Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas

BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

The evolution and present status of the study on peak oil in China

Peak oil theory is a theory concerning long-term oil reserves and the rate of oil production. Peak oil refers to the maximum rate of the production of oil or gas in any area under consideration. Its inevitability is analyzed from three aspects. The factors that influence peak oil and their mechanisms are discussed. These include the amount of resources, the discovery maturity of resources, the depletion rate of reserves and the demand for oil. The advance in the study of peak oil in China is divided into three stages. The main characteristics, main researchers, forecast results and research methods are described in each stage. The progress of the study of peak oil in China is summarized and the present problems are analyzed. Finally three development trends of peak oil study in China are presented.

Multi-model comparison of CO2 emissions peaking in China:Lessons from CEMF01 study

The paper summarizes results of the China Energy Modeling Forum's(CEMF)first study.Carbon emissions peaking scenarios,consistent with China's Paris commitment,have been simulated with seven national and industry-level energy models and compared.The CO2 emission trends in the considered scenarios peak from 2015 to 2030 at the level of 9e11 Gt.Sector-level analysis suggests that total emissions pathways before 2030 will be determined mainly by dynamics of emissions in the electric power industry and transportation sector.Both sectors will experience significant increase in demand,but have low-carbon alternative options for development.Based on a side-by-side comparison of modeling input and results,conclusions have been drawn regarding the sources of emissions projections differences,which include data,views on economic perspectives,or models'structure and theoretical framework.Some suggestions have been made regarding energy models'development priorities for further research.

Parents' experience of caring for children with type 1 diabetes in China's Mainland: A qualitative study

BACKGROUND Parents of children with type 1 diabetes mellitus(T1DM)are under heavy caregiving stress,and parental caregivers'experience can affect the health outcomes of children with T1DM.AIM To describe the true inner feelings of parents caring for children with T1DM.METHODS Descriptive research methods were used to classify and summarize parents'experience when adapting to the role of caregivers for children with T1DM.The data was sorted and analyzed using content analysis.Themes of parents'experience caring for children with T1DM were refined,and their feelings were deeply investigated.RESULTS A total of 4 themes and 12 subthemes were identified:(1)Desire for information(disease-related information,home care information,and channels of information acquisition);(2)Skill guidance needs(insulin injection techniques,skills required for symptom management,and skills for parent-child communication);(3)Seeking emotional support(family support,peer support from other parents of children with T1DM,and professional support);and(4)Lack of social support(needs for financial support and needs for social security).Exploring the true experience of parents caring for children with T1DM is of great significance for helping them adapt to their role as caregivers.Nurses should provide professional guidance in terms of information,skills,emotion,and social support to parental caregivers.

Trans-Thoracic Echocardiographic Aortic Blood Flow Peak Velocity Variation, Distance Minute, Aortic Velocity Time Integral and Postoperative Outcome in Pediatric Surgical Patients—An Observational Pilot Study Protocol

Background: A Randomized Controlled Trial (RCT) has been elaborated where goal directed fluid and hemodynamic therapy (GDFHT) will be realized with trans-thoracic echocardiographic aortic blood flow peak velocity variation (ΔVpeak) and distance minute (DM) to guide fluid therapy and hemodynamics in high risk pediatric surgical patients. This RCT will clarify the impact of GDFHT with ΔVpeak and DM on postoperative outcome in terms of morbidity, length of stay in the intensive care unit (LOSICU), length of mechanical ventilation (LMV) and length of hospital stay (LOS) in children. To determine values of ΔVpeak, DM and VTI predictive of these postoperative outcomes, an observational pilot study will be realized. This pilot study is described here. The primary objective of this study is to determine values of ΔVpeak, DM and ITV predictive of postoperative outcome in children in terms of morbidity. The secondary objectives are to determine values of ΔVpeak, DM and ITV predictive of LOSICU, LMV, LOS, intraoperative, postoperative fluid administration and vasoactive-inotropic therapy. Methods: 500 - 1000 children aged less than 18 years will be included prospectively. Statistic analysis will be realized with XLSTAT 2019.4.2 software or plus. Results and Conclusions: This trial protocol will determine values of ΔVpeak, DM and ITV with echocardiography predictive of postoperative outcome in children.

