quality of Inpatients with Hematologic Neoplasms

Objective:To explore the clinical application value of humanistic nursing care in the treatment of hematologic neoplasm inpatients.Methods:Fifty-two patients with hematologic neoplasms admitted to a hospital from May 2019 to February 2022 were selected as the research subjects.According to a random number table,they were divided into two groups:the control group(n=25,routine clinical nursing)and the observation group(n=27,humanistic nursing care).The negative emotion score,nursing satisfaction,and sleep quality were compared between the two groups under different nursing modes.Results:The SAS and SDS scores before and after nursing were compared between the two groups.There was no significant difference between the two groups before nursing(p>0.05).However,the SDS and SAS scores in the two groups after nursing were lower than those before nursing,in which the observation group was slightly lower than the control group,and the difference was statistically significant(p<0.001).In terms of nursing satisfaction,it was as high as 96.29%in the observation group,whereas in the control group,the satisfaction rate was only 72.00%;the PSQI scores were compared between the two groups before and after nursing,and there was no significant difference between the two groups before nursing(p>0.05).However,the PSQI scores and total score of the observation group after nursing were lower than those of the control group(p<0.001).Conclusion:In the clinical treatment of patients with hematologic neoplasms,the implementation of humanistic nursing care can significantly improve patients’anxiety,depression,other negative emotions,sleep quality,and nursing satisfaction,all of which have significance in promoting the prognosis of patients and improving their quality of life.

Knowledge and Attitudes of Oncology Nurses Toward Clinical Trials-A Secondary Publication

Purpose:The purpose of this study was to identify the knowledge and attitudes of oncology nurses toward clinical trials and to provide evidence for the development of clinical trial education programs for oncology nurses.Methods:The study was conducted on 142 nurses who had more than six months of nursing experience working with cancer patients at a tertiary hospital in Seoul,Korea.A structured questionnaire was used to measure the knowledge and attitudes of oncology nurses toward clinical trials.Results:The participants scored an average of 15.03±3.52 out of 19 in terms of knowledge about clinical trials.In terms of attitudes toward clinical trials,the participants scored an average of 5.91±1.37 out of 8.There was a significant positive correlation between the knowledge and attitudes of the participants toward clinical trials(r=0.23,P=0.007).Conclusion:This study found that there was a relationship between the knowledge and attitudes of oncology nurses toward clinical trials.To improve the competency of oncology nurses and provide high-quality care to patients participating in clinical trials,more systematic and sustainable education is required.

Effects of cooperative nursing and patient education on postoperative infection and self-efficacy in gastrointestinal tumors

BACKGROUND Gastrointestinal tumors have a high incidence rate.The application value of the cooperative nursing care system of medical care has received widespread attention in recent years.However,there are few studies on the value of the joint application of collaborative nursing care and self-efficacy education.AIM To explore the effect of cooperative nursing care management/self-efficacy education on postoperative infection and self-efficacy in gastrointestinal tumor surgery patients.METHODS A total of 102 patients with gastrointestinal tumors treated in our hospital from October 2018 to February 2020 were selected and divided into a conventional group(n=51)and a combined group(n=51)according to the nursing plan.The routine group adopted routine nursing,and the joint group adopted the medical care cooperative responsibility system nursing management combined with selfefficacy education.The self-efficacy scores,coping style scores,self-experience burden scores,and postoperative complication rates of the two groups before and after intervention were counted.RESULTS After intervention,the daily life behavior management,cognitive symptom management,and disease management scores of the two groups were higher than those before the intervention,and those of the combined group were higher than those of the conventional group(all P=0.000).After the intervention,the positive response scores of the two groups were higher than those before the intervention,the negative response scores were lower than those before the intervention,and the combined group was better than the conventional group(all P=0.000).After the intervention,the two groups’emotional,economic,and physical factor scores were lower than those before the intervention,and the combined group was lower than the conventional group(all P=0.000).The incidence of infection in the combined group(1.96%)was lower than that in the conventional group(15.69%)(P=0.036).CONCLUSION Cooperative nursing care management and self-efficacy education improved the physical and mental states of gastrointestinal cancer surgery patients,change the response to disease,and reduce the risk of postoperative infection.

