Holistic conditions after colon cancer:A randomized controlled trial of systematic holistic care vs primary care

BACKGROUND Study showed that systemic holistic care not only aids in disease treatment and physical recovery to a certain extent but also effectively enhances patient psychological well-being,social support,and overall quality of life(QoL).AIM To assess systematic holistic care impact on the recovery and well-being of postoperative patients with colon cancer.METHODS Our randomized controlled trial included 98 postoperative patients with colon cancer admitted to our hospital from June 2021 to June 2022.Patients were divided into control and study groups.The control group received conventional postoperative nursing care,whereas the study group received systematic holistic nursing care.We monitored gastrointestinal function recovery,and recorded changes in serum albumin(ALB),prealbumin(PA),psychological state,selfmanagement,self-efficacy,QoL,and the occurrence of complications in patients before,at discharge,and 2 wk post-discharge.Spearman analysis assessed correlations between psychological state,self-management,self-efficacy,and QoL of patients in the study group 2 wk post-discharge.RESULTS Following the nursing intervention,we observed significantly shorter postoperative bowel sound recovery time,anal exhaust time,and defecation time in the study group than in the control group(P<0.05).Patient ALB and PA levels,psychological status,self-management ability,self-efficacy and QoL at discharge and 2 wk post-discharge significantly improved,with greater improvements observed in the study group(P<0.05).Both groups experienced complications post-interventions,but the intervention group had significantly lower complication rate(3/49,6.12%)(P<0.05).In the study group,patient anxiety,depression,self-management and QoL scores at 2 wk post-discharge exhibited a significant negative correlation(3/49,6.12%)with QoL scores,with correlation coefficients of r=-0.273,-0.522,-0.344,and P<0.01,respectively.Conversely,patient self-efficacy scores 2 wk postdischarge showed a positive correlation with QoL scores(r=0.410,P=0.000).CONCLUSION Systemic holistic nursing significantly benefits postoperative patients with colon cancer by promoting gastrointestinal recovery,improving post-operation well-being,reducing complications,and enhancing QoL.

Application Effect of Hierarchical Group Responsibility System Holistic Nursing in Department of Gastroenterology

Objective:To analyze the application effect of hierarchical group responsibility system of holistic nursing in Department of Gastroenterology.Methods:655 patients in our hospital from August 2020 to January 2021 were selected as the research objects.They were randomly divided into experimental group(328 cases)and control group(327 cases)to explore nursing satisfaction,nursing quality score and clinical symptoms before and after nursing.Results:In the experimental group,266 cases(81.10%)were very satisfied,33 cases(10.06%)were satisfied and 29 cases(8.84%)were dissatisfied.The total number of satisfied cases(very satisfied+satisfied)was 299 cases(91.16%);In the control group,167 cases(51.07%)were very satisfied,63 cases(19.27%)were satisfied,97 cases(29.66%)were dissatisfied,and 230 cases(70.34%)were satisfied.The nursing satisfaction of the experimental group was significantly higher than that of the control group;The nursing quality score of the experimental group was(91.67±0.66),and that of the control group was(71.66±0.88),which was significantly higher than that of the control group;The clinical symptom score of the experimental group was(2.42±0.32),and that of the control group was(4.66±1.11),which was significantly better than that of the control group.Conclusion:The application of hierarchical group responsibility holistic nursing mode in gastroenterology department can not only improve the nursing satisfaction of patients,but also improve the quality of nursing,promote the good development of patients'condition,and provide a comfortable treatment environment for patients,which is worthy of clinical promotion.

A review of whole-medical systems and holistic care approach for type 2 diabetes and associated metabolic syndrome