Hikikomori, a Phenomenon of Social Withdrawal and Isolation in Young Adults Marked by an Anomic Response to Coping Difficulties: A Qualitative Study Exploring Individual Experiences from First- and Second-Person Perspectives

Hikikomori is a recent phenomenon among young adults in which they isolate themselves from social contacts and responsibility for more than 6 months. This problem has assumed epidemic proportions in Japan and has been widely discussed across disciplines. Previous studies have associated hikikomori with a maladaptation to structural change, an emergent mental problem that needs new diagnosis, or an under-diagnosed schizophrenic disorder. Most previous work has adopted a clinical perspective, and there have been no qualitative studies exploring the individual feelings of people suffering from the syndrome. We adopted a qualitative method using a grounded theory approach. Data collection and analysis took place between September 2006 and August 2008. Theoretical sampling included eight informants from snowball sampling and an online observation consisting of 160 online participants. Analysis focused on informants’ first- and second-person experiences of hikikomori. Data analysis revealed one overriding theme: coping difficulties consisting of the two categories stasis and expression. As a result of conflicting demands and reduced autonomy, respondents experienced stasis, which prevented them from moving forward;“hiding” or “avoiding” heightened the expression of their behaviors. This is the first study to explore the in-depth experience of individuals suffering from hikikomori syndrome in a non-clinical setting. We argue that hikikomoriis not a result of asocial behavior, but rather an anomic response to a situation that informants felt powerless to change and from which they could see no way out. We also observed that feelings of hopelessness and relationship fatigue might be overcome by introducing a relaxed social environment that people can control during rehabilitation.

Experiences of Chinese nurses studying for master’s degree in the UK: a qualitative study

Objective:To explore experiences of Chinese nurses who study for Master of Science in Professional Practice(health care)in the United Kingdom.Methods:A qualitative approach was applied,consisting of semi-structured telephone interviews(n=8).The Colaizzi seven-step framework analysis method was used to extract themes.Results:The themes that emerged are as follows:(1)gains from studying overseas,(2)difficulties during studying,and(3)impacts of learning experience on work.The gains for nurses studying overseas include the improvement of scientific research capabilities,reconstruction of critical thinking,and development of reflection ability.Difficulties while studying mainly include language barrier,strict assessment,and boring life.Conclusions:The education of nursing postgraduate attaches impor tance to the cultivation of thinking.Nurses are very interested in nursing research including qualitative and quantitative methods.Nurses encountered language barriers in their study and life even though they knew a cer tain level of English.

Experiences of Women Receiving Multifraction High Dose-Rate Brachytherapy for Cervical Cancer: A Prospective Qualitative Study

Objective: The aim of this study was to establish cervical cancer patients’ expectations and experiences during high dose-rate (HDR) intracavitary brachytherapy procedure, as part of a process to develop guidelines for quality patient-centered care. Methodology: A prospective, qualitative study with a descriptive phenomenological approach was used. Purposive sampling was carried out to recruit 31 women undergoing HDR brachytherapy for cervical cancer from June to August 2020 at the National Institute of Oncology in Rabat. Semi-structured, one-to-one interviews guided by a theme list were conducted by a female radiation oncologist in Arabic before, during and after treatment. The following aspects were discussed: expectations, experiences in the waiting room, in the treatment room, and suggestions for improvement. Data was transcribed, translated and thematic analysis performed. Results: Most of the patients felt unprepared and did not have a clear understanding of brachytherapy. Brachytherapy was a difficult experience causing fear and anxiety throughout treatment. Most women dreaded the procedure, before receiving the first treatment and even after having had one. Pain was a major problem for the participants. Some women compared this pain to childbirth, a process they preferred to brachytherapy. Patients agreed that the preventative medication received was not efficient to relieve the pain. Despite these negative experiences, patients were left with a positive outlook. Dialogue with the healthcare professionals, support from their family and fellow patients, envisaged outcomes and desires to heal were used to cope, whilst faith and spirituality gave them strength to endure the procedure. Conclusion: Women undergoing uterovaginal brachytherapy for cervical cancer experience pain and emotional distress. Providing patients with adequate information, more sensitive support during the procedure and debriefing afterwards could lessen feelings of fear and anxiety. Our findings advocate for the revision of pain management protocols. Further studies should be carried out to define patient-centered recommendations and provide quality care to this group of women.

