Safety and effectiveness of tunneled peripherally inserted central catheters versus conventional PICC in adult cancer patients.

OBJECTIVES: This study aimed to compare the safety and effectiveness of tunneled peripherally inserted central catheters (T-PICC) vs. conventional PICCs (C-PICC) in adult cancer patients. METHODS: A multicentre randomized controlled trial was conducted between April 2021 and January 2022 in seven hospitals in China. 564 participants were randomly assigned to T-PICC or C-PICC. These data were collected and compared: the baseline characteristics and catheterization-related characteristics, periprocedural complications, and long-term complications. RESULTS: Five-hundred fifty-three participants (aged, 52.6 ± 12.3 years; female, 39.1%) were ultimately analyzed. No significant differences in periprocedural complications were found between the T-PICC and C-PICC groups (all p > 0.05). Compared with C-PICC, T-PICC significantly reduced the incidence of long-term complications (26.4% vs. 39.9%, p < 0.001). Specifically, reduced complications were found in central line-associated bloodstream infection (1.8% vs. 5.1%, p = 0.04), thrombosis (1.1% vs. 4.0%, p = 0.03), catheter dislodgement (4.7% vs. 10.1%, p = 0.01), non-infectious oozing (17.3% vs. 28.6%, p = 0.002), local infection (3.6% vs. 7.6%, p = 0.04), skin irritation (6.1% vs. 10.9%, p = 0.046), and reduced unplanned catheter removal (2.2% vs. 7.2%, p = 0.005). No significant differences were found between T-PICC and C-PICC regarding catheter occlusion (6.5% vs. 5.8%, p = 0.73) or skin damage (2.2% vs. 2.9%, p = 0.58). CONCLUSION: T-PICC is safe and effectively reduces long-term complications. CLINICAL RELEVANCE STATEMENT: The tunneled technique is effective in reducing PICC-related long-term complications. Thus, it is recommended for cancer patients at high risk of PICC-related complications. TRIAL REGISTRATION: The registration number on https://www.chictr.org.cn/ is ChiCTR2100044632. The name of the trial registry is "A multicenter randomized controlled study of clinical use of tunneled vs. non-tunneled PICC". KEY POINTS: Cather-related complications are associated with the technique of catheterization. Compared with conventional PICC, tunneled PICC reduced catheter-related long-term complications. Tunneled PICC placement provides an alternative catheterization method for cancer patients.

Alexithymia in a Chinese Patient with Chronic Pain and Associated Factors: A Cross-Sectional Study.

BACKGROUND: Alexithymia is more prevalent among those with patients living with chronic pain. Information on the prevalence of alexithymia in Chinese patients with chronic pain and associated factors is limited. AIM: The primary objective of this study was to determine the prevalence of alexithymia, as defined by a score of 61 or greater in the 20-item Toronto Alexithymia Scale (TAS-20), in a Chinese patient with chronic pain. The secondary objective was to investigate the relationship between alexithymia and the clinical and psychological aspects of chronic pain. METHODS: A cross-sectional observational study used the TAS-20 to assess alexithymia of Chinese patients with chronic pain. Sociodemographic and clinical information were obtained and participants filled in the Fear Avoidance Beliefs Questionnaire, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and General Self-efficacy Scale. RESULTS: Of the 346 patients screened, 321 patients living with chronic pain were enrolled into the study. The prevalence of alexithymia among the study population (TAS-20 score ≥61) was 19.6% (95% confidence interval [CI]: 15.3-24.0). The findings showed anxiety (odds ratio [OR] = 2.474; 95% CI, 1.241-4.935), pain catastrophizing (2.649; 1.014-6.921), and self-efficacy (0.952; 0.908-0.988) as independent predictors of alexithymia in patients living with chronic pain. CONCLUSIONS: Patients with chronic pain exhibiting alexithymia were at higher risk of pain catastrophizing, anxiety, and lower self-efficacy, compared with patients without alexithymia. It is important to identify and pay a special attention in clinical practice to patients with chronic pain exhibiting alexithymia, as these individuals are unable to properly express their emotions.

Characteristics and risk factors of nasal mucosal pressure injury in intensive care units.

