Effects of high-quality neurosurgical nursing care on improving clinical nursing quality

BACKGROUND With continuous advancements in medical technology,neurosurgical nursing is constantly developing and improving to provide higher-quality nursing services.AIM To explore the effects of different types of high-quality nursing care on clinical nursing quality and patient satisfaction in neurosurgical nursing.METHODS Eighty patients who received neurosurgical treatment in the Affiliated Hospital of Southwest Medical University from June to December 2020 were selected as study participants and categorised into study and control groups.The study group comprised 40 patients who received 4 different types of high-quality nursing care,whereas the control group comprised 40 patients who received conventional nursing care.After a specific period,nursing satisfaction levels and adverse event and complication rates were compared between the two groups.RESULTS Satisfaction with high-quality care was higher than that with conventional care,and high-quality health services and regional services showed the highest satisfaction levels,with an average score of 12 on the Glasgow scale.The satisfaction levels of the study and control groups were 75%and 57%,respectively,with a statistically significant difference(t=7.314,P<0.05).During the nursing period,the adverse event and complication rates were the highest in patients with level III pathology grade and those who underwent neurosurgery(40.02%and 85.93%,respectively),and the difference was statistically significant.CONCLUSION In neurosurgical nursing,employing appropriate high-quality nursing methods can effectively reduce adverse event and complication rates in patients,thereby improving the quality of nursing care and increasing clinical nursing value.

Palliative care with adequate pain relief challenges the need for euthanasia legislation

Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persistence of this debate,there has been the emergence of the concept of the so-called alternative:palliative care.Positioned as a substitute for euthanasia,palliative care aims to alleviate suffering in terminally ill patients without engaging in the ethical dilemmas associated with euthanasia.Methods:This paper explores the facets of palliative care highlighting its core objectives such as providing adequate pain relief as a compassionate alternative to euthanasia.Results:By examining palliative care as a comprehensive approach to end of life support,this study challenges the perceived necessity of euthanasia and advocates,for compassionate and dignified end of life experiences.Conclusion:In conclusion,palliative care emerges as a viable and ethically sound alternative to euthanasia,emphasizing the importance of compassionate end-of-life care and pain management.

Analysis of the Significance of Key Points of Patient Interventional Psychological Care and Pain Care

Interventional therapy has become increasingly popular in clinical practice due to advancements in medical technology.However,patients often experience psychological and physiological pressure due to its invasive nature.The management of patient discomfort and tension is crucial to ensure effective treatment.Psychological and pain management are essential components of interventional therapy,as they significantly impact patient recovery and prognosis.This article discussed the importance of interventional psychological and pain care for patients,starting with the development and spread of interventional therapy.The significance of providing high-quality nursing services to patients and improving their quality of life was also discussed.

Medical School Students’ Knowledge of Pain and Palliative Care: An Observational Study

Background: Pain and palliative care are a reality in daily routines of medical treatment. However, the theoretical-practical curricula of traditional medical school course still unsatisfactorily contemplate pain management, as well as the palliative care approach. Objective: To assess the knowledge of medical students about pain and palliative care, as well as to identify their perception of teaching these topics during hospitalization. Methods: A cross-sectional observational study, with a descriptive and exploratory approach, data collection for which was carried out between August and November 2020. The target population was medical students, who responded to an online survey of a quantitative, anonymous and follow-up nature. The survey study variables concerned knowledge about pain management and palliative care. Results: An expressive majority of academics showed difficulty in understanding the pathophysiology of pain related to prescribing drugs for pain management purposes, and all of them believe that it is necessary to acquire more knowledge about pain treatment. In parallel, only 9.3% report having received sufficient information regarding palliative care during medical school. Conclusion: The results suggest a certain lack of knowledge and insecurity among medical school students with respect to pain management and care for patients receiving palliative care. The didactical approach to this theme is still deficient in the medical curriculum and requires immediate improvement and new proposals that address the training of these professionals in a more specific and effective way.

