Effect of cetuximab plus FOLFOX4 regimen on clinical outcomes in advanced gastric carcinoma patients receiving evidence-based care

BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.

Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Research on the Application of Evidence-Based Quality Control Circle to Improve the Implementation Rate of Airway Management Measures in Adult Critically Ill Patients

Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.

Reality of evidence-based practice in palliative care

There has been a paradigm shift in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine(EBM). In palliative care however, statistically significant benefits may be marginal and may not be related to clinical meaningfulness. The typical treatment vs. placebo comparison necessitated by ‘gold standard' randomised controlled trials(RCTs) is not necessarily applicable. The complex multimorbidity of end of life care involves considerations of the patient's physical, psychological, social and spiritual needs. In addition, the field of palliative care covers a heterogeneous group of chronic and incurable diseases no longer limited to cancer. Adequate sample sizes can be difficult to achieve, reducing the power of studies and high attrition rates can result in inadequate follow up periods. This review uses examples of the management of cancer-related fatigue and death rattle(noisy breathing) to demonstrate the current state of EBM in palliative care. The future of EBM in palliative care needs to be as diverse as the patients who ultimately derive benefit. Non-RCT methodologies of equivalent quality, validity and size conducted by collaborative research networks using a ‘mixed methods approach' are likely to pose the correct clinical questions and derive evidencebased yet clinically relevant outcomes.

Evidence-based Care for Rehabilitation Nursing Effect of Patients with Patellar Fracture

Objective.To analyze the effect of applying evidence-based care in rehabilitation nursing effect of patients with patellar fractures.Methods.A total of 54 patients with patellar fractures were randomly selected from the hospital.The diagnosis and treatment time were from the beginning of July 2018 to end of June 2019.The digital table grouping was adopted to divide patients into two groups with each group consists of 27 patients with this disease.Both groups underwent routine nursing and the experimental group with increased evidence-based care.Results.Compared with the control group,the knee function evaluation,complications and nursing satisfaction of the experimental group were more ideal,and the difference was statistically significant(P<0.05).Conclusion.Evidence-based care in rehabilitation nursing of patients with patellar fracture can obtain ideal nursing effect.

Evidence-Based Practice and Job Satisfaction of Nurses in Long-Term Care

Purpose: The purpose of this study was to identify the relationship between evidence-based practice (EBP) and job satisfaction among nurses working in long-term care facilities. Methods: The study used a descriptive cross-sectional design. A total of 146 nurses working in 6 long-term care facilities in South Korea self-reported their perception of EBP implementation, barriers to research utilization, and job satisfaction. Results: The level of job satisfaction was higher in nurses who were single, older, more experienced, and had a higher income. Lower perceived barriers to research utilization were associated with greater job satisfaction. However, there was no significant relationship between a level of EBP implementation and job satisfaction. Factors influencing job satisfaction included lower barriers to the organization and communication domains of research utilization, being unmarried and older. Conclusion: Decreasing barriers to research utilization may improve the job satisfaction of nurses working in long-term care facilities.

CICARE沟通模式的赋能护理对经尿道前列腺等离子剜除术治疗的前列腺增生患者术后自护能力及治疗依从性的影响

目的回顾性分析CICARE沟通模式的赋能护理在经尿道前列腺等离子剜除术治疗前列腺增生中的应用效果。方法选取我院2022年10月到2023年10月88例经尿道前列腺等离子剜除术治疗的前列腺增生患者,按入院顺序分为CICARE组(n=44)、常规组(n=44),常规组行常规护理,CICARE组在此基础上给予CICARE沟通模式的赋能护理。比较两组前列腺症状改善情况[国际前列腺症状评分量表(IPSS)]、自护能力[自我护理能力测定表(ESCA)]、治疗依从性、生活质量[生活质量测定量表简表(WHOQOL-BREF)]。结果两组干预后IPSS评分均较干预前降低(P<0.05);干预后CICARE组IPSS评分降低幅度大于常规组(P<0.05);两组干预后ESCA评分均较干预前升高(P<0.05);干预后CICARE组ESCA评分升高幅度大于常规组(P<0.05);两组干预后治疗依从性评分均较干预前升高(P<0.05);干预后CICARE组治疗依从性评分升高幅度大于常规组(P<0.05);两组干预后WHOQOL-BREF评分均较干预前升高(P<0.05);干预后CICARE组WHOQOL-BREF评分升高幅度大于常规组(P<0.05)。结论对经尿道前列腺等离子剜除术治疗的前列腺增生患者实施CICARE沟通模式的赋能护理,能提高治疗依从性、自护能力,改善前列腺症状,从而提高生活质量。

Effect of medical care linkage-continuous management mode in patients with posterior circulation cerebral infarction undergoing endovascular interventional therapy