An Investigation of Samoan Student Experiences in Two Homework Study Groups in Melbourne

This research examines Samoan student experiences in two Homework Study Groups （HSGs） in Melbourne using a researcher-practitioner approach. It highlights that school teachers need to acknowledge students＇ preferred learning methods, especially those of minority backgrounds like the Samoan participants in this investigation. A detailed exploration of the experiences of students in two HSGs finds that while students and their families place a high priority on learning, their cultural practices are not compatible with standard Western learning approaches. The HSGs provided a social space in which students could ask the teacher questions without fear of appearing foolish, in which they could apply themselves to study. It provided a physical study space away from the demands some Samoan families place on their young people, and it provided a cultural space in which the students could learn according to fa＇aSamoa （traditional values and beliefs）. This research makes a contribution to an understanding of the motivations of Melbourne-based Samoan students to learn, of what concerns them, and of impediments to their educational success. It also offers insight into the benefits that set up a specific space for students offers, when its specific intent is influencing the merging of Samoan and Western ideas to further learning.

Experimental Study on the Treatment of Tertiary Oil Recovery Wastewater via a Novel Electro-Coagulation Method

At present,methods for treating tertiary oil recovery wastewater via electro-coagulation are still in their early stage of development.In this study,a device for electro-coagulation wastewater treatment was built and tested in an oil field.The effects that the initial pH value,electrode type,and connection mode have on the coagulation and separation effect were assessed by measuring the mass fraction and turbidity of oil.The results have shown that when the electro-coagulation method is used,the effectiveness of the treatment can be significantly increased in neutral pH conditions(pH=7),in acidic conditions,and in alkaline conditions.Compared to an Al electrode,the floc that is produced by an Fe electrode is smaller;thus,it does not easily coagulate and settle in a short time.Using the oil removal rate,turbidity removal rate and energy consumption as a basis to assess the performances,the results have demonstrated that the combined aluminum alloy iron composite electrode should be used as electrolytic electrode.

Nursing in a Globalized World: Nursing Students with International Study Experience Report Higher Competence at Graduation

Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences (ISE) in other countries during basic nursing education had an impact on newly graduated nurses as regards to self-reported competence. Moreover, a second aim was to explore what background factors that facilitated or constituted a hindrance for nursing students to choose to conduct part of their basic nursing education abroad. At 11 Universities/University Colleges (henceforth called Higher Education Institutions [HEIs]) in Sweden, 565 nursing students responded to the Nurse Professional Competence (NPC) Scale. Students with ISE rated their competence significantly higher on three NPC competence areas—“Legislation in nursing and safety planning”, “Leadership and development of nursing” and “Education and supervision of staff/students”. Background factors that significantly seemed to enhance ISE were living alone, not having children or other commitments in relation to family, international focus at the HEI and previous international experience. Lack of financial means was reported to prevent students from choosing ISE. The study implies that several background factors are of importance whether students choose ISE or not. ISE during basic nursing education might result in better self-reported competence in leading and developing nursing care, including education of future nurses, and in providing safe care.

社区共病老年人居家疾病体验的质性研究

背景面对老年慢性病患病率高、多种慢性病共存形势带来的严峻挑战,社区共病老年人的健康问题亟待关注。共病管理模式正不断被探索实践,疾病体验作为来自患者自我报告的健康信息有望成为“以患者为中心”社区共病管理模式的重点内容。目的 深入了解社区共病老年人居家的真实疾病体验,为社区共病老年人的个性化健康管理和支持策略提供依据。方法 采用目的抽样法、最大差异化抽样于2022年8—9月在郑州市某社区卫生服务中心所管辖的4个社区中抽取符合条件的访谈对象,基于信息饱和的原则最终纳入20例研究对象。在研究目的、文献回顾及专家咨询结果的基础上初步拟定访谈提纲,预访谈2例后确定最终访谈提纲。以现象学研究方法为指导,对研究对象进行半结构式访谈。采用Golaizzi分析法分析资料。结果 共提炼出4个主题和11个亚主题,主要有长期存在的症状困扰(身体功能障碍、疲劳、睡眠障碍、疼痛)、负性心理体验(对未来生活的无助感和担忧、社会价值感和自我认同感降低、社交活动改变的孤独感)、与共病和谐共存的积极心态(感恩知足、积极适应)、困境下的期望(希望功能改善、寻求多方社会支持)。结论 身体功能障碍、睡眠障碍、疲劳、疼痛是社区共病老年人最关注的健康困扰,社区共病老年人的症状管理和多元社会支持有待加强。未来有望采用多维数据进行动态化健康评估,探索共病的共性和个体性规律,实现社区共病的精准管理及干预。