Application of Wax Therapy in Pain Care of Patients with Rheumatoid Arthritis

Objective: To investigate the effect of wax therapy in pain care of patients with rheumatoid arthritis. Methods: Convenience sampling method was used to select inpatients with rheumatoid arthritis admitted to the rheumatology and immunology department of a 3A hospital in Jingzhou City. 75 patients from January 2021 to June 2021 were selected as the control group, and 75 patients from January 2022 to June 2022 were selected as the observation group. The control group was given routine nursing, and the observation group was implemented wax therapy nursing on the basis of the control group. The relief of clinical symptoms (morning stiffness time, pain score) and quality of life score of the two groups were observed. Results: After intervention, there was statistical significance between the two groups (P Conclusion: Wax therapy can improve the time of morning stiffness, the degree of pain and the quality of life of patients with rheumatoid arthritis.

Pain management in chronic pancreatitis

Pain in chronic pancreatitis(CP)is difficult to manage.Many patients suffer from inadequate pain relief,completely incapacitating them in their daily activities.Historically,despite their well-known adverse effects,opioids have been the pillar of treatment regimens in painful CP.The management is now gradually evolving with a better understanding of the underlying pathophysiology of CP-related pain.Clinicians should follow a holistic approach to the management of CPassociated pain,which must involve lifestyle changes that are coupled with analgesic medications and other pain-relieving interventions.Furthermore,there is no easy cure for vanquishing CP-associated pain.Each patient must be evaluated on a case-by-case basis by a multidisciplinary team to decide which treatment option is best suited for that individual.

Optimizing pain management in elderly patients post-knee surgery:A novel collaborative strategy

Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of such surgeries,the article highlights the critical need for effective postoperative care strategies.This editorial provides an overview of rehabilitation care for pain in elderly knee replacement patients,emphasizing the importance of a multimodal approach to postoperative recovery.Furthermore,the article advocates for a patient-centered,comprehensive rehabilitation regimen that enhances recovery and quality of life in elderly patients undergoing knee replacement surgery.

Effect of information-motivation-behavioral skills model based perioperative nursing on pain in patients with gallstones

BACKGROUND The incidence of cholecystolithiasis is on the rise.Use of information,motivation,and behavioral skills can play a positive role in promoting changes in individual health behaviors.However,reports on the effects of information-motivationbehavioral(IMB)skills model based high-quality nursing as a perioperative nursing intervention for patients with gallstones are nonexistent.AIM To explore the application of IMB skills model based high-quality nursing in patients with gallstones.METHODS Two hundred and sixteen patients with cholecystolithiasis treated at our hospital from January 2022 to January 2023 were enrolled and divided into a control,highquality,and combined nursing groups,with 72 patients in each group.The control,high-quality,and combination groups received conventional,high-quality,and IMB skills model based perioperative nursing services,respectively.Differences in clinical indicators,stress levels,degree of pain,emotional state,and quality of life were observed,and complications and nursing satisfaction among the three groups were evaluated.RESULTS After nursing,the time to recovery of gastrointestinal function in the high-quality and combined nursing groups was significantly shorter than that of the control group,with the recovery of gastrointestinal function being the fastest in the combined nursing group(P<0.05).After nursing intervention,cortisol and norepinephrine levels in the high-quality and combined nursing groups were closer to normal than those of the control group 24 h after surgery,with the combined nursing group having the closest to normal levels(P<0.05).After 3 and 7 d of intervention,the patients’pain significantly improved,which was more prominent in the highquality and combination groups.Meanwhile,the pain score in the combination group was significantly lower than those of the control and high-quality nursing groups(P<0.05).After nursing intervention,the emotional states of all patients improved,and the scores of patients in the combination group were significantly lower than those of the control and high-quality nursing groups.The quality of life of patients in the high-quality and combined nursing groups significantly improved after nursing intervention compared to that of the control group,with the combined nursing group having the highest quality of life score.After intervention,the incidence of complications in the high-quality and combination groups was significantly lower than that of the control group(P<0.05),but the difference between the combination and high-quality nursing groups was not significant.Nursing satisfaction of patients in the high-quality and combination groups was significantly higher than that of the control group,with the nursing satisfaction being the highest in the combination group(P<0.05).CONCLUSION IMB skills model based nursing can improve surgical stress levels,degrees of pain,emotional state,quality of life,and nursing satisfaction of patients with gallstones and reduce the incidence of complications.

