Impact of the Rapid Recovery Concept on Complications and Patient Quality of Life in the Perioperative Nursing of Robot-Assisted Radical Oesophageal Cancer

Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE). Methods: A total of 150 patients who underwent RAMIE from January 2020 to January 2022 at our hospital were randomly assigned to either the observation group or the control group, with 75 patients in each. The control group received standard perioperative management and nursing care, while the observation group was treated with ERAS nursing strategies. Interventions continued until discharge, and outcomes such as postoperative complications, quality of life, and nutritional status were compared between the groups. Results: The observation group exhibited a significantly lower incidence of postoperative adverse reactions compared to the control group (P ionally, all dimension scores of the Short-Form 36 Health Survey (SF-36), including the total score, were higher in the observation group (P < 0.05). Furthermore, the Nutritional Risk Screening (NRS) scores for impaired nutritional status and disease severity, along with the total NRS score, were significantly lower in the observation group compared to the control group (P Conclusion: Implementing ERAS nursing in the perioperative care of patients undergoing RAMIE is associated with reduced postoperative complications and enhanced postoperative quality of life and nutritional status. .

Recommended Design and Direction of Development for Humanoid Nursing Robots Perspective from Nursing Researchers

The purpose of this article is to describe recommendations towards the design and direction of development for Humanoid Nursing Robots (HNRs) from the standpoint of researchers of nursing care practice. Efforts to introduce robot technologies in nursing practice and to use them in elderly and high-tech healthcare environments have begun in developed countries like Japan. Companies are developing various types of robots, although their types and functionalities continue to require a clear identification and definition. Regardless, robot developments for health care purposes are progressing well to meet universal technological demands. While human caring has been a human-to-human relationship, in a nonhuman-to-human relationship in the case of HNRs, it is essential to consider ethical concerns and human safety. If HNRs are to support patients directly, they must be required to have the same level of comprehensive judgment ability and responsiveness as that of human nurses. This includes abilities to genuinely observe, judge, rapidly respond, and conduct human caring practice emphasizing individuality. If HNRs support patients independently, abilities which are much like those of humans will be required of them in addition to the appropriate intelligence and skillfulness to do so. A low level robot nurse exerts work that should be called non-nursing or as a medical aid assistant no matter who thinks and what these technologies can do. Similarly, a higher level HNR with higher level artificial intelligence is expected to exceed the capabilities of human beings. As such, current discourse and debate also include the concern that HNRs may now become one’s superior or rather that the HNR is a subordinate thereby requiring human management.

Robotic nurse duties in the urology operative room:11 years of experience

The robotic nurse plays an essential role in a successful robotic surgery.As part of the robotic surgical team,the robotic nurse must demonstrate a high level of professional knowledge,and be an expert in robotic technology and dealing with robotic malfunctions.Each one of the robotic nursing team“nurse coordinator,scrub-nurse and circulating-nurse”has a certain job description to ensure maximum patient’s safety and robotic surgical efficiency.Well-structured training programs should be offered to the robotic nurse to be well prepared,feel confident,and maintain high-quality of care.

Development of a nurse robot serving in infectious disease isolation wards

A prototype of nurse robot system serving in infectious disease wards is developed by analyzing the systems requirement. Firstly, the type synthesis and dimension synthesis for optimizing the workspace are presented. Secondly, the tele-control system based on velocity control mode is introduced, and tele-control program is written. Finally, the imitation of position workspace and experiment of transforming objects from buffer area to isolation area are carried out.

The Intermediary Roles of Public Health Nurses (PHNs) in Utilizing Communication Robots (CRs) in Community Health Care Practice

Robot technology is expected to reduce the burden of medical professionals, a concern in the super-aged society. The aim of this article is to determine the intermediary roles of Public Health Nurses (PHNs) in using Communication Robots (CRs) in Community Health care. It is necessary to consider who will manage, and how to draw lines of responsibility when a problem occurs when using robots in the future. Regarding the mediator or intermediary role of PHNs in the use of CRs, PHNs are expected to be cognizant of varieties of robots for use with persons of diverse ages and health levels, as well as of robot performances. As one of the community healthcare workers who service the elderly living in the community, the role of PHNs as mediators or intermediaries is to pay attention to ethical and moral issues while working with CRs to manage the health of the community. Lack of understanding of the intermediary role might create possible ethico-moral issues in the future. Therefore, it is critical for PHNs to understand their role as intermediaries. In doing so, it is expected that older people at home will be able to live peaceful lives, as well as be physically and mentally healthy.