Whole-person care and holistic care approach has been proposed for complementary and integrative health care for type 2 diabetes mellitus.However,some doubts still exist on the feasibility of replicating processes followed in clinical trials and observational studies in real-world settings.This narrative literature review summarized and assessed existing clinical evidence(clinical trials,observational studies,and case reports)describing holistic and integrated care approach in adult and adolescent individuals with type 2 diabetes mellitus in clinical practice.The goal was to highlight existing evidence for implementation and outcomes of whole-medical systems and holistic integrated care approach for type 2 diabetes mellitus.A nonsystematic literature search was performed on Google Scholar,PubMed,Web of Science,ProQuest and ScienceDirect to identify clinical evidence from different parts of the world,evaluating the use of whole-medical systems and/or holistic care interventions in clinical practice for management of type 2 diabetes mellitus.Relevant keywords were used in the search.Data were analyzed using content analysis and simple descriptive statistics(percentages).Most of the studies(64%)were mainly conducted in Eastern countries(India,China and Israel)while 36%of the studies were conducted in the Western countries(USA,Netherlands,Canada and Mexico).Lifestyle medicine and integrated naturopathy were shown to be the commonly used whole-medical systems for type 2 diabetes mellitus management.Significant improvements in type 2 diabetes parameters,medication use,other symptoms,and overall feeling of wellness were observed in all studies.This review study revealed limited utilization and/or documentation of whole-medical systems or holistic care treatments for type 2 diabetes mellitus in regions of the world other than eastern countries.Lifestyle medicine,naturopathy,yoga,Ayurveda and traditional Chinese medicine were shown to be effective for type 2 diabetes mellitus,either as an alternative or as a complementary therapy.

Holistic care model of time-sharing management for severe and critical COVID-19 patients

The rapid global outbreak of coronavirus disease 2019(COVID-19)and the surge of infected patients have led to the verge of exhaustion of critical care medicine resources worldwide,especially with regard to critical care staff.A holistic care model on time-sharing management for severe and critical COVID-19 patients is proposed,which includes formulation of individualized care objectives and plans,identification of care tasks in each shift and making detailed checklist,and management of quality of care.This study was conducted in the COVID-19 treatment center of Harbin,Heilongjiang Province.The data collected from the treatment center were recorded and analyzed.From the results we can deduce that it is especially suitable for non-intensive care unit(non-ICU)nurses to adapt care management mode of ICU as soon as possible and ensure the quality and efficiency of care during the epidemic.The holistic care model on time-sharing management for severe and critical cases with COVID-19 proposed based on our daily work experiences can assist in improving the quality and efficiency of care,thus reducing the mortality rate of patients in ICU.

Holistic care for patients with severe coronavirus disease 2019: An expert consensus

Objective:To standardize the holistic care for patients with severe coronavirus disease 2019(COVID-19)in China.Methods:The consensus was preliminarily formed by combining relevant literature findings and frontline medical working experiences,and it was eventually confirmed by five rounds of online discussions and expert consultations.Results:This consensus included nursing assessment,nursing priorities,nursing goals,and thirteen key points of nursing procedures such as oxygen therapy and respiratory nursing,etc.Conclusion:This scientific and practical consensus guideline can provide clinical guidance on the holistic nursing care of patients with severe COVID-19.

Holistic Care in the Treatment of Cachexia

Cachexia is a state of wasting metabolism,which is mainly caused by cancer and other major chronic diseases and can seriously reduce the survival rate and the quality of life of the patients.Although there have been increasing researches on cachexia in recent years,the underlying mechanism has not yet been elucidated and there is no effective means to cure cachexia in the clinic.The terminal character of cachexia is irreversible,and thus holistic care needs to be applied to the treatment,in order to improve the quality of life of patients with cachexia.In the present review,we summarize the role of holistic care in treating cachexia,providing a theoretical basis for the development and application of holistic care in China.

Holistic approaches to mitigating psychological distress in gynecological cancer patients

This article delves into the psychological impact of gynecological malignancies and suggests pathways to improve the quality of life(QoL)for affected patients.Building on Shang et al's comprehensive analysis,this piece integrates insights from various studies to highlight the profound influence of psychological and physical symptoms on patients undergoing treatment for gynecological cancers.The study underscores that anxiety and depression significantly exacerbate the disease's toll.Factors such as physical exercise and digital and interactive health interventions show promise in mitigating these adverse effects.The article emphasizes the necessity for a holistic care approach that addresses both physical and emotional needs.Recommendations include enhanced training for healthcare providers,public awareness campaigns,streamlined diagnostic pathways,and improved access to specialist care.These integrated strategies aim to ensure that women facing gynecological cancers can maintain an optimal QoL through comprehensive and multidisciplinary care models.