BACKGROUND Acute cerebral infarction is a severe type of ischemic stroke that can be divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction(PCCI).PCCI affects the structure of the posterior circulation brain,because posterior part of the brain,which has more complex anatomical structures and more prone to posterior circulation vascular variation.Therefore,improving the prognosis of PCCI patients is necessary.AIM To explore the effect of medical care linkage-continuous management mode(MCLMM)on endovascular interventional therapy(EIT)for PCCI.METHODS Sixty-nine patients with PCCI who received EIT and conventional nursing intervention were selected as the control group,and 78 patients with PCCI who received EIT and MCLMM intervention were selected as the observation group.The incidence of postoperative complications,compliance and disease selfmanagement behavior after six months of intervention,modified Rankin scale(mRS)and Barthel index(BI)scores in the acute phase and after one year of intervention,and recurrence within one year were compared between the two groups.RESULTS The total incidence rate of postoperative complications in the observation group(7.69%)was lower than that in the control group(18.84%)(P<0.05).The scores for medical compliance behavior(regular medication,appropriate diet,and rehabilitation cooperation rates)and disease self-management behavior(self-will,disease knowledge,and self-care ability)in the observation group were higher than those in the control group(P<0.05).After one year of intervention,in the observation group,the mRS score was significantly lower,and the BI score was significantly higher than those in the control group(P<0.05).The recurrence rate within one year in the observation group(3.85%)was significantly lower than that in the control group(13.04%)(P<0.05).CONCLUSION MCLMM can reduce the incidence of complications after EIT for PCCI,improve patient compliance behavior and disease self-management ability,and promote the recovery of neurological function.

Clinical application of multidisciplinary team-and evidence-based practice project in gynecological patients with perioperative hypothermia

BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with PH.AIM To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with PH.METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting.Based on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP program.The incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the program.RESULTS The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the scheme.The implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001).The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97±2.04,which was significantly increased compared with the score of 21.27±1.57 observed by researchers at baseline(P<0.001).The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03±3.16 and 13.93±2.64 to 4.30±1.15 and 3.53±0.78,respectively,with statistically significant differences(P<0.001).The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17±1.68 to 26.93±1.11,also with statistical significance(P<0.001).CONCLUSION MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations,improve nurses'awareness and behavioral compliance with gynecological hypothermia management,and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’negative emotions and enhancing their cognitive function.

Effect of internet multiple linkage mode-based extended care combined with in-hospital comfort care on colorectal cancer patients undergoing colostomy

BACKGROUND Patients with colorectal cancer may need postoperative nursing to improve prognosis,and conventional nursing is not effective.Clinical research is needed to explore nursing methods that can more effectively improve postoperative conditions on colorectal cancer patients undergoing colostomy.AIM To explore the effect of internet multiple linkage mode-based extended care combined with in-hospital comfort care on colorectal cancer patients undergoing colostomy.METHODS Data from 187 patients with colostomy treated in our hospital from May 2019 to March 2022 were collected and divided into three groups,A(n=62),B(n=62)and C(n=63),according to different intervention methods.Group A received internet multiple linkage mode-based extended care combined with in-hospital comfort care.Group B received internet multiple linkage mode-based extended care.Group C received usual care intervention.Complications were compared among the three groups.The stoma self-efficacy scale,Hamilton Anxiety Scale,RESULTS The complication rate of group A,B and C(16.13%,20.97%and 60.32%,respectively)was significantly different(all P<0.05).The incidence of complications in groups A and B was lower than that in group C,and there was no significant difference between groups A and B(P>0.05).After intervention,the scores of ostomy care,social contact,diet choice,confidence in maintaining vitality,confidence in self-care of ostomy,confidence in sexual life,confidence in sexual satisfaction and confidence in physical labor in the three groups were all higher than before intervention,and the scores of groups A and B were higher than those of group C,with statistical significance(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Scale scores of the three groups after intervention were lower than those before intervention.The scores of groups A and B were lower than those of group C,and the score of group A was lower than that of group B,all with statistical significance(all P<0.05).There was a statist-ically significant difference in cancer-induced fatigue among the three groups(P<0.05).After intervention,the scores of physical health,psychological health,social health and mental health of the three groups were lower than before the intervention.The scores of group A and B were lower than that of group C;and the score of group A was lower than that of group B,all with statistical significance(all P<0.05).CONCLUSION Internet multiple linkage mode-based extended care combined with in-hospital comfort care can effectively improve self-efficacy,bad mood,cancer-related fatigue and life quality of colorectal cancer patients undergoing colostomy.