Characteristics of a Transactive Phenomenon in Relationships among Older Adults with Dementia, Nurses as Intermediaries, and Communication Robot

Healthcare for older adults with dementia is an important healthcare problem in Japan and in other developed countries. Importantly, healthcare workers in Japan are also getting older. In order to address solutions to this problem, using robots is being realized and is starting to assist healthcare and welfare practice needs. The aim of this study was to identify the characteristics of a transactive phenomenon in relationships among older adults with dementia, with nurses as intermediaries and with a cognitive skill-aid robot. Subjects were two institutionalized older adults who were diagnosed with dementia using Hasegawa’s Dementia Scale-Revised;a Kabochan (Nodding Kabochan) fixed with a remote-controlled speaker, Pechat (Kabochan with Pechat). Measurements of autonomic nervous activity were done using wearable electrocardiography attached to the subjects for four hours. Heart Rate Variability data were assessed at various frequency bands using a HRV software tool. In a continuously recorded data, interbeat (R-R) intervals were obtained for a 1-min segment using the maximum entropy method. In this study, the two major spectral components of HRV, the variances of the low-frequency (LF: 0.04 - 0.15 Hz) band and high-frequency (HF: 0.15 - 0.4 Hz) band, were calculated. Activities and behaviors of subjects transacting with Kabochan were observed by the expert nurses and video-recorded. Throughout the transaction period, observations were recorded of patients’ behavior, words uttered and over-all contents of the transactive conversation with the Kabochan or Kabochan with Pechat. Identified characteristics were transactive relationship phenomenon;changes in autonomic nervous system activity of persons with dementia are expressed as per one minute, linguistic response of elderly people, transactive relations among Kabochan, Kabochan with Pechat, and nurses as intermediaries. These were exhibited as Figures: Situation 1, A Sense of Fear, Situation 2, A Pleasant Sensation, and Situation 3, Misunderstanding and Confusion. It also showed that autonomic nervous system activity of persons with communication skills is actively changing in older adults with dementia. Conversation of adding Pechat to the Kabochan illustrated that nurses as intermediaries showed emotional conversations as established by effectively manipulating the Pechat. Also, it was revealed that if Kabochan with Pechat uttered words about patient’s personal information in a conversation, the patient felt a sense of fear. The researchers suggest that when developing future communication robot for elderly with dementia, it is necessary to consider, for an effective conversation, transactive relationships including nurses as intermediaries. The role functions of these intermediaries have been shown of high versatility, indicating that situations such as these can also be controlled by other healthcare providers such as by occupational therapists.

机器人辅助下结直肠癌根治术患者强化康复护理干预体会

目的:总结2例达芬奇机器人辅助下结直肠癌根治术患者的术后强化康复护理干预方案,提炼护理干预要点。方法:对2例达芬奇机器人辅助下结直肠癌根治术患者实施围手术期强化康复护理干预方案,干预内容包括术前健康教育、心理干预、术前准备干预、术后疼痛管理、术后康复锻炼5大项,干预时间从患者入院第1 d至出院。结果:2例患者均顺利完成机器人辅助下结直肠癌根治术,术后均未出现切口感染、压力损伤等并发症及恶心、呕吐、头晕等不良反应,康复情况较好,出院时情绪稳定。结论:强化康复护理干预范围全面,可为临床机器人辅助下结直肠癌根治术护理管理提供一定参考。

福祉机器人基础研究与系统开发及展望

以沈阳工业大学中日福祉机器人研究中心科技成果为主线,指出福祉机器人领域中某些观念误区、基础研究的重要性及推广应用中的技术瓶颈。提出福祉机器人的简明定义,从系统构成角度阐明福祉机器人与工业机器人的本质区别,并以自主研发的机能康复机器人、部分失能者自立生活辅助机器人、完全失能者护理机器人等为例,通俗地论述了其社会背景、基本研究理念、具体研究内容及难点、取得的创新性成果及正在攻关的挑战性课题。对福祉机器人新兴领域的科研机遇、人才需求、市场规模及就业前景等进行了展望。