羊膜腔穿刺介入性产前诊断孕妇决策前体验的质性研究

目的 探讨羊膜腔穿刺(amniocentesis, AC)介入性产前诊断孕妇决策前的真实体验,为制订针对性的干预措施提供依据。方法 2022年3-8月,采用目的抽样法对13例AC孕妇进行半结构式访谈,采用Colaizzi 7步分析法进行归纳、提炼主题。结果 AC孕妇决策前的体验可归纳为4个主题,即:术前的心理反应;迫切寻求信息支持;手术决择前面临困扰和社会支持发挥重要作用。结论 医护人员应关注AC孕妇决策前的体验和需求,探索有效的干预措施,促进其做出理性决策。

基于数据挖掘分析中药治疗糖尿病合并血脂异常的用药规律

目的基于数据挖掘分析梁晓春教授治疗糖尿病合并血脂异常的组方特点,传承梁晓春教授临床治疗糖尿病合并血脂异常的学术思想。方法应用回顾性真实世界研究方法,以北京协和医院信息系统的电子病历为载体,采集梁晓春教授2021年1月至2022年12月北京协和医院中医科门诊治疗糖尿病合并血脂异常患者的临床信息,构建数据库并将其录入中医传承计算平台(V 3.5),运用关联规则、聚类分析等方法分析病案处方的用药频次、性味归经、常用药物组合,总结梁晓春教授治疗糖尿病合并血脂异常的治则治法和用药规律。结果共整理梁晓春教授治疗糖尿病合并血脂异常的验方559则,中药249味,使用次数最多的药物为桑白皮、鸭跖草、葛根、丹参、女贞子及荷叶等,性味多甘寒,归经多属于肝脾胃经。最核心的药物组合为葛根-丹参、桑白皮-葛根、桑白皮-鸭跖草、桑白皮-丹参、葛根-黄芪等。聚类分析得出4个核心处方为桑白皮-鸭跖草-荷叶-女贞子-葛根-姜黄、鸭跖草-桑白皮-葛根-丹参-女贞子-黄芪、桑白皮-鸭跖草-葛根-丹参-荷叶-黄芪、桑白皮-鸭跖草-黄芪-川芎-葛根-丹参。结论梁晓春教授治疗糖尿病合并血脂异常以益气养阴、活血化瘀兼祛湿化浊为原则,用药经验体现了健脾、补肾治其本,活血祛瘀、祛湿化浊治其标的学术思想。

情境视角下儿童农耕研学服务体验设计研究--以钱唐农园为例

针对传统农耕研学体验单一、家庭参与度弱、社会关注度低等问题,从设计视角重构农耕研学创新服务体系,探讨基于情境体验的农耕研学服务体验设计研究。在情境体验理论与用户体验设计相关方法的指导下,研究儿童、家长对农园情境的理性和感性认知,挖掘其需求痛点与期望,归纳整理出农耕研学服务体验的三大情境需求。从情境体验设计的角度提出满足儿童农耕研学服务体验的设计策略并进行设计实践。乐学乐教、智能情感、可持续性的情境体验符合儿童农耕研学的需求,以设计实践验证了情境体验设计方法的应用价值。

RAD51基因突变的首诊卵巢癌患者真实患病体验质性研究

目的:了解DNA重组修复基因(RAD51)突变的首诊卵巢癌(OC)患者真实患病体验,为后续制定干预措施提供理论依据.方法:采用目的抽样的方法抽取2022年1-12月在北京市某三级甲等医院妇科收治的RAD51基因突变、未开展治疗的OC患者作为研究对象,采用现象学方法进行半结构化访谈并现场录音,应用Colaizzi现象学7步分析法对访谈资料进行分析、提炼主题.结果:本研究归纳提炼出3个主题,即积极与消极并存、希望专业指导和行为观念转变.RAD51基因突变OC患者存在明显的负性情绪,也有积极心态养成的趋势,存在自我行为观念转变,有意愿监督易感亲属行为,对OC的认知程度较低,希望得到专业指导.结论:RAD51基因突变OC患者存在负性情绪及认知不足的情况,医护人员应及时关注RAD51基因突变OC患者的负性情绪,促进其积极心态的养成,纠正患者的不良认知.医疗机构应尽早构建OC基因检测咨询体系,为患者提供专业基因检测后续指导.