The artificial intelligence evidence-based medicine pyramid

Several studies exist in the literature regarding the exploitation of artificial intelligence in intensive care.However,an important gap between clinical research and daily clinical practice still exists that can only be bridged by robust validation studies carried out by multidisciplinary teams.

Wisdom and Old --age Pension： Reflections on China＇s Elderly Care Model

The care of the elderly is both a human basic human rights and a manifestation of social civilization. ＂Family pension＂ has always been the main pension model in China for thousands of years. However, with the transformation of social structure and population structure, the traditional ＂family pension＂ model is facing increasing challenges. While other emerging ＂institutions pension＂, ＂community pension＂ and failed to become a ＂family pension＂ alternative options, the role is limited. With the development of a variety of integrated technology, a new integrated technology based on the wisdom of the pension model began to emerge, wisdom pension as a new pension model has been in China with a preliminary attempt, it can maximize the elimination of the Chinese labor force The risk of population loss, the greatest extent to meet the needs of the elderly, the risk of dealing with old age, improve pension efficiency, and give the elderly equalization of power and ability, so as to fundamentally enhance the subjectivity of the elderly. But as a new exploration, but also faced with manyproblems, it is worth our in-depth thinking.

Thoughts on the Innovative Design of the Integrated Service Mode of Pharmacies and Elderly Care Centers

Objective To evaluate the service model that integrates medical treatment and elderly care to provide a reference for the development of pharmacies and elderly care centers.Methods Through the literature investigation and case analysis,the domestic integrated medical treatment and elderly care service model was analyzed,and new ideas for the integration of pharmacies and elderly care centers were provided.Results and Conclusion The integrated service model of pharmacies and elderly care centers is designed and the integration mode of pharmacies,hospitals and elderly care centers is proposed by analyzing their advantages.The“pharmacy+elderly care”mode and the“pharmacy+medical treatment+elderly care”mode that integrates pharmacies,hospitals,and elderly care centers are put forward to predict its new development opportunities in the future.

运用CICARE沟通模式的药学服务对布地格福吸入气雾剂使用效果的影响

目的:观察运用CICARE沟通模式的药学服务对布地格福吸入气雾剂使用效果的影响。方法:选取2024年1—3月江门市人民医院门诊使用布地格福吸入气雾剂的咳喘患者50例作为对照组(采用常规药学服务);2024年4—6月门诊使用布地格福吸入气雾剂的咳喘患者50例作为观察组(采用CICARE沟通模式的药学服务)。比较两组吸入气雾剂操作正确率、遵医行为、患者满意度。结果:两组刻度认识正确率比较,无统计学差异(P>0.05);观察组操作顺序、吸入方法正确率高于对照组(P<0.05)。观察组遵医行为依从性优于对照组(P=0.028)。观察组患者满意度高于对照组(P=0.001)。结论:运用CICARE沟通模式的药学服务能提高咳喘患者布地格福吸入气雾剂操作正确率,患者遵医行为依从性及对门诊药学服务的满意度更高。

Enhanced recovery after surgery-based evidence-based care plus ice stimulation for thirst management in convalescent patients following digestive surgery under general anesthesia

BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.

CICARE沟通模式在2型糖尿病患者延伸性护理中的应用效果

目的评估实施六步标准沟通模式(CICARE)在2型糖尿病患者住院及出院延伸性护理工作中的效果。方法选取新疆医科大学第六附属医院2018年1月—2020年6月收治的2型糖尿病患者489例,采用随机数字表法分为对照组(244例)和观察组(245例)。对照组实施常规护理,观察组在此基础上运用CICARE沟通模式进行护理。比较两组患者入院时、出院时及出院第3、6个月的血糖值、总胆固醇、甘油三酯、护理满意度及生存质量情况。结果与对照组比较,观察组出院第3、6个月的空腹血糖值,餐后2 h血糖值,总胆固醇值和甘油三酯值降低,差异均有统计学意义(P<0.05);观察组出院第3、6个月总有效率(93.1%、86.5%)均高于对照组(81.2%、60.2%),且有效人数均显著增多(P<0.01);与对照组比较,观察组住院期间护理满意度显著提高(P<0.05);与对照组比较,观察组第3、6个月生理功能、心理和精神、治疗3个维度得分增加,差异均有统计学意义(P<0.05)。结论CICARE沟通模式护理既能提高住院期间2型糖尿病患者满意度及治疗效果,又能有效维持2型糖尿病患者出院后的治疗效果,提高患者自我健康管理能力及生存质量,值得临床推广应用。