失效模式与效应分析在骨科机器人手术流程改善中的应用

目的:探究失效模式与效应分析(FMEA)在骨科机器人手术流程改善中的应用效果。方法:选取2021年1月—2022年12月在我院实施骨科机器人手术的病人为研究对象,将2021年1月—12月(流程改善前)的300例病人作为对照组,将2022年1月—12月(流程改善后)的300例病人作为研究组。对照组实施常规骨科机器人手术流程,研究组实施采用FMEA改善后的骨科机器人手术流程。比较两组手术流程管理失效模式风险优先指数得分、手术时间、术中出血量、住院时间、并发症发生情况及病人满意度。结果:研究组手术流程管理失效模式风险优先指数得分低于对照组;研究组手术时间为(39.12±5.68)min,住院时间为(3.56±1.71)d,均短于对照组[手术时间为(48.31±6.71)min,住院时间为(5.12±1.98)d];研究组术中出血量为(65.23±8.36)mL,少于对照组(71.36±9.11)mL;研究组并发症发生率为3.33%,低于对照组(7.00%);研究组病人满意度为95.00%,高于对照组(89.67%),差异均有统计学意义(P<0.05)。结论:采用FMEA方法能够根据量化指标确定风险因素,从而制定针对性的预防措施,帮助临床医生改善骨科机器人手术流程,降低手术风险,提高手术质量。

精准化护理在泌尿外科机器人辅助手术中的应用效果及其对护理满意度的影响

目的:探讨泌尿外科机器人辅助手术患者实施精准化护理对临床效果及护理满意度的影响。方法:收集2021年5月—2023年5月行泌尿外科机器人辅助手术的患者共计100例,基于随机数字表法规范化分组,将其分为对照组(行常规护理)与观察组(行精准化护理),各组均50例。对比两组患者心理状态、术后康复指标、并发症发生率、生活质量、护理满意度。结果:干预后,两组SAS、SDS评分均降低,且观察组评分低于对照组,两组SF-36评分升高,且观察组评分高于对照组(P<0.05);相较对照组,观察组麻醉苏醒、肛门首次排气、盆腔引流、住院的时间均缩短,术后并发症发生率更低,观察组护理满意度高于对照组(P<0.05)。结论:泌尿外科机器人辅助手术患者开展精准化护理,不仅能显著改善焦虑抑郁情绪,同时具有控制术后并发症的积极作用,实现加速康复、改善生活质量的干预目的。

机器人手术护理配合中国专家共识(2024版)

由于具有3D高清可放大的手术视野、震颤自动过滤系统及7个自由度的可转腕手术器械,机器人手术系统可以极大地提高手术的准确度和安全性,进一步加强手术的精细化和微创化,所以在临床外科手术中的应用越来越广泛。机器人辅助手术的优势既与医生专业技能水平、手术适应证的选择相关,也与手术护理配合密切相关。本共识从制度体系建设,手术前、中、后护理配合,机器人手术安全管理5个方面规范了机器人手术护理技术,旨在进一步提高机器人手术护理的规范化和标准化。

基于CiteSpace可视化软件对我国机器人手术护理研究文献的分析

目的:基于文献分析探讨机器人手术系统手术护理的应用现状和研究热点。方法:检索2013-2022年中国知网、万方数据和维普中文网站收录的以机器人手术护理为关键词相关文献。采用CiteSpace可视化软件对文献作者、研究机构以及关键词进行提取,并对该领域的合作关系及热点进行探讨分析。结果:通过中国知网、万方数据和维普中文网共检索出2013-2022年期间发表的875篇中文文献,经去重筛选,最终纳入454篇中文文献进行分析。2013-2022年机器人手术护理年发文量逐年上升,2019年发文量稍有回落,2021-2022年发文数量快速增长,分别为70篇和90篇;关键词出现频次从高到低前10的为护理、机器人、护理配合、手术配合、腹腔镜、围手术期、并发症、前列腺癌、手术护理和手术;不同研究机构及作者合作度较弱;研究热点包括护理配合和围术期并发症护理;研究内容以护理经验分享和护理模式探讨为主,而护理质量标准、培训模式以及护理干预的相关研究较少。结论:基于CiteSpace可视化软件分析我国机器人手术系统手术护理的应用现状和研究热点,能够了解我国各研究机构与文献作者对于机器人手术在护理领域的研究热点和趋势,为机器人手术护理研究方向提供参考。