AIMS AND OBJECTIVES: This study aimed to understand the risk factors that contribute to medical device-related (MDR) nasal mucosal membrane pressure injuries (MM PI) in ICU patients. BACKGROUND: ICU patients require substantial tube-based life support such as oxygen tubes, tracheal intubation and indwelling gastric tubes. As a result, there is an increased risk of PI occurrence; however, few studies have assessed the risk factors associated with nasal mucosal MDR-MMPI in ICU patients. DESIGN: A cross-sectional study design was performed. METHODS: From January 2019 to June 2020, data from 912 patients treated in the ICU of a tertiary first-class a hospital in China were collected. The occurrence of PI of the nasal mucosa was obtained by nasopharyngoscope when replacing the nasal catheter fixation patch every day. The study methods were followed by the STROBE guidelines. RESULTS: The incidence of nasal mucosal MDR-MM PI was 10.9%. The degree of nasal mucosal MM PI was mainly grade 1 (62cases, 62.6%), and no grade 4 were observed. The columella (58 cases, 58.6%) was the most common site of nasal mucosal MM PI followed by the anterior septum (18 cases, 18.2%). A high patient APACHE-Ⅱ score, the disturbance of consciousness, a history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and the use of vasoconstrictors were identified as significant influencing factors of nasal MM PI in ICU patients (p < .05). CONCLUSIONS: A high APACHE-Ⅱ score, disturbance of consciousness, history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and use of vasoconstrictive drugs were risk factors for nasal mucosal MDR-MM PI in ICU patients. This study informs on the risk factors of nasal mucosal MM PI that will allow medical support staff to carry out key interventional measures to prevent nasal mucosal MM PI. RELEVANCE TO CLINICAL PRACTICE: This study illustrates the characteristics and risk factors of nasal mucosal pressure injury in intensive care units, potentially contributing to the prevention of the incidence of nasal mucosal MDR-PI in ICU patients.

Prevalence and risk factors of ischemic stroke-related headache in China: a systematic review and meta-analysis.

BACKGROUND: Headache accompanying ischemic stroke is considered an independent predictor of neurological deterioration. This meta-analysis aims to estimate the prevalence of ischemic stroke-related headaches and identify its risk factors in China. METHODS: PubMed, Embase, Cochrane Library database, Web of Science, PsycINFO, and four Chinese databases for the related publications were searched. Two researchers independently selected the literature, extracted the relevant data, and assessed its methodological quality. The meta-analysis applied a random-effects model with R software to calculate the pooled prevalence of ischemic stroke-related headaches in Chinese patients, and to merge the odds ratio (OR) of risk factors. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed by a funnel plot and Egger test. RESULTS: Ninety-eight studies were eligible for inclusion. The overall pooled prevalence of ischemic stroke-related headache was 18.9%. Subgroup analysis showed that the prevalence of ischemic stroke related-headaches was higher among studies using self-report to diagnosis headache (18.9%; 95%CI, 8.9% to 40.2%), and those focused on age ≥ 55 years (19.7%; 95%CI, 14.9% to 25.9%), rural settings (24.9%; 95%CI, 19.7% to 31.6%). There were no significant differences in the headache prevalence between studies in the south and north, and inland and coastal studies. The prevalence of pre onset headache (13.9%) and tension-type headache (15.5%) and was higher compared with other types. History of headache (OR = 3.24; 95%CI, 2.26 to 4.65.), female gender (OR = 2.06; 95%CI, 1.44 to 2.96.), midbrain lesions (OR = 3.56; 95%CI, 1.86 to 6.83.), and posterior circulation stroke (OR = 2.13; 95%CI, 1.14 to 4.32) were major risk factors. CONCLUSION: The prevalence of ischemic stroke-associated headache is high in China. In addition, women, presence of midbrain lesions, posterior circulation stroke and a history of migraine were high-risk factors for ischemic stroke-related headaches. Designing effective interventions to prevent or alleviated headaches is necessary to promote patients' neurological recovery and quality of life.

Pain catastrophizing and associated factors in preoperative total knee arthroplasty in Lanzhou, China: a cross-sectional study.

