BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperati...BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)patients.Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel prepara-tion.However,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.AIM To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.METHODS Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023.The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients.Colaizzi's seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview data.RESULTS The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'knowledge of bowel preparation is not adequate,and they may encounter numerous difficulties and challenges during the process.Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.展开更多
The concept of enhanced recovery after surgery(ERAS)has been practiced for decades and has been implemented in numerous surgical specialties.ERAS is a global surgical quality improvement initiative,and it is an elemen...The concept of enhanced recovery after surgery(ERAS)has been practiced for decades and has been implemented in numerous surgical specialties.ERAS is a global surgical quality improvement initiative,and it is an element in the field of perioperative care.ERAS had shown significant clinical outcomes,patientreported satisfaction,and improvements in medical service cost.ERAS has been developed for specific surgical procedures,but with the fast progress of newly introduced surgical procedures,the original ERAS have been developed and modified.Recently appearing Topics and future research trends encompass ERAS protocols for other types of surgery and the enhancement of perioperative status,including but not limited to pediatric surgery,laparoscopic and robotic assisted surgery,bariatric surgery,thoracic surgery,and renal transplantation.The elements and pathways of ERAS have been developed with the introduction of up-to-date methodologies in the pre-operative,operative,and post-operative pathways.ERAS costs are higher than traditional care,but the patient’s clinical outcome and satisfaction are higher.ERAS is in progress in the fields of anesthetic tasks,pediatric surgery,and organ transplantation.Although ERAS has shown significant clinical outcomes,there are needs to modify the protocol for specific cases,hospital facilities,resources,and nurses training on elements of ERAS.Several challenges and limitations exist in the implementation of ERAS that deserve consideration,it includes:Frailty,maximizing nutrition,prehabilitation,treating preoperative anemia,and enhancing ERAS adoption globally are all included.展开更多
目的:检索国内外妇科手术术前肠道准备的相关证据,并汇总成为最佳证据。方法:使用PIPOS工具明确研究问题,计算机检索英国国家卫生与临床优化研究所、加拿大安大略省注册护士协会、UpToDate、BMJ Best Practice、Web of Science、the Coc...目的:检索国内外妇科手术术前肠道准备的相关证据,并汇总成为最佳证据。方法:使用PIPOS工具明确研究问题,计算机检索英国国家卫生与临床优化研究所、加拿大安大略省注册护士协会、UpToDate、BMJ Best Practice、Web of Science、the Cochrane Library、PubMed、CINHAL、中国生物医学文献数据库、中国知网、万方数据库、医脉通等数据库,收集关于妇科手术术前肠道准备的方法及管理等相关证据,检索时限为建库至2023年6月,筛选出符合标准的文献。结果:共纳入7篇文献,其中,系统评价2篇,专家共识5篇,从术前评估、饮食护理、中医肠道准备3个方面汇总妇科手术术前肠道准备的12条最佳证据。结论:总结了关于妇科手术术前肠道准备的相关证据,为临床护理人员指导妇科手术病人术前肠道准备提供临床依据和参考。展开更多
目的:总结结肠镜检查病人肠道准备时咀嚼口香糖的最佳证据,为降低病人肠道准备不耐受发生率提供参考。方法:确定检索式,按照循证护理“6S”模型自上而下检索国际各大指南网、中国胃肠内镜学会网、欧洲胃肠内镜学会网、美国胃肠内镜学会...目的:总结结肠镜检查病人肠道准备时咀嚼口香糖的最佳证据,为降低病人肠道准备不耐受发生率提供参考。方法:确定检索式,按照循证护理“6S”模型自上而下检索国际各大指南网、中国胃肠内镜学会网、欧洲胃肠内镜学会网、美国胃肠内镜学会网、Up To Date、BMJ Best Practice、the Cochrane Library、澳大利亚Joanna Briggs Institute(JBI)循证卫生保健中心、PubMed、Web of Science、中国生物医学文献数据库、万方数据库、中国知网数据库等有关结肠镜检查病人肠道准备时咀嚼口香糖的相关证据。检索时间为2014年1月1日—2021年6月20日。证据类型包括临床决策、临床实践指南、专家共识、证据总结、系统评价和原始研究。由2名研究者对纳入文献质量进行独立评价并提取相关证据。结果:共纳入12篇文献,包括2篇指南、1篇临床决策、2篇系统评价、7篇随机对照试验。总结出10条证据,包括咀嚼口香糖的安全性和有效性、评估、宣教、口香糖种类、咀嚼时机、每次咀嚼时长、咀嚼数量、效果监测8个方面。结论:临床医护人员需结合病人偏好及临床实践选择最佳证据,降低病人肠道准备不耐受发生率,提高肠道准备效果。展开更多
文摘BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)patients.Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel prepara-tion.However,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.AIM To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.METHODS Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023.The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients.Colaizzi's seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview data.RESULTS The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'knowledge of bowel preparation is not adequate,and they may encounter numerous difficulties and challenges during the process.Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.