European vs 2015-World Health Organization clinical molecular and pathological classification of myeloproliferative neoplasms

The BCR/ABL fusion gene or the Ph^1-chromosome in the t(9;22)(q34;q11)exerts a high tyrokinase acticity,which is the cause of chronic myeloid leukemia(CML).The1990 Hannover Bone Marrow Classification separated CML from the myeloproliferative disorders essential thrombocythemia(ET),polycythemia vera(PV)and chronic megakaryocytic granulocytic myeloproliferation(CMGM).The 2006-2008 European Clinical Molecular and Pathological(ECMP)criteria discovered 3variants of thrombocythemia:ET with features of PV(prodromal PV),"true"ET and ET associated with CMGM.The 2008 World Health Organization(WHO)-ECMP and 2014 WHO-CMP classifications defined three phenotypes of JAK2^(V617F)mutated ET:normocellular ET(WHO-ET),hypercelluar ET due to increased erythropoiesis(prodromal PV)and ET with hypercellular megakaryocytic-granulocytic myeloproliferation.The JAK2^(V617F)mutation load in heterozygous WHO-ET is low and associated with normal life expectance.The hetero/homozygous JAK2^(V617F)mutation load in PV and myelofibrosis is related to myeloproliferative neoplasm(MPN)disease burden in terms of symptomaticsplenomegaly,constitutional symptoms,bone marrow hypercellularity and myelofibrosis.JAK2 exon 12mutated MPN presents as idiopathic eryhrocythemia and early stage PV.According to 2014 WHO-CMP criteria JAK2 wild type MPL^(515)mutated ET is the second distinct thrombocythemia featured by clustered giant megakaryocytes with hyperlobulated stag-horn-like nuclei,in a normocellular bone marrow consistent with the diagnosis of"true"ET.JAK2/MPL wild type,calreticulin mutated hypercellular ET appears to be the third distinct thrombocythemia characterized by clustered larged immature dysmorphic megakaryocytes and bulky(bulbous)hyperchromatic nuclei consistent with CMGM or primary megakaryocytic granulocytic myeloproliferation.

PVSG and WHO vs European Clinical,Molecular and Pathological Criteria for prefibrotic myeloproliferative neoplasms

The Polycythemia Vera Study Group(PVSG),World Health Organization(WHO) and European Clinical,Molecular and Pathological(ECMP) classifications agree upon the diagnostic criteria for polycythemia vera(PV) and advanced primary myelofibrosis(MF). Essential thrombocythemia(ET) according to PVSG and 2007/2008 WHO criteria comprises three variants of JAK2V617 F mutated ET when the ECMP criteria are applied. These include normocellular ET,hypercellular ET with features of early PV(prodromal PV),and hypercellular ET due to megakaryocytic,granulocytic myeloprolifera-tion(ET.MGM). Evolution of prodromal PV into overt PV is common. Development of MF is rare in normocellular ET(WHO-ET) but rather common in hypercellular ET.MGM. The JAK2V617 F mutation burden in heterozygous mutated normocellular ET and in heterozygous/homozygous or homozygous mutated PV and ET.MGM is of major prognostic significance. JAK2/MPL wild type ET associated with prefibrotic primary megakaryocytic and granulocytic myeloproliferation(PMGM) is characterized by densely clustered immature dysmorphic megakaryocytes with bulky(bulbous) hyperchromatic nuclei,which are never seen in JAK2V617 F mutated ET,and PV and also not in MPL515 mutated normocellular ET(WHO-ET). JAK2V617 mutation burden,spleen size,LDH,circulating CD34+ cells,and pre-treatment bone marrow histopathology are mandatory to stage the myeloproliferative neoplasms ET,PV,PMGM for proper prognosis assessment and therapeutic implications. MF itself is not a disease because reticulin fibrosis and reticulin/collagen fibrosis are secondary responses of activated polyclonal fibroblasts to cytokines released from the clonal myeloproliferative granulocytic and megakaryocytic progenitor cells in ET.MGM,PV and PMGM.

Effectiveness of integrated nursing interventions for fatigue in patients with advanced cancer:a systematic review of randomized controlled trials

Objective:To evaluate the effectiveness of integrated nursing interventions for fatigue in patients with advanced cancer.Methods:Medline,Pubmed,Embase,CINAHL,Web of Science,and the Cochrane Library were searched systematically till June 2017.A systematic review was conducted to collect randomized controlled trials(RCTs)reporting on the effect of nurse-driven interventions to improve fatigue in patients with advanced cancer.Quality assessment was conducted using the Cochrane Collaboration’s risk of bias tool.Results:Six RCTs involving 736 adult participants were included.The fatigue intensity was improved significantly by nursing interventions.The analyzed results revealed significant improvements in the intervention group:less than 3 months(standard mean difference[SMD]=?0.33,95%confidence interval[CI][?0.48,?0.19],P<0.01)and more than or equal to 3 months(SMD=?0.40,95%CI[?0.57,?0.24],P<0.01).Four studies with a moderate risk of bias were judged,and the remaining studies were at high risk of bias.Conclusions:The results indicate that integrated nursing interventions may relieve fatigue in patients with advanced cancer.However,due to the high risk of bias in most of the included studies and the diversity of interventions,the results and implementation process should be carefully monitored.