High-risk factors for delirium in severely ill patients and the application of emotional nursing combined with pain nursing

BACKGROUND Delirium is a neuropsychiatric syndrome characterized by acute disturbances of consciousness with rapid onset,rapid progression,obvious fluctuations,and preventable,reversible,and other characteristics.Patients with delirium in the intensive care unit(ICU)are often missed or misdiagnosed and do not receive adequate attention.AIM To analyze the risk factors for delirium in ICU patients and explore the applica-tion of emotional nursing with pain nursing in the management of delirium.METHODS General data of 301 critically ill patients were retrospectively collected,including histories(cardiovascular and cerebrovascular diseases,hypertension,smoking,alcoholism,and diabetes),age,sex,diagnosis,whether surgery was performed,and patient origin(emergency/clinic).Additionally,the duration of sedation,Richmond Agitation Sedation Scale score,combined emotional and pain care,ven-tilator use duration,vasoactive drug use,drainage tube retention,ICU stay du-ration,C-reactive protein,procalcitonin,white blood cell count,body tempe-rature,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment score were recorded within 24 h after ICU admission.Patients were assessed for delirium according to confusion assessment method for the ICU,and univariate and multivariate logistic regre-ssion analyses were performed to identify the risk factors for delirium in the patients.RESULTS Univariate logistic regression analysis was performed on the 24 potential risk factors associated with delirium in ICU patients.The results showed that 16 risk factors were closely related to delirium,including combined emotional and pain care,history of diabetes,and patient origin.Multivariate logistic regression analysis revealed that no combined emotional and pain care,history of diabetes,emergency source,surgery,long stay in the ICU,smoking history,and high APACHE II score were independent risk factors for de-lirium in ICU patients.CONCLUSION Patients with diabetes and/or smoking history,postoperative patients,patients with a high APACHE II score,and those with emergency ICU admission need emotional and pain care,flexible visiting modes,and early intervention to reduce delirium incidence.

Management of procedural pain in the intensive care unit

Pain is a common experience for inpatients,and intensive care unit(ICU)patients undergo more pain than other departmental patients,with an incidence of 50%at rest and up to 80%during common care procedures.At present,the management of persistent pain in ICU patients has attracted considerable attention,and there are many related clinical studies and guidelines.However,the management of transient pain caused by certain ICU procedures has not received sufficient attention.We reviewed the different management strategies for procedural pain in the ICU and reached a conclusion.Pain management is a process of continuous quality improvement that requires multidisciplinary team cooperation,painrelated training of all relevant personnel,effective relief of all kinds of pain,and improvement of patients'quality of life.In clinical work,which involves complex and diverse patients,we should pay attention to the following points for procedural pain:(1)Consider not only the patient's persistent pain but also his or her procedural pain;(2)Conduct multimodal pain management;(3)Provide combined sedation on the basis of pain management;and(4)Perform individualized pain management.Until now,the pain management of procedural pain in the ICU has not attracted extensive attention.Therefore,we expect additional studies to solve the existing problems of procedural pain management in the ICU.

Kangaroo Care (Skin-to-Skin) for Clustered Pain Procedures: Case Study

Background: Pain management for term newborns undergoing clustered painful procedures has not been tested. Kangaroo Care (chest-to-chest, skin-to-skin position of infant on mother) effectively reduces pain of single procedures, but its effect on pain from clustered procedures is not known. Aim: The aim was to test Kangaroo Care’s effect on pain in one term infant who received clustered painful procedures while determining feasibility of the Kangaroo Care intervention. Design, Setting, and Participant: A case study design was used with one healthy term newborn who received two heel sticks and one injection in one session in the mother’s postpartum room. Method: Heart rate and oxygen saturation (recorded from Massimo Pulse Oximeter every 30 seconds), crying time (total seconds of crying on videotape) and behavioral state (using Anderson Behavioral State Scoring system every 30 seconds) were measured before (5 minutes), during (10.5 minutes) and after (30 minutes) the three clustered painful procedures in a newborn who was in Kangaroo Care during all observations. One staff nurse administered the clustered procedures. Results: Heart rate increased sequentially with each heelstick, oxygen saturation remained unchanged, sleep predominated, and crying was minimal throughout the procedures. Conclusion: Kangaroo Care appeared to reduce pain from clustered painful procedures and can be further tested.