Influence of humanistic care-based operating room nursing on safety,recovery,and satisfaction after radical surgery for colorectal carcinoma

BACKGROUND Radical surgery is a preferred treatment for colorectal carcinoma,wherein nursing intervention is essential for postoperative recovery and prevention of complications.Recently,the application of humanistic care in medical care has attracted attention.Humanistic care emphasizes comprehensive care,with importance attached to patients’physical needs as well as psychological and emotional support to provide more humane and personalized care services.However,no clinical reports have examined the use of humanistic care in patients undergoing radical surgery for colorectal carcinoma.AIM To investigate the influence of humanistic care-based operating room nursing on the safety,postoperative recovery,and nursing satisfaction of patients who have undergone radical surgery for colorectal carcinoma.METHODS In total,120 patients with rectal cancer who underwent surgery in Zhongnan Hospital of Wuhan University between August 2023 and March 2024 were selected and grouped based on the nursing methods employed.Of these patients,55 were treated with routine nursing intervention(control group)and 65 were provided humanistic care-based operating room nursing(research group).The patients’vital signs were recorded,including systolic/diastolic blood pressure(SBP/DBP)and heart beats per minute(BPM),as well as serum stress indices,including norepinephrine(NE),adrenal hormone(AD),and cortisol(Cor).Postoperative recovery and complications were also recorded.Patients’negative emotions,life hope,and nursing satisfaction were evaluated using the Self-rating Depression/Anxiety Scale(SDS/SAS),Herth Hope Index(HHI),and self-deve-loped nursing satisfaction questionnaire,respectively.RESULTS During emergence from anesthesia,SBP,DBP,and BPM levels were found to be lower in the research group than those in the control group,also serum Cor,AD,and NE levels were lower.In addition,the research group had shorter operative,awakening,anal exhaust,first postoperative ambulation,drainage tube removal,intestinal recovery,and hospital times.The total complication rate and the SDS and SAS scores were lower in the research group than those in the control group.The HHI and nursing satisfaction scores were higher in the research group.CONCLUSION Humanistic care-based operating room nursing can mitigate physiological stress responses,reduce postoperative complications,promote postoperative recovery,relieve adverse psychological emotions,and enhance life hope and nursing satisfaction in patients undergoing radical surgery for colorectal carcinoma,which can be popularized in clinical practice.

Improvement of the Legal System for Addressing the Issue of Elderly Care in China in the Context of Population Aging

Rapid population aging is a social reality facing China at present,and the issue of elderly care has become a hot topic of social concern.Legislation to address the issue of elderly care in the context of population aging should follow systematic concepts to achieve“vertical and horizontal integration.”In terms of content,it is necessary to formulate specific legal approaches around“the elderly and children,”with a focus on guaranteeing the livelihood and protection of the rights of the elderly while taking into account childbirth,employment and other issues.the laws should not only safeguard the social participation and labor rights of the elderly,but also effectively respond to the social challenges brought about by the aging of the population.It is also necessary to optimize the family planning policy to ease the burden of child-raising,improve the population structure and promote the long-term balanced development of the population,thus fundamentally solving the problem of population aging.the effort to improve the legal system to deal with the issue of elderly care in the context of population aging will better advance Chinese modernization.

Envita’s Precision Cancer Care: 35-Fold Improvement in Response Rates

New clinical approaches are imperative beyond the widely adopted National Comprehensive Cancer Network (NCCN) guidelines, utilized by prominent cancer institutions. Cancer is the leading cause of death among individuals younger than 85 years within the United States. Despite significant technological advances, including the expenditure of hundreds of billions, treatment outcomes and overall survival have not notably improved for most types of advanced cancer over the last several decades. Over the past 24 years, Envita Medical Centers has pioneered a unique form of personalized treatment approach for late-stage and refractory cancer patients, introducing groundbreaking innovations in the field. Our integrated algorithm utilizes advanced genomics, transcriptomics, and highly tailored immunotherapy, resulting in remarkable outcome improvements. This study presents Envita’s innovative personalized treatment algorithms and examines the response outcomes of 199 late-stage cancer patients treated at Envita Medical Centers over a two-year period. Compared to standard of care and palliative chemotherapy, Envita’s treatment demonstrated a remarkable 35-fold improvement in overall response rates (Figure 1). Moreover, 88% of the patients, the majority presenting with Stage 3 or 4 cancer, experienced a 43-fold improvement in quality of life with minimal side effects, as compared to standard of care chemotherapy and palliative care. This revolutionary success is attributed to Envita’s personalized therapeutic algorithms, which incorporate customized immunotherapy. Envita’s precision care approach has also achieved a 100% better response rate compared to over 65 global chemotherapy clinical trials with more than 2700 patients. The results from this study suggest that a wider utilization of Envita’s personalized approach can significantly benefit patients with late-stage and refractory cancer.