手术室护士行超声引导下疑难外周静脉穿刺置管内心体验的质性研究

目的:深入了解手术室护士对超声引导下疑难外周静脉穿刺置管术的实施态度和真实体验,为此项技术能够在临床上精准化操作、广泛应用提供参考依据。方法:采用目的抽样法,选取南京某三级甲等医院11名手术室护士为研究对象,采用现象学研究方法对其进行半结构式访谈,根据Colaizzi七步分析法分析资料。结果:共提炼出4个主题、11个亚主题:超声是可视化静脉穿刺的重要辅助工具,包括超声在血管穿刺方面具有独特的优势,使用超声的外在及内在资源;超声引导下疑难外周静脉穿刺置管精准操作的影响因素,包括超声引导穿刺相关知识技能的掌握,留置针导管型号的选择,手眼协调能力,平时操作练习;护士职业成就感,包括护士面对疑难外周静脉穿刺时的自信、底气,得到同行称赞,得到病人认可;对新知识、新技能学习和应用的意愿与热情,包括希望得到更多培训和学习交流的机会,希望此项技术能够得到广泛应用。结论:护士能够在超声引导下疑难外周静脉穿刺置管操作中获得积极体验,且将解决临床问题转化为对新技术、新技能学习的内在动力。护理管理者应该通过培训考核,营造科室组织氛围等方法提高护士此项技术掌握程度,推进其在临床广泛应用,精准实施。

基于渥太华决策支持框架语前聋人工耳蜗植入病人家属决策体验的质性研究

目的:了解语前聋人工耳蜗植入术(cochlear implant,CI)病人院前就医过程的内心体验,明确病人家属就医决策障碍的影响因素,为其决策制定提供解决思路,帮助病人家属权衡治疗利弊,做出决策。方法:2022年9月—12月基于渥太华决策支持框架设计访谈提纲,运用现象学研究方法对18例CI病人家属进行半结构式深入访谈,应用Colaizz 7步法进行资料分析。结果:提炼出3个一级主题和8个二级主题,分别为决策需求(信息需求、利弊分析需求、经济需求)、决策支持(国家政策支持、社会群体支持、自我认知)及决策结局(决策过程质量一般,决策结果较满意)。结论:CI病人家属就医决策障碍亟待解决,以增加信息支持和提高认知为前提,以培养良好的应对方式为关键,以提高社会支持力度为保障,对重度或极重度感音神经性耳聋病人及家属开展健康教育,促使CI病人家属及时做出符合价值观和自身情况的就医决策,让更多耳聋病人能够重获新声,同时为临床工作提供指导。

火星表面硫酸盐探测与研究进展

作为太阳系类地行星中与地球最为类似的一颗行星,火星是人类深空探测的重要目标,也是未来太空移民的主要候选星球。火星探测至今已有60多年的历史,到目前共有47次探测任务对火星开展探测并取得了一系列重要科学发现。硫酸盐作为火星表面水蚀变/水岩作用重要的产物,对其展开研究可以深入了解火星水演化历史和气候变化特征,助力评估地表环境宜居性和生命痕迹的可能性等重大科学问题。本文主要回顾了火星硫酸盐的轨道遥感与就位探测研究进展,探讨了硫酸盐模拟实验研究的科学意义以及硫酸盐对未来火星资源利用的重要价值,以期为未来火星探测任务和火星科研站建设提供有益参考。

中国女性反化妆性别经验的质性考察——以“返璞归真|AwakendPhoenixes”豆瓣小组为例

一批中国青年女性正经历从化妆转变为不化妆。研究发现,反化妆对青年女性来说是一种认知重构后的性别实践,同时,放弃化妆被她们视为抵抗父权制的微观政治诉求。在这个过程中,她们采取组合化和策略化的方式使用媒介。中国青年女性的反化妆实践,一方面体现了对消费主义的一定抵制,展现了对性别平等的追求;另一方面体现了她们对美的认知较为切面化和功能化。媒介在女性反化妆实践中起到了基础设施的作用,然而又在一定程度上遏制了该实践在“再做性别”方面的潜力。