达芬奇机器人辅助下肝癌根治术的临床疗效及围手术期护理路径的构建

目的:探究达芬奇机器人辅助下肝癌根治术的临床疗效以及护理路径在患者围手术期的应用效果。方法:选取2020年1月—2022年12月在四川省人民医院和成都市第三人民医院接受达芬奇机器人辅助下肝癌根治术的80例患者,采用随机数字表法将其分为研究组和对照组,各40例。对照组给予常规护理干预,研究组给予临床护理路径(CNP)。对比两组临床疗效、肝功能指标、生活质量评分、心理状态评分及住院指标。结果:所有手术均顺利完成,仅有1例胆漏,3例肝断面积液,经保守治疗后相关患者症状均消失;随访6~36个月所有患者均无复发或死亡;比较两组术后肝功能指标、各项生活质量评分、心理状态评分,差异具有统计学意义(P>0.05);出院前,两组肝功能指标和心理状态评分均明显降低,两组各项生活质量评分均明显升高,且研究组明显优于对照组,差异具有统计学意义(P<0.05);研究组卧床时间、住院时间、住院费用明显低于对照组,差异具有统计学意义(P<0.05)。结论:达芬奇机器人辅助下肝癌根治术能够取得良好的手术效果。同时与传统护理干预措施相比,临床护理路径构建的标准化护理流程能够改善患者肝功能、提高生活质量、调节不良情绪,具有较高的临床应用和推广价值。

移乘背抱护理机器人舒适性生物力学模型分析

为探索移乘背抱护理机器人人机交互力学特性与被护理人舒适性感受的潜在关联,研究显性的人机接触力相对于人体生物力学特性的映射关系,揭示影响被护理人舒适性的主要作用肌群,提出了舒适性测试试验与AnyBody背抱运动人体生物力学模型相结合的方法.从被护理人的肌肉激活程度入手,对移乘背抱护理机器人背抱运动舒适性特征进行了分析.首先,介绍了移乘背抱护理机器人典型结构工作原理并进行了运动学分析,在此基础上搭建了舒适性测试试验系统,基于主观舒适性评分规划了服务于试验的基础运动轨迹,并通过试验得到了人机主要接触部位力学信息.然后,以试验数据为边界条件构建了基于AnyBody的背抱运动人体生物力学模型,依托逆动力学仿真分析得到了肌肉激活程度,并对比舒适性测试肌肉激活程度验证了仿真模型的有效性.最后,结合人机主要接触部位受力、肌肉激活程度及主观舒适性评分综合分析了移乘背抱护理机器人背抱运动舒适性特征,明确了影响被护理人舒适性的主要作用肌群.结果表明:影响被护理人舒适性的主要作用肌群有7个,且被护理人胸部压力与腋下压力值大小分别与影响其躯干和上肢舒适性的肌肉激活程度呈正相关.可通过建立胸部压力与腋下压力值相关的加权函数有效描述不同被护理人整体舒适性特征,为移乘背抱护理机器人舒适性运动控制提供了理论依据.

经腹膜外入路单孔手术机器人辅助前列腺癌根治术护理配合的初步经验

目的:总结采用国产“术锐”单孔机器人手术系统完成经腹膜外入路前列腺癌根治术的手术护理配合初步经验。方法:选择2021年11月—2022年2月在本院泌尿外科接受国产“术锐”单孔机器人辅助经腹膜外入路前列腺癌根治术的5例患者,对其术前准备、术中配合和术后护理经验进行总结与分析。结果:5例患者均在单孔机器人辅助下顺利完成手术,无中转开放,均未增加辅助通道,平均手术时间为179.4 min(145~249 min),平均机器人操作时间129.8 min(106~194 min),术中平均出血量为66 ml(30~100 ml),术后腹腔引流管留置时间3~11 d,无护理相关并发症发生,术后3个月随访患者尿控均良好。器械护士和巡回护士分工合作,并与术者及助手做到沟通有效、优化协作,全程提供优质护理,保障患者手术安全。结论:单孔机器人辅助经腹膜外入路前列腺癌根治术中采取优质护理措施能够有效提高手术的成功率,缩短手术时间和患者术后的住院时间,降低相关并发症的发生率,优质护理对单孔机器人手术的开展具有积极意义,值得推广。

人工智能在养老护理中的应用与展望

人工智能的理论与技术日益成熟,其主要目标是让机器代替人完成复杂的工作。人工智能技术与养老护理相结合,有效地弥补传统养老模式的不足,有力推动养老护理行业的发展。人工智能在养老护理中的应用主要表现为生活照护、健康账款监测、病情变化预测、运动康复训练、智能药物管理等方面。目前,人工智能的应用在缓解职业压力、弥补养老护理人力资源的不足、改变养老护理模式等方面取得了一定成效,同时也存在着智能养老护理产品功能单一、缺乏管理法规、产品价格偏高、技术安全不能完全保障和一定的伦理风险等问题。人工智能在养老护理中的应用虽然存在一些问题,但它是一种新生事物,具有广阔的发展前景。在未来,应提高对人工智能的认识,着力解决存在的问题,积极推动人工智能在养老护理中的应用。