Stages of care for patients with chronic hepatitis C at a hospital in southern Brazil

BACKGROUND Hepatitis C virus(HCV)is defined as a public health problem by the World Health Organization(WHO)and since then has defined targets through the HCV elimination.The HCV cascade of care highlights the progress towards these goals and essential interventions that need to be delivered along this continuum care.AIM To document the treatment cascade for patients with HCV infection at the Hospital Nossa Senhora da Conceição(HNSC),defining the percentage of antibody-positive patients who collected molecular biology tests(polymerase chain reaction),attended outpatient clinic assistance,underwent treatment,and achieved a virologic cure termed sustained virologic response(SVR).METHODS With the retrospective cohort design,patients diagnosed with HCV infection in the period between January 1,2015 and December 31,2020 were included.Data from HCV notification forms,electronic medical records,Computerized Laboratory Environment Manager System,and Medicine Administration System(evaluation of special medications)were collected in 2022 and all information up to that period was considered.The data were analyzed with IBM SPSS version 25,and Poisson regression with robust simple variance was performed for analysis of variables in relation to each step of the cascade.Variables with P<0.20 were included in the multivariate analysis with P<0.05 considered significant.Pearson’s chi-square test was applied to compare the groups of patients who persisted in follow-up at the HNSC and who underwent follow-up at other locations.RESULTS Results were lower than expected by the WHO with only 49%of candidates receiving HCV treatment and only 29%achieving SVR,despite the 98%response rate to direct acting antivirals documented by follow-up examination.The city of origin and the place of follow-up were the variables associated with SVR and all other endpoints.When comparing the cascade of patients who remained assisted by the HNSC vs external patients,we observed superior data for HNSC patients in the SVR.Patients from the countryside and metropolitan region were mostly assisted at the HNSC and the specialized and continuous care provided at the HNSC was associated with superior results,although the outcomes remain far from the goals set by the WHO.CONCLUSION With the elaboration of the HCV cascade of care using local data,it was possible to stratify and evaluate risk factors associated with losses between each step of the cascade,to inform new strategies to guide elimination efforts in the future.

数字化重症快速反应体系建设探索

目的:建设数字化重症快速反应体系,实现急危重症患者早期识别和干预,保障患者医疗安全。方法:利用物联网、大数据和人工智能等技术,建设重症快速反应信息平台,完善快速反应管理体系。结果:构建急危重症大数据中心、智能预警及快速反应系统、组织管理体系三位一体的重症快速反应体系,为患者提供智慧、同质、高效的医疗服务。结论:重症快速反应体系建设在我国尚处于探索阶段,通过全流程的信息化、数字化管理,切实提高患者医疗安全保障,不断推动构建适合我国医疗高质量发展的重症快速反应体系。

儿童脑瘫精细化管理在康复治疗中的作用

目的探讨精细化管理在脑瘫患儿康复治疗中的应用价值。方法2021-10—2022-12共71例脑瘫患儿(A组)入住郑州大学第二附属医院进行康复治疗及常规责任制整体护理,2023-02—2023-08入院的84例脑瘫患儿(B组)在精细化管理模式下行责任制整体护理的康复治疗。2组患儿均在入院时和半年后进行运动发育指数(PDI)和智力发育指数(MDI)评分,以及家长满意度调查。比较2组患儿PDI和MDI评分及家长满意度。结果入院时2组患儿PDI和MDI评分无统计学差异(分别为t=0.1495、1.498,P>0.05),治疗半年后,2组患儿PDI和MDI评分均较入院时明显提高,B组优于A组,差异均有统计学意义(分别为t=3.161、3.181,P<0.05)。B组患儿家长满意度显著高于A组,差异有统计学意义(χ^(2)=4.492,P=0.034)。结论精细化管理能够提高脑瘫患儿的康复治疗效果,提高患儿家长的满意度,改善患儿远期预后。