BACKGROUND: Pain catastrophizing in preoperative total knee arthroplasty (TKA) patients is associated with several poorly characterised factors in the literature. This study investigated the current state and associated factors of preoperative pain catastrophizing in patients undergoing TKA. METHODS: This descriptive cross-sectional study was conducted at the orthopedics ward of two tertiary hospitals in Lanzhou, China. Pain catastrophizing was measured using the Chinese versions of the Pain Catastrophizing Scale, Short Form-36 (physical function domain), Numerical Rating Scale, Oxford Knee Score, Hospital Anxiety and Depression Scale, and Life Orientation Test-Revised. RESULTS: The study included 360 participants. Preoperative TKA pain catastrophizing in all patients was high, with a mean score of 24.92 (SD: 12.38). The stepwise multiple linear regression analysis revealed anxiety (ß = 0.548, P < 0.01), education level (ß = - 0.179, P < 0.01), physical function (ß = - 0.156, P < 0.01), and pain intensity during activity (ß = 0.105, P = 0.015) as associated factors for pain catastrophizing, possibly explaining 51.2% of the total variation (F = 95.149, P < 0.01). CONCLUSION: Anxiety was the most relevant factor for pain catastrophizing in patients with preoperative TKA. Lower education levels, poor physical function, and stronger pain intensity during the activity were also associated with pain catastrophizing.

Mindfulness-Based Cognitive Therapy for Treating Chronic Pain A Systematic Review and Meta-analysis.

Chronic pain is a significant public health problem with emotional and disabling factors, which may not completely respond to current medical treatments such as opioids. The systematic review and meta-analysis aimed to examine the effectiveness and safety of MBCT for patients with chronic pain. Database searches of PubMed, Medline, EMBASE, the Cochrane Library, PsycINFO, Web of Science, Scopus and CINAHL up to 15 October 2019. Included studies assessed with the Cochrane risk-of-bias tool. Eight RCTs involved 433 patients, including chronic low back pain, fibromyalgia, migraine, rheumatoid arthritis and mix etiology. MBCT intervention demonstrated a short-term improvement on depression mood [standardized mean difference -0.72; 95% confidence interval = -1.22 to -0.22, p = 0.005] compared with usual care and was associated with short-term improvement in mindfulness compared with non-MBCT [SMD 0.51; 95% CI = 0.01 to 1.01, p = 0.04]. Between-group differences in pain intensity, pain inference and pain acceptance were not significant at short- or long-term follow-up. Compared to active treatments, MBCT intervention not found significant differences in either short- or long-term outcomes. MBCT showed short-term efficacious on depressed mood and mindfulness of chronic pain patients. Longer follow-ups, large sample and rigorous RCTs that can be best understand remaining uncertainties needed.

Alexithymia, social support, depression, and burnout among emergency nurses in China: a structural equation model analysis.

BACKGROUND: Several factors are associated with the incidence of burnout, including alexithymia, social support, and depression. The relative importance of these three key parameters as mediators of burnout, however, is not well understood. In addition, there have been few studies to date specifically examining the association between alexithymia and burnout among nurses in China. PURPOSE: To evaluate the relationship of burnout with alexithymia, social support, and depression across emergency department nurses in China. METHODS: This descriptive, cross-sectional survey was conducted using a convenience sampling methodology to survey nurses responsible for direct emergency care (n = 413) from 18 tertiary hospitals in Western, Eastern, Northern, and Southern China between May 2020 and June 2020. A structural equation modeling approach was then used to assess a hypothetical model wherein alexithymia both directly and indirectly affects burnout among emergency nurses via impacting the incidence of depression and perceived social support. RESULTS: Results supported all driving hypotheses. Alexithymia was positive direct correlated with burnout (ß = 0.35; P < 0.001) and depression (ß = 0.50; P < 0.001), and exhibited a negative direct effect on social support (ß = - 0.14; P = 0.041). Depression was associated with burnout, both directly (ß = 0.24; P < 0.001) and indirectly (ß = 0.15; P < 0.001) through its relationship with social support. Alexithymia was the factor most strongly associated with burnout, and it was able to affect burnout indirectly through depression and social support. CONCLUSIONS: We found that among emergency nurses in China, alexithymia was correlated with burnout, depression, and social support. Alexithymia was the factor most strongly associated with burnout. These data suggest that providing better social support and alleviating alexithymia may decrease rates of burnout among emergency nurses.

Development of a nomogram for predicting nasogastric tube-associated pressure injuries in intensive care unit patients.