CICARE 沟通模式结合人文关怀在危重症患者家属探视沟通中的应用

目的研究危重症患者家属探视沟通中实施CICARE沟通模式结合人文关怀的效果。方法选择郑州大学第一附属医院2019年4月至2022年4月430例危重症患者家属作为研究对象,随机分为观察组和对照组,各215例。对照组接受人文关怀,观察组接受人文关怀和CICARE沟通模式。观察两组患者家属干预前后心理状态变化情况[焦虑自评量表(SAS)、抑郁自评量表(SDS)],护理干预后家属需求满足情况(病情动态信息、救治方案及预后、自身舒适、安抚患者、明确治疗费用)、护理满意度及投诉率。结果观察组护理干预后SAS、SDS评分均低于对照组(P<0.05);观察组护理干预后,病情动态信息、救治方案及预后、自身舒适、安抚患者、明确治疗费用评分均高于对照组(P<0.05);观察组护理干预后护理满意率为93.96%,高与对照组(86.98%),投诉率为0.93%低于对照组(6.98%)(P<0.05)。结论危重症患者家属探视沟通中实施CICARE沟通模式结合人文关怀能有效改善患者家属不良情绪,同时改善家属需求满足情况,进而提升护理满意度,降低投诉率,临床应用价值较高。

应用CICARE沟通模式对内科住院患者护理质量的影响

目的探讨CICARE沟通模式对内科住院患者护理质量的影响。方法对2017年1月—2017年6月的患者采用CICARE沟通模式实施护理服务,观察比较实施前后分级护理工作质量和患者满意度评价。结果实施CICARE沟通模式后,对分级护理质量进行比较,实验组健康教育维度得分、总分明显增高,比较差异有统计学意义(P<0.05)。实施CICARE沟通模式后,实验组综合满意度、单项满意度得分高于对照组,比较差异有统计学意义(P<0.05)。结论运用CICARE沟通模式,围绕护患沟通重点环节制作标准作业指导书,能够促进各层级护士同质化的执行护理工作,从而提高分级护理质量和患者满意度。

医院康复科长期护理对象照护需求调查分析

目的:调查深圳市长期护理对象在生存、康复、安全、精神方面的照护需求及期望,为服务质量评价及职业化培训提供指导。方法:自行编制照护需求问卷进行调查。将2022年7—9月深圳市4家医院康复科的长期护理对象及其家属、专职陪护、医护技纳入调查范围。结果:长期护理对象重要的30项照护需求呈多样化。家属、专职陪护对长期护理对象30项照护指标的权重打分与医护技人员强正相关,家属的权重分数欧氏距离优于专职陪护。陪护对长期护理对象的基础护理、安全管理、尊重照料、生活重建、精神慰藉方面照护条目的权重打分明显低于医护技。结论:家属较大程度满足了长期护理对象的照护需求,专职陪护需进一步提高医疗护理和精神照料方面的照护质量。

CICARE沟通模式联合小丑照护在居家隔离手足口病患儿门诊健康教育中的应用

目的探讨CICARE沟通模式联合小丑照护在居家隔离手足口病(HFMD)患儿门诊健康教育中的应用效果。方法选取2018年1月至2019年9月经南阳医学高等专科学校第一附属医院门诊确诊并实施居家隔离的90例HFMD患儿及其家长为研究对象。按照收治时间的先后顺序,分为对照组和研究组,每组45例。对照组患儿男27例,女18例,年龄(4.18±0.39)岁;研究组患儿男24例,女21例,年龄(4.10±0.43)岁。对照组实施传统模式门诊宣教,研究组在对照组基础上实施CICARE沟通联合小丑照护。记录两组患儿相关临床症状的改善情况,采用儿童孤独量评估患儿孤独感水平,自制HFMD治疗依从性调查问卷评估患儿治疗依从性,采用《HFMD儿童家长疾病认知表》评估家长对疾病知识的掌握水平,根据第4周随访情况评价家长居家遵医行为的执行状况,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估家长焦虑、抑郁水平。结果研究组患儿溃疡痊愈时间、皮疹消退时间、食欲不振消失时间、腹泻停止时间、退热时间及口腔黏膜愈合时间均低于对照组,差异均有统计学意义(均P<0.001);研究组的治疗依从性总分[(9.83±1.24)分比(18.79±1.56)分]、孤独感评分[(28.70±3.18)分比(39.20±6.15)分]均低于对照组,差异均有统计学意义(均P<0.001);干预1个月后,研究组家长居家隔离认知情况得分、居家隔离遵医率均高于对照组,SAS、SDS评分均低于对照组,两组比较差异均有统计学意义(均P<0.05)。结论CICARE沟通模式联合小丑照护干预,利于缩短居家隔离HFMD患儿各症状的改善时间,缓解其孤独感,避免自我隔绝,促进遵医行为,夯实治疗效果,提高患儿及其家长的隔离依从性,防止交叉感染,保障患儿健康。