残疾人托养照护筹资体系与政策的责任边界

托养照护是重度残疾人长期而迫切的现实需要。近年来,我国残疾人托养照护制度逐步建立,初步形成了财政投入为主、多项政策配合的筹资体系,重点保障了困难重度残疾人基本生活照护。现行政策与残疾人自主生活愿望和未来托付关切尚有较大差距,促进发展功能发挥不足,家庭自费和保险付费很少,服务系统处于松散配合的分割运行状态。从责任边界视角看,需要基于残疾人家庭照护能力、收入水平及需求层级,厘清各方职责与配合关系,强化保险和信托作用,建立以残疾人为主体、回应多层级目标的托养照护制度。

Colorectal cancer:Getting the perspective and context right

Colorectal cancer(CRC)is a significant global health burden,being the third leading cancer globally.Its incidence has been observed to be higher in developed regions such as North America and Europe with geographical variations in mortality rates.Efforts to address this disease burden include promoting early detection through screening and implementing treatment strategies to improve patient outcomes.With the growing and aging population,the incidence of CRC will undoubtedly increase.These epidemiological trends will mean that healthcare professionals will increasingly encounter CRC in more complex patients.Hence,it becomes imperative to have a deeper appreciation of the pathophysiology of CRC and understand the intricate interplay between a patient’s physiology and their goals of care before offering treatment.This review article will aim to encapsulate the important nuances and perspectives of managing this disease in the context of an elderly patient.

糖尿病患儿的整体护理效果分析

目的探究整体护理对糖尿病患儿的应用价值。方法选取2022年6月—2023年7月滕州市中心人民医院收治的50例糖尿病患儿为研究对象,通过随机数表法将其分为常规组与研究组,各25例。常规组开展常规护理,而研究组开展整体护理,对比两组血糖、护理满意度。结果护理后,研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平低于常规组,差异有统计学意义(P均<0.05)。与常规组相比,研究组护理满意度更高,差异有统计学意义(P<0.05)。结论针对糖尿病患儿,整体护理模式效果显著,能够明显改善患儿的血糖指标,有效提升患儿家属的满意度。

分阶段护理在达芬奇机器人辅助肺癌根治术患者中的应用

目的分析基于德尔菲法的分阶段护理在达芬奇机器人辅助肺癌根治术患者中的应用效果。方法选取医院2021年5月至2022年10月收治的87例肺癌患者,均在全麻下接受达芬奇机器人辅助肺癌根治术治疗,依照随机数字表法分为两组,对照组(43例)接受常规护理干预,观察组(44例)在对照组基础上接受基于德尔菲法指导的分阶段护理,比较两组干预前后心理应激反应、生理应激反应、癌因性疲乏程度、生活质量。结果术前30 min,两组14项汉密尔顿焦虑量表(HAMA)、17项汉密尔顿抑郁量表(HAMD)评分均降低,且观察组低于对照组(P<0.05);术前30 min,两组心率、收缩压、舒张压水平均升高,但观察组较对照组低(P<0.05);干预后,观察组Piper疲乏量表(PFS)评分低于对照组,肺癌患者生存质量测定量表(FACT-L)评分高于对照组(P<0.05)。结论基于德尔菲法指导的分阶段护理应用于全麻下达芬奇机器人辅助肺癌根治术患者,能有效减少心理、生理应激,缓解癌因性疲乏程度,提高生活质量。