文摘The concept of enhanced recovery after surgery(ERAS)has been practiced for decades and has been implemented in numerous surgical specialties.ERAS is a global surgical quality improvement initiative,and it is an element in the field of perioperative care.ERAS had shown significant clinical outcomes,patientreported satisfaction,and improvements in medical service cost.ERAS has been developed for specific surgical procedures,but with the fast progress of newly introduced surgical procedures,the original ERAS have been developed and modified.Recently appearing Topics and future research trends encompass ERAS protocols for other types of surgery and the enhancement of perioperative status,including but not limited to pediatric surgery,laparoscopic and robotic assisted surgery,bariatric surgery,thoracic surgery,and renal transplantation.The elements and pathways of ERAS have been developed with the introduction of up-to-date methodologies in the pre-operative,operative,and post-operative pathways.ERAS costs are higher than traditional care,but the patient’s clinical outcome and satisfaction are higher.ERAS is in progress in the fields of anesthetic tasks,pediatric surgery,and organ transplantation.Although ERAS has shown significant clinical outcomes,there are needs to modify the protocol for specific cases,hospital facilities,resources,and nurses training on elements of ERAS.Several challenges and limitations exist in the implementation of ERAS that deserve consideration,it includes:Frailty,maximizing nutrition,prehabilitation,treating preoperative anemia,and enhancing ERAS adoption globally are all included.
文摘目的:检索国内外妇科手术术前肠道准备的相关证据,并汇总成为最佳证据。方法:使用PIPOS工具明确研究问题,计算机检索英国国家卫生与临床优化研究所、加拿大安大略省注册护士协会、UpToDate、BMJ Best Practice、Web of Science、the Cochrane Library、PubMed、CINHAL、中国生物医学文献数据库、中国知网、万方数据库、医脉通等数据库,收集关于妇科手术术前肠道准备的方法及管理等相关证据,检索时限为建库至2023年6月,筛选出符合标准的文献。结果:共纳入7篇文献,其中,系统评价2篇,专家共识5篇,从术前评估、饮食护理、中医肠道准备3个方面汇总妇科手术术前肠道准备的12条最佳证据。结论:总结了关于妇科手术术前肠道准备的相关证据,为临床护理人员指导妇科手术病人术前肠道准备提供临床依据和参考。
文摘目的:总结结肠镜检查病人肠道准备时咀嚼口香糖的最佳证据,为降低病人肠道准备不耐受发生率提供参考。方法:确定检索式,按照循证护理“6S”模型自上而下检索国际各大指南网、中国胃肠内镜学会网、欧洲胃肠内镜学会网、美国胃肠内镜学会网、Up To Date、BMJ Best Practice、the Cochrane Library、澳大利亚Joanna Briggs Institute(JBI)循证卫生保健中心、PubMed、Web of Science、中国生物医学文献数据库、万方数据库、中国知网数据库等有关结肠镜检查病人肠道准备时咀嚼口香糖的相关证据。检索时间为2014年1月1日—2021年6月20日。证据类型包括临床决策、临床实践指南、专家共识、证据总结、系统评价和原始研究。由2名研究者对纳入文献质量进行独立评价并提取相关证据。结果:共纳入12篇文献,包括2篇指南、1篇临床决策、2篇系统评价、7篇随机对照试验。总结出10条证据,包括咀嚼口香糖的安全性和有效性、评估、宣教、口香糖种类、咀嚼时机、每次咀嚼时长、咀嚼数量、效果监测8个方面。结论:临床医护人员需结合病人偏好及临床实践选择最佳证据,降低病人肠道准备不耐受发生率,提高肠道准备效果。
