Anxiety and depression in older adult patients undergoing elective liver surgery in allopatry medical treatment

Background:Allopatry medical treatment is common in China.However,allopatry medical therapy can result in many problems,including a negative psychological impact on patients.Patients undergoing liver surgery often experience anxiety and depression.To understand the psychological status of older adult patients undergoing surgery better,this study was designed to investigate the incidence of anxiety and depression in older adult patients undergoing elective liver surgery and to analyze factors associated with it in allopatry medical therapy.Methods:A total of 173 older adult patients undergoing elective liver surgery were included in the study.Patients were evaluated using the hospital anxiety and depression scale(HADS).The contributing factors affecting the psychological state of older adult patients undergoing elective surgery were analyzed using a linear regression method.Results:The HADS-A(hospital anxiety and depression scale-anxiety).The correlation(scale)score of the older adult patients undergoing elective liver surgery was(8.69
2.38),including 53 asymptomatic patients,86 suspicious patients,and 34 symptomatic patients.The HADS-D(hospital anxiety and depression scale-depression)score was(8.31
2.90),including 83 asymptomatic patients,56 suspicious patients,and 34 symptomatic patients.Multivariate analysis showed that residence and complication grade(Clavien–Dindo Classification of Surgical Complications or Accordion Severity Grading System)significantly correlated with the anxiety level of patients undergoing elective surgery.Residence,a requirement of blood transfusion,total transfusion volume,and Accordion complication grade showed a significant correlation with depression in patients undergoing elective surgery.Conclusions:Anxiety and depression in older adult patients undergoing elective liver surgery were common.Regional differences(local patients vs non local patients)and the severity of complications were the risk factors for anxiety and depression in older adult patients undergoing elective liver surgery.Reducing both regional differences and the severity of complications would be beneficial to alleviate the risk of anxiety and depression in older adult patients undergoing elective liver surgery and thus promote their physical and mental health.

Hourly Rounding and Fall Prevention among the Elderly in Long Term Care: A change Process

Long term care facilities have a rising rate of falls and fall related injuries with increasing cost and more hospitalization.Hourly rounding®is an evidenced based intervention that is proactive for nursing staff to be able to identify patient’s needs.This helps with positive fall prevention out­come.This project focused on process improvement efforts for 10 weeks and examining the education and implementation of an evidenced-based hourly rounding program that assisted in reducing the number of falls in the pilot unit.The implementation of the intervention took place in a long-term care facility located in Dallas,Georgia.The hourly rounding tools used in this project were the Studer Group hourly rounding log and competency checklist with permission.Twenty staff members were in­cluded in the sample,age 18 years and 60 years.The unit has 41 residents who were included in the pilot case study design.Staff members were first educated regarding hourly rounding and documentation on the hourly rounding log was done two days before implementation and the pre and post fall rate was retrieved from the facilities fall database.Competency checklist was completed prior to implementation and post implementa­tion to evaluate staff understanding of the main tenets of the 4 P’s(potty,pain,possession,and position).For this project,descriptive statistics was used to help determine fall rates.Minitab was used to analyzed data and to determine if it was clinically significant.In the ten weeks following the hourly rounding implementation,participants performed hourly rounding by incorporating it to each resident’s daily routine and documented their rounds on the log sheet.The results indicated that it is statistically signifi­cant and with a P-values=-<0.0001 and t-value=-5.81.