社会网络对中青年群体养老责任认同的影响研究——基于CGSS 2018年数据的检验

从人口代际更迭的角度看,我国目前的中青年群体步入老年阶段后将面临重度老龄化和高龄老龄化并存的养老困境,亟须通过前瞻性制度规划和资源准备避免养老压力的代际叠加。由于认知是意愿形成和行为选择的前提与基础,中青年群体对养老责任归属的态度直接关系未来规模庞大的老年人口的养老方式,厘清其对养老责任主体的倾向与偏好可以在一定程度上预判未来潜在的养老需求,从而在养老资源总量不足、结构不均的情况下实现“有备而老”的积极老龄化目标。同时,我国是典型的人情关系社会,人们往往会借助血缘、亲缘、地缘等社会关系网络及相应资源降低养老活动的运行成本,尤其在家庭养老功能日趋萎缩的背景下,社会网络正在成为个体应对养老风险的重要支持力量,以互联网为代表的新型社交形式日益普及,也为保障老年福祉提供了新的可能。但目前学界相关研究对中青年群体和社会网络因素关注不足,仍然存在研究内容和研究维度上的缺位。基于此,本研究使用中国综合社会调查(CGSS)数据,分析我国中青年养老责任认同的变迁趋势,采用无序多分类Logistic回归模型探究社会网络各因素对中青年养老责任认同的作用机制,并以倾向得分匹配法(PSM)对结果进行稳健性检验。研究发现:在家庭赡养功能持续弱化的宏观背景下,传统的代际责任伦理在我国中青年群体中仍具有相当强的生命力,同时其对社会养老机制和自我养老机制的接受度逐渐提高。而社会关系网络能够发挥非正式保险的效用,对正式养老制度形成补充,进而降低社会风险对家庭的冲击。其中,以朋友交往为代表的强关系对子女养老发挥强有力的替代作用,弱关系网络主要具有补充功能,说明群体信任更强的强关系网络具备弱关系无法比拟的养老资源优势。而互联网作为社会网络中交往行为和互动关系的新表征形态,通过信息传递与政策普及,增强互助养老意识,社会信任则代表个体获取社会关系网络中信息与资源的能力,通过建构社会资本,弱化人们对子女和家庭养老的依赖。因此,以社会支持网络对现有养老实践作出补充,或将在有限养老资源的约束下缓解我国持续加剧的养老压力。

企业社会责任与政府补助对养老企业财务绩效的影响

在积极应对人口老龄化、推动养老事业与产业协同发展的背景下,养老企业承担社会责任,获得政府补助,给财务绩效带来了重要影响。文章以2016—2021年中国A股上市并从事养老产业的公司为样本,分析了企业社会责任对财务绩效的影响及作用机制。研究发现,企业积极履行社会责任能够提升财务绩效,政府补助起到部分中介效应,媒体关注度对直接效应以及中介效应的前半路径具有负向调节作用。异质性分析显示,在老年人口抚养比高的地区以及规模小的企业中,企业社会责任对财务绩效的促进作用更加显著。研究结果有助于进一步理解企业社会责任对提升财务绩效的重要作用,从而引导企业积极承担社会责任、合理使用政府补助,为国家的老龄事业贡献力量。

多模式促排痰护理联合全人照护管理在支气管肺炎氧疗患儿中的应用

目的探讨支气管肺炎氧疗患儿采用多模式促排痰护理联合全人照护管理的效果。方法选取2017年8月至2019年2月郑州市妇幼保健院接收的86例支气管肺炎氧疗患儿,以随机数字表法分为干预组(n=43,多模式促排痰护理联合全人照护管理干预)与对照组(n=43,常规护理干预),对两组排痰时间、排痰量、肺功能[第1秒用力呼气容积(FEV_1)、最大呼气流速(PEF)]、症状消失情况、生活质量[儿童生活质量测定量表(PedsQL 4.0)]进行比较。结果干预组排痰时间较对照组更短,排痰量更多,差异有统计学意义(P<0.05);干预后两组FEV_1、PEF均有所提高,且干预组高于对照组,差异有统计学意义(P<0.05);干预组症状消失时间较对照组更短,差异有统计学意义(P<0.05);干预后两组PedsQL 4.0评分均提高(P<0.05),且干预组高于对照组,差异有统计学意义(P<0.05)。结论支气管肺炎氧疗患儿给予多模式促排痰护理联合全人照护管理干预能够促进痰液排出,缩短排痰时间,促进肺功能恢复及症状消失,提升生活质量。