Relevant nursing measures for the adverse reactions associated with chimeric antigen receptor T cells(CAR-T) immunotherapy: a systematic review of case reports

Objective: Cytokine release syndrome (CRS) and tumor lysis syndrome (TLS) that occur after chimeric antigen receptor T (CAR-T) cells are reinfused, which severely affect the survival and prognosis of patients. Although several articles have reported on the care of CAR-T cell immunotherapy, the quality of the study and the effectiveness of holistic nursing interventions have not been systematically reviewed. The purpose of this study was to systematically evaluate the existing holistic nursing interventions of CAR-T cell immunotherapy. Methods: A literature search for keywords was performed in PubMed, EMBASE, the Cochrane Library, CNKI, CBM, and Wanfang Data from its inception until January 2018. Studies were deemed eligible if they comprised patients with tumor receiving CAR-T cell immunotherapy, described the holistic nursing process, and were published in Chinese and English. Results: A total of 6 articles on holistic nursing interventions of CAR-T cell immunotherapy are reported, and the nursing methods and results of each article are analyzed. The quality of the studies included was medium. All nursing measures were considered effective. Conclusions: Holistic nursing programs reduce the incidence of CRS and TLS and improve the quality of life of cancer patients.

Epithelioid Angiosarcoma of Bone: A Neoplasm with Potential Pitfalls in Diagnosis

Angiosarcoma of bone is an exceedingly rare primary bone malignancy that can present as an aggressive osteolytic lesion. This subset can radiologically mimic non-vascular neoplasms and impose serious challenges in reaching the correct diagnosis. Meanwhile histological diagnosis can be extremely challenging too, as the pathological features often resemble that of aneurysmal bone cysts. We present an unusual case of a 22-year-old woman who presented with a rapidly growing humeral tumor of 8 months’ duration. The case of intraosseous angiosarcoma presented as a diagnostic dilemma and the relevant radiological and pathologic findings were discussed. We describe the clinical, radiological and pathological features of this unique case, and review the literature concerning Angiosarcoma of bone. Our case highlights the diagnostic difficulties for such very rare tumours and clinico-pathological correlation is of paramount importance to differential diagnosis.

Analysis of Nursing Care Concept: Perspective of the Person Submitted to Care

This study aimed to analyze the concept of nursing care to patients with breast cancer on chemotherapy treatment, according to the perspective of the person submitted to care. The study followed the conceptual analysis methodology proposed by Walker and Avant according to Waldow, and it was developed through consultation to SCOPUS and CINAHL databases. The selection was carried out by inclusion and exclusion criteria, constituting a sample of 7 articles. There have been identified the main uses of the risk concept, defining attributes, antecedents and consequences of the concept. The evaluation of the concept and nursing care to breast cancer patient on chemotherapy treatment allowed a broader understanding of the phenomenon, with emphasis on the skills and competencies in nursing care dispensed to woman on chemotherapy treatment for breast cancer.

以脑梗死为首发症状的卵巢癌患者围手术期护理

总结1例以脑梗死为首发症状的卵巢癌患者围手术期护理体会。针对患者病情危重复杂,围手术期易诱发血栓和出血,术后并发症风险增加,患者心理康复、肢体康复等问题,组建多学科合作团队全程管理;术前充分评估病情,制订护理计划;做好桥接抗凝期间用药护理;积极预防肺栓塞及新发脑梗死;采用中药灌肠法预防术后肠梗阻;鼓励家属参与患者心理护理,促进康复。通过积极治疗和护理,患者于术后第9天顺利出院。术后随访6个月,恢复良好。