Here, we aimed to build a nomogram model to estimate the probability of nasogastric tube-associated pressure injuries (NTAPIs) in intensive care unit(ICU)patients. This prospective cohort study included 219ICU patients with nasogastric tube between September 2019 and January 2020.Univariate and multivariate logistic regression analyses were used to develop the nomogram model. The resulting nomogram was tested for calibration, discrimination, and clinical usefulness. Of the included patients, 58 developed NTAPIs, representing an incidence rate of 26.5%. Binary logistic regression analysis revealed that the prediction nomogram included C-reactive protein, vasopressor use, albumin level, nasogastric tube duration, and Sequential Organ Failure Assessment score. The value of these predictors was again confirmed using theLasso regression analysis. Internal validation presented a good discrimination of the nomogram, with an area under the curve value of 0.850, and good calibration (Hosmer-Lemeshow test, P = 0.177). The decision curve analysis also demonstrated preferable net benefit along with the threshold probability in the prediction nomogram. The nomogram model can accurately predict the risk factors for NTAPIs, to formulate intervention strategies as early as possible to reduce NTAPI incidence.

Auditory and Visual Stimulation for Abdominal Postoperative Patients Experiencing Enhanced Recovery After Surgery (ERAS).

The Enhanced Recovery After Surgery program can reduce postoperative complications, hospital stay, and overall costs in patients, although the evidence for physical intervention with patients is still lacking. This study provides visual and auditory physical interventions to patients in order to explore the effects of Enhanced Recovery After Surgery following abdominal surgery. The study group consisted of patients who had undergone laparoscopic cholecystectomy, radical resection of gastric cancer, or radical resection of colon cancer; we randomly divided them into a control group and a visual and auditory intervention group. We then monitored the bowel sound frequency and time of the first anal self-exsufflation for both groups after surgery. We found that compared with the control group, patients who had undergone laparoscopic cholecystectomy and radical gastrectomy who received auditory intervention had increased bowel sound frequency and a shorter time until first anal self-exsufflation. In addition, patients with colon cancer who received both auditory and visual stimulation had increased bowel sounds and shorter time until the first anal self-exsufflation. These results suggest that visual and auditory interventions significantly improve patients' gastrointestinal function, shorten the hospitalization period, and reduce complications after operation.

Knowledge, attitude, and practice of nurses in intensive care unit on preventing medical device-related pressure injury: A cross-sectional study in western China.

The knowledge, attitude, and practice of nurses in intensive care units (ICUs) are determinants for the efficacy of preventing the medical device-related pressure injury (MDRPI). The aim of this study was to determine the level and factors of knowledge, attitude, and practice of nurses' ICUs on preventing medical MDRPI in western China. An annual cross-sectional study was conducted in hospitals of western China from May 2020 to September 2020. Nurses' knowledge and attitudes were assessed using Clinical Nurses Prevention MDRPI of Critically Ill Patients for the Knowledge, Attitude, Practice Assessment Scale. SPSS software version 25.0 and independent t-test, Chi-square, Fisher exact, one-way analysis of variance, and multiple linear regression tests were used for data analysis. A total of 1002 nurses in ICUs from 37 hospitals in Gansu Province, China, participated in this study. The scores of overall KAP, knowledge, attitudes, and practice were 149.17 ± 24.62, 53.83 ± 12.23, 37.24 ± 6.35 and 58.10 ± 9.83, respectively. There was a positive and significant relationship between three variables. Findings revealed that nurses' knowledge score in the Tertiary hospital was higher than scores of other hospitals as 3.840 units. Moreover, the knowledge score and practice score of nurses with bachelor's degree or above were higher than other nurses and are 0.978 and 1.106 units, respectively. Based on the findings, practice of nurses increased by 0.992 units, with a 1-year increase in work experience of nurses in the ICU. The levels of knowledge, attitude, and practice of nurse in ICUs on preventing MDRPI were acceptable. The findings of the study highlight that a comprehensive approach should be conducted for raising the level of knowledge, attitude, and practice of nurses' ICUs on preventing medical MDRPI, as well as improving the quality of care for critically ill patients.

[A study on loneliness among people who lost their children in disaster area of 5.12 Earthquake].

OBJECTIVE: To evaluate