Nurses' experiences with health care in pain clinics: A qualitative study

Background: Recent research has focused on the effectiveness of different treatment regimens in pain clinics,where a call for more multifaceted treatment has been highlighted.Less attention has been paid to improvements within pain clinics,and how registered nurses-who usually play a key role-perceive and experience the accessibility,treatment options and follow-up offers at public pain clinics.Objective: The overall aim was to explore and describe how nurses experience health care provided to patients with chronic non-cancer pain at pain clinics.Methods: We used 10 individual interviews with nurses working at 10 different public pain clinics in Norway.The interviews were analyzed using qualitative content analysis.Results: One theme was developed from the content analysis: "Nurses' striving to provide whole-person care in pain clinics." The nurses experienced allocation of limited resources as challenging,especially when the dilemma between accepting new patients from the waiting list and offering follow-up to existing patients became apparent.Multifaceted treatment was perceived as vital,although resources,priorities,and theoretical understanding of pain within the team were challenging.Conclusions: The needs for multifaceted and integrated treatments in chronic pain management were obvious,although this approach appeared to be too demanding of resources and time.Stronger cooperation between pain clinics in specialist care and health care providers in primary care to ensure better patient flow and treatment is required.Emphasis is placed on coherent theoretical approaches to pain management within the team in the pain clinics to ensure whole person care.

Clinical Audit Project Report —Audit of the Palliative Care Practitioners’ Adherence to WHO Guidelines in Managing Patients’ Pain at Cancer Diseases Hospital, Lusaka, Zambia

Appropriate adherence to World Health Organisation (WHO) pain management guidelines is vital in palliative care centres as it promotes the comfort of patients who are experiencing pain and it improves their quality of life. WHO (1996) highlighted the use of the WHO analgesic ladder guideline. This “analgesic ladder” proposes that after proper assessment with an appropriate pain assessment tool, patients in mild pain should be given non-opioids plus or minus adjuvants (including anticonvulsants and steroids);patients in moderate pain should be given weak opioids plus or minus non-opioids plus or minus adjuvants;and patients in severe pain should be given strong opioids plus or minus non-opioids plus or minus adjuvants as per the WHO pain ladder. The audit project was focused on assessing the palliative care practitioners’ (PCPs) adherence to WHO guidelines in managing their patients’ pain at Cancer Diseases Hospital (CDH). 15 participants were involved in the study and the data collection method used was a cross-sectional study in which the auditor observed PCPs, with an observation checklist comparing practice with WHO analgesic ladder guidelines. The result revealed that most of the PCPs were not meeting 80% of the standard set in the specific objectives for the audit. 7 (47%) PCPs were scoring the pain level before analgesia administration, whereas 8 (53%) PCPs were not scoring the pain level before analgesia administration. On the other hand, 47% (7 PCPs) were adhering to the WHO ladder of pain management, but 53% (8 PCPs) were not adhering to the WHO ladder of pain management. Therefore, effective adherence to the WHO analgesic ladder practice is still lacking in the PCPs at CDH. The percentage of PCPs who were not scoring the pain and not adhering to the WHO pain ladder guidelines was high, which is 8 (53%). Therefore, a re-audit is recommended to find out if levels of adherence have improved or not.

Pain Management and Factors Associated with Its Severity among Post Surgical Patients Admitted in the Intensive Care Unit at Muhimbili National Hospital, Tanzania