乳腺癌细胞条件培养基对骨髓间充质干细胞生物学行为的影响

目的探讨MCF-7乳腺癌细胞条件培养基对骨髓间充质干细胞(BMSC)增殖、凋亡和迁移的影响及分子机制。方法正常环境下培养的BMSC为对照组,以MCF-7细胞条件培养基培养的BMSC为MCF-7条件培养基组,向MCF-7条件培养基组添加10 nmol/L GSK690693(Akt抑制剂)为Akt抑制剂组,向MCF-7条件培养基组添加10µmol/L Reparixin(CXCR1/2抑制剂)为CXCR1/2抑制剂组。MTT实验检测各组BMSC增殖情况,Annexin V-FITC/PI双标记流式细胞凋亡实验检测各组BMSC凋亡率,Transwell细胞迁移实验检测各组BMSC的迁移能力,酶联免疫吸附试验检测两种细胞培养上清液和MCF-7细胞条件培养基中白细胞介素(IL)-8蛋白含量,Western blot检测各组BMSC的蛋白激酶B(Akt)/磷酸化Akt(p-Akt)和哺乳动物雷帕霉素靶蛋白(mTOR)/磷酸化mTOR(p-mTOR)蛋白表达。结果与对照组相比,MCF-7条件培养基组BMSC的细胞增殖水平、迁移数目以及p-Akt和p-mTOR蛋白相对表达量均增高,细胞凋亡率降低(P<0.05);与MCF-7条件培养基组相比,CXCR1/2抑制剂组和Akt抑制剂组BMSC的细胞增殖水平、迁移数目以及p-Akt和p-mTOR蛋白相对表达量均降低,细胞凋亡率增加(P<0.05);MCF-7细胞条件培养基和MCF-7培养上清液中IL-8蛋白含量均较BMSC培养上清液中IL-8蛋白含量高(P<0.05)。结论MCF-7细胞条件培养基通过激活Akt-mTOR信号通路促进BMSC增殖和迁移,抑制BMSC凋亡,其中IL-8-CXCR1/2轴发挥关键作用。

中医特色护理联合健康信念模式在老年骨质疏松患者中的应用效果分析

目的:探讨中医特色护理联合健康信念模式在老年骨质疏松患者中的应用效果。方法:选取2022年2月—2023年7月无锡市中医医院收治的80例老年骨质疏松患者作为研究对象,按照随机数字表法分成观察组、对照组,各40例。对照组实施常规护理,观察组在对照组基础上实施中医特色护理联合健康信念模式。结果:护理3个月后,两组骨保护素水平高于护理前,且观察组高于对照组,两组骨碱性磷酸酶、Ⅰ型胶原C端肽水平低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组骨折发生率低于对照组,差异有统计学意义(P=0.023)。护理3个月后,两组生理功能、心理功能、精神健康、社会功能评分高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:中医特色护理联合健康信念模式在老年骨质疏松患者中的应用效果显著,可改善患者骨代谢相关指标,降低骨折发生率,提高生活质量。

骨折联络服务中骨科专科护士联络员的概念分析

目的 对骨科专科护士作为骨折联络服务(fracture liaison service, FLS)联络员的全面概念分析。方法 借鉴Walker和Avant的经典概念分析框架,用于识别FLS联络员角色的属性、前因、后果和经验参照物,展示FLS联络员角色示范案例。检索中国知网、万方、Sinomed、Web of Science、PubMed、 Medline等数据库中FLS的相关文献,检索时间为建库至2023年3月31日。结果 共纳入31篇文献,骨科专科护士联络角色定义属性为在患者骨折后给与协调护理,并促进各环节之间的有效沟通及合作,具有完善的骨质疏松知识储备、临床风险预判技能及团队合作能力;前置因素为能明确作为FLS联络员角色的定位、较完善的评估沟通协调能力、各方面的技术人员资金支持;后果为降低了患者的再次骨折和跌倒风险,提高了患者的参与度,有助于改善医疗保健结果,并通过减少继发性骨折和并发症来减轻财务负担,极大地降低了医疗成本。实证测评有FLS联络员核心能力评价体系、焦点小组访谈、360度调查反馈问卷。结论 通过骨科专科护士联络员的概念分析,正确理解、运用、识别FLS模式中的骨科专科护士,有助于为今后开展适合我国国情的FLS模式提供参考。

下咽-食道同时性多原发癌伴Ⅲ度喉梗阻患者围手术期护理

总结1例下咽-食道同时性多原发癌伴Ⅲ度喉梗阻患者围手术期护理体会。针对患者气道高风险、病情进展迅速、肺部感染、全身营养状态差、运动功能衰弱等问题,采取气道梗阻风险预警及应急处理,阶段化实施肺保护性策略,以目标为导向的术前预康复营养管理,低负荷小强度个体化抗阻运动改善虚弱促进患者康复等措施。经过34 d的积极治疗与护理,患者病情稳定出院,出院后随访1个月,患者状态良好。