达芬奇机器人辅助下行保留乳头切除术的男性乳房发育症围手术期的心理护理1例

目的总结1例在达芬奇机器人辅助下行保留乳头切除术的男性乳房发育症围手术期的心理护理过程。方法该研究对象为在达芬奇机器人辅助下行保留乳头切除术的男性乳房发育症患者,对患者实施围术期心理护理,分析护理效果。结果在达芬奇机器人辅助下行保留乳头切除术的男性乳房发育症围术期心理护理干预后,其焦虑自评量表(SAS)评分从54分降低至36分,抑郁自评量表(SDS)评分从55分降低至35分,术后恢复良好,无不良后果,现已出院。结论在男性乳房发育症患者实施达芬奇机器人辅助下保留乳头手术治疗期间,实施围术期心理护理的干预效果良好,有利于减轻负性情绪,增强治疗信心,提高手术治疗和护理的配合度,患者顺利出院。

多学科协作加速康复外科模式在骨科机器人导航下椎弓根钉内固定术病人中的应用

目的探讨多学科协作加速康复外科(MDT⁃ERAS)模式在骨科机器人导航下椎弓根钉内固定术病人中的应用效果。方法选取我院2022年1月至2022年12月收治的行骨科机器人导航下椎弓根钉内固定术病人42例,按照随机数字法分为观察组和对照组,每组21例。对照组病人给予常规护理,观察组病人给予MDT⁃ERAS护理干预。观察两组病人静息性和活动性疼痛、腰椎功能恢复情况、住院时间、病人满意度和围手术期并发症发生情况。结果观察组病人术后静息性和活动性疼痛评分、Oswestry功能障碍指数(ODI)均低于对照组,差异均有统计学意义(P<0.05);住院时间明显较对照组缩短,术后并发症发生率亦明显低于对照组,差异均有统计学意义(P<0.05)。结论对骨科机器人导航下椎弓根钉内固定术的病人采用MDT⁃ERAS模式,可有效降低病人术后疼痛,帮助病人安全度过围手术期,促进病人术后腰椎功能恢复,提高生活质量。

前列腺癌根治术患者日间手术全程护理管理方案的构建与应用

目的:构建前列腺癌根治术患者日间手术全程护理管理方案并分析其应用效果,以期促进患者快速、优质康复,为临床提供参考。方法:采用便利抽样法,选取2021年1月—12月入院的患者作为对照组,选取2022年1月—12月入院的患者作为实验组。实验组采用全程护理管理方案,对照组采用常规围手术期加速康复外科护理方案。比较两组患者48 h内出院占比、术后首次下床活动时间、术后直立不耐受发生率、手术并发症发生率、出院后30 d内非计划再入院率及术后1个月中重度尿失禁发生率的差异。结果:实验组共纳入62例患者,对照组共纳入64例患者,实验组患者术后首次下床活动时间早于对照组(P<0.05),且实验组患者48 h内出院占比及术后直立不耐受发生率优于对照组(P<0.05),实验组患者术后1个月中重度尿失禁发生率低于对照组(P<0.05),实验组出院30 d内非计划再入院率低于对照组(P<0.05),两组手术并发症差异无统计学意义(P>0.05)。结论:前列腺癌根治术患者日间手术全程护理管理方案可促进患者快速、优质康复,保证日间手术治疗顺利进行,并且能够降低患者术后1个月中重度尿失禁的发生率,实现前列腺癌根治术患者日间手术的高质量管理。

机器人胃癌手术围术期加速康复外科护理的最佳证据总结

目的检索、评价和整合机器人胃癌手术围术期加速康复外科护理的最佳证据,为临床提供参考。方法应用循证护理方法系统检索国内外相关数据库和专业网站中有关机器人胃癌手术围术期加速康复外科护理的所有临床决策、最佳实践建议、临床指南、专家共识。检索时限为建库至2023年4月16日。由2名研究者完成文献质量评价和资料筛选工作。结果共纳入文献12篇,包括临床决策2篇、指南3篇、专家共识7篇,最终形成36条最佳证据,包括机器人胃癌手术围术期加速康复外科的护理流程、麻醉评估与方式、营养护理、术中系统管理与故障处理、团队培训共计7个方面。结论本研究从7个方面总结了目前关于机器人胃癌手术围术期加速康复外科护理管理的最佳证据36条,为护理工作者推动机器人胃癌手术围术期护理与加速康复外科理念坚实结合,促进患者快速康复提供循证依据。