Background: Pain is the common experience among post operative patients admitted to the intensive care unit. Inadequate management can lead to undesired complications which can increase risk for morbidity and mortality. Objective: The aim of this study was to assess pain management and factors associated with its severity among post surgical patients admitted in intensive care unit at MNH. Method: A prospective study was conducted from October 2017 to February 2018 involving a total of 123 post operative patients aged 18 years and above admitted to the surgical and obstetric intensive care units. Structured questionnaires were used to obtain the required perioperative information. Severity of pain was assessed by using the Numerical Rating Scale (NRS). Data was analyzed using SPSS version 23.0. Frequency, percentages, tables and charts were used to summarize the study findings. Bivariate analysis and multivariate logistic regression were done. P-value of Results: The prevalence of severe post operative pain within 24 and 72 hours was 32.1% and 41.5% respectively. Pre operative use of analgesia (OR: 2.66, CI: 1.15 - 6.12, P value = 0.02), abdominal surgery (OR: 4.12 CI: 1.12 - 15.88, P value = 0.03) and thoracic surgeries (OR;7.42, CI: 1.54 - 35.88, P value = 0.01) was significantly associated with severe pain. Age, sex, ASA class, duration of surgery, and level of education did not show significant association with pain severity. Opioids prescribed postoperatively were pethidine (70.7%), morphine (11.4%) and fentanyl (11.4%). Other analgesics used were paracetamol (60.2%) and diclofenac (22%). Conclusion: The magnitude of post operative pain was high. Pre operative uses of analgesia, abdominal and thoracic surgery were the factors associated with severe pain. Pethidine and paracetamol were the most prescribed drugs, however the prescription pattern used was inadequate to control pain.

Application of Palliative Care in Improving the Quality of Life of Patients with Cancer Pain

Objective: To explore the effect of palliative care on the quality of life of patients with cancer pain. Methods: For May 2015 to May 2016 hospitalized 57 patients with advanced cancer pain carry out palliative care. At the same time, the quality of life questionnaire, including physical function, role function, emotional function, cognitive function and social function, were investigated at the time of admission and 6 weeks after admission. Results: Patients with various functions have significantly improved after palliative care (P Conclusions: Palliative care can effectively improve the quality of life of patients with cancer pain. It is worth in clinical promotion.

Inter-Professional-Compassionate pain management during endotracheal suctioning: a valuable lesson from a Chinese surgical intensive care unit

Objective:To compare the effects of a pain management program and routine suctioning methods on the level of pain presence and agitation in Chinese adults admitted to the intensive care unit.To disseminate the results from the implementation of the evidence-informed pain management interventions for reducing pain presence and agitation during endotracheal tube suctioning(ETS)and translate the key finding to clinical nursing practice.Methods:A quasi-experimental study of a two-group post-test design was conducted in adults admitted after surgery to a surgical intensive care unit(SICU)of the Second Affiliated Hospital of Kunming Medical University,Yunnan,China in 2018.Fifty-two adults who met the study eligibility were included after consent,26 in each group.Patients in the control group received usual care while patients in the intervention group received interventions to reduce agitation and pain-related ETS.The impacts of the intervention on the level of pain presence and agitation were measured at 5 measuring time points using the Chinese versions of Critical-Care Pain Observation Tool(CPOT)and Richmond Agitation Sedation Scale(RASS).Results:The level of pain presence in the intervention group statistically significantly decreased during,immediately after,and 5 min after suctioning.The level of agitation in the intervention group significantly decreased during and immediately after suctioning.Conclusions:The findings provide support for the positive pain-relieving effects of the evidence-informed pain-related ETS management interventions when compared with the usual ETS practice.The study interventions were sufficiently effective and safe to maintain patent airway clean and patent as standardized suctioning and helps pain relief.So,evidence-based pain-related ETS management intervention is worthy of recommending to utilize in SICU patients as well as other patients who required suctioning.It is worth noting that integrating pre-emptive analgesia prescription and administration with non-pharmacological intervention plays a critical role in achieving pain relief.

Pain and Care： Interventions in Daily Nursing Practice

Pain is a common symptom in humans, which differs significantly depending on their status of health. This review lists the specific features of pain that are necessary for its evaluation and treatment by the health professionals. Extensive review of the recent literature was conducted in electronic databases （PubMed, Medline and Iatrotek） and scientific journals in Greek and English. Pain is perceived as any uncomfortable feeling, and emotional experience that occurs anywhere in the body when there is some kind of injury. The assessment of pain in humans is a complex and demanding process. Pain should be treated early with appropriate pharmaceutical or other treatment. Each pain has a different cause and treatment. The objective of health professionals＇ interventions is to cure or at least reduce pain and to relieve those who are in pain.