脑肿瘤患者围术期深静脉血栓非药物预防的循证护理实践

目的 探讨基于最佳证据的脑肿瘤患者围术期深静脉血栓(DVT)非药物预防方法并评价其应用效果。方法 以“基于证据的持续质量改进模式”为指导,于2021年4-9月,按照证据获取、现状审查、证据引入和效果评价4个阶段将循证实践应用于脑肿瘤围术期患者,比较循证实践应用前后患者DVT发生率等指标的变化。结果 总结19条静脉血栓非药物预防证据并把证据转化为34条审查指标开展循证实践,脑肿瘤围术期DVT预防审查指标执行率及护士DVT相关知识、态度、行为水平明显提高,其中知识、行为维度差异具有统计学意义(P<0.05)。DVT发生率由10.75%降低到4.05%(P=0.020),患者知识得分由(14.00±2.14)分提高至(22.00±2.87)分(P<0.001)。结论 通过开展脑肿瘤围术期DVT非药物预防的循证实践,能有效改善临床实践环境,培养护士循证理念,提高其DVT预防知识、态度及临床措施依从性,提升患者预防知识水平,降低临床DVT发生率。

基于健康信念模式下社区前列腺癌筛查远程管理方案的构建及应用

目的 构建基于健康信念模式下社区前列腺癌筛查远程管理方案,并验证其应用价值。方法 构建基于健康信念模式下前列腺癌筛查远程管理方案,应用于2021年12月-2022年3月我院在社区筛查的86例前列腺癌初筛阳性患者的健康管理(观察组),与2021年8-11月83例患者(对照组)进行历史对照。对照组接受社区医院的常规健康教育,综合医院电话随访;观察组在对照组的基础上,实施基于健康信念模式的前列腺癌筛查远程管理。比较2组患者就诊率、就诊间隔时间、前列腺癌确诊率、下尿路症状、疾病知识知晓水平及健康促进生活方式,记录观察组患者管理程序使用数据和使用满意度。结果 初筛阳性患者就诊率由30.12%提升到58.13%,就诊间隔时间由(12.5±7.1)d缩短到(10.5±6.7)d, 2组比较差异均有统计学意义(P<0.05);观察组前列腺癌确诊率为6.98%,高于对照组的2.41%,观察组程序随访反馈率达89.64%,程序使用满意度高于90%。结论 本研究构建的前列腺癌筛查远程管理方案能为社区患者提供科学、高效的健康管理,提高患者就诊率,促进前列腺癌患者的早诊早治。

消化道肿瘤患者参与“互联网+护理服务”意愿现状及影响因素分析

目的探讨消化道肿瘤患者参与“互联网+护理服务”意愿现状及其影响因素,为促进“互联网+护理服务”在消化道肿瘤领域的有效应用提供参考依据。方法选取2023年7月-11月我科收治的200例消化道肿瘤患者为研究对象,采用“互联网+护理服务”意愿调查问卷对其进行调查。结果消化道肿瘤患者参与“互联网+护理服务”意愿总分为(52.81±6.16)分,处于中等水平。多元线性回归分析结果显示,居住地、主要照顾者、经济来源、家庭月收入是消化道肿瘤患者参与“互联网+护理服务”意愿的影响因素(P<0.05)。结论消化道肿瘤患者参与“互联网+护理服务”意愿水平有待提高,未来应重点关注县区及以下居住地、家庭经济收入低的患者,拓宽宣传范围,以满足更多患者的线上护理服务需求。

全程关护护理模式在二氯化锶治疗前列腺癌骨转移患者中的应用效果

目的 探讨全程关护护理模式在二氯化锶治疗前列腺癌骨转移患者中的应用效果。方法 选取2011年5月至2021年5月我院收治的80例前列腺癌骨转移患者为研究对象,随机将其分为试验组(n=40,全程关护护理模式)和对照组(n=40,常规护理)。比较两组的护理效果。结果 护理前、后,对照组的疼痛程度有所改善,但差异无统计学意义(P=0.094);护理前、后,试验组的疼痛程度总体改善,差异具有统计学意义(P<0.05);护理后,试验组的疼痛程度轻于对照组,但差异无统计学意义(P=0.068)。试验组的骨髓抑制、反跳痛发生率高于对照组,消化道反应、心慌发生率低于对照组,差异具有统计学意义(P<0.05)。护理后,试验组的生活质量综合评定问卷-74(GQOLI-74)各维度评分高于对照组(P<0.05)。结论 全程关护护理在二氯化锶治疗前列腺癌骨转移患者中的应用效果明显,可以缓解疼痛,提升生存质量,值得临床应用。

胃癌围术期病人预后营养指数纵向变化规律及应用的研究进展

对胃癌病人的预后营养指数概念及影响因素、围术期纵向变化规律、营养干预对预后营养指数的影响及其在术前与术后的应用价值进行综述,旨在为临床医护人员精准应用营养监测指标、进一步完善胃癌营养管理方案提供参考。