Study on the Effect of High-quality Nursing Combined with Breathing Exercises on Patients with Chronic Obstructive Pulmonary Disease

Objective:To study the effect of high-quality nursing combined with breathing exercises on patients with COPD.Methods:Using the random number table method of medical experiments,60 patients with COPD received in our hospital from March 2020 to March 2021 were used as research samples.According to the differences in treatment measures,they were equally divided into control group and intervention group.Symptomatic support treatment and nursing routine,high-quality nursing combined with respiratory function exercise treatment and nursing were given respectively,and the application effects of the two groups were compared and analyzed.Results:The controllable rate of disease between the intervention group and the control group was 93.33%(28/30)and 66.67%(20/30)respectively,which was statistically significant(P<0.05).The comparison between the intervention group and the control group on the pulmonary function indexes of VT,TPTEF/Te,VEF/Te/,Ti/Te was statistically significant(P<0.05).The results of the intervention group on exercise pulse and 6-minute walking distance were significantly higher than those of the control group(P<0.05).Conclusions:The combination of high-quality nursing care and breathing exercises has outstanding disease controllable rate in patients with COPD,especially in improving the lung function of the patients and the level of treatment and care.It can be used as a feasible measure in the subsequent clinical treatment and nursing practice of patients.It is worthy of clinical promotion and implementation.

Effect of High-Quality Nursing on Patients with Hemorrhagic Fever with Renal Syndrome

Objective:To explore and analyze the effect of high-quality nursing on patients with epidemic hemorrhagic fever with renal syndrome.Methods:Ninety patients with epidemic hemorrhagic fever with renal syndrome treated in Huyi District People’s Hospital from October 2021 to January 2022 were randomly divided into an experimental group and a control group,with 45 cases in each group.The control group received routine nursing and the experimental group received high-quality nursing.The effect of routine nursing and high-quality nursing were compared and analyzed based on the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),the degree of satisfaction with nursing care,and the patients’quality of life.Results:Before nursing,there was no significant difference in the patients’psychological state between the two groups(P>0.05);after nursing,there was significant difference in the patients’psychological state between the two groups(P<0.05);the degree of satisfaction with nursing care of the experimental group was significantly higher than that of the control group(P<0.05);comparing the quality of life of the two groups,the quality-of-life score of the control group was significantly lower than that of the experimental group(P<0.05).Conclusion:For patients with epidemic hemorrhagic fever with renal syndrome,high-quality nursing can significantly and effectively improve their psychological state,level of satisfaction with nursing care,and quality of life.

联合应用多种中医适宜技术干预阿片类药物相关性便秘的多中心临床研究

目的通过多中心临床研究,评价多项中医适宜技术联合干预对阿片类药物相关性便秘的临床疗效。方法2021年7月至2022年10月,在上海中医药大学附属岳阳中西医结合医院肿瘤科病房、利群医院安宁疗护病房、长征社区卫生服务中心安宁疗护病房选取符合阿片类药物相关性便秘诊断标准及便秘津亏肠燥证辨证标准的住院患者为研究对象,采用随机数字法分为对照组(n=164)与观察组(n=164)。两组患者均参照《阿片类药物相关性便秘中西医结合护理方案》开展常规护理工作。对照组在常规护理的基础上,给予乳果糖口服液(每日3次,每次10 mL空腹服用)及相应的用药指导;观察组在常规护理的基础上,采用中药贴敷、中药离子导入、耳穴压豆3项中医适宜技术联合干预。两组患者干预时间均为14 d,比较两组患者干预后的日均排便次数、平均排便间隔时间,干预前后的便秘症状、便秘相关生活质量及疼痛评分。结果观察组患者治疗便秘的显效率(31.71%)高于对照组(8.54%),且两组便秘症状疗效比较,差异有统计学意义(Z=-5.41,P<0.01);治疗后两组患者的日均排便次数及平均排便间隔时间差异均无统计学意义(P>0.05);两组患者治疗后便秘症状及相关生活质量较治疗前均有明显改善和提高,且观察组便秘症状及便秘相关生活质量评分的变化均比对照组更为明显,差异均有统计学意义(P<0.01);两组患者干预后疼痛评分均明显低于干预前,差异有统计学意义(P<0.01),但组间差异无统计学意义(P>0.05)。结论多种中医适宜技术联合干预可改善阿片类药物相关性便秘患者的便秘情况,同时可有效缓解患者的便秘不适症状、提高患者的生活质量,符合晚期肿瘤患者安宁疗护的理念,具有一定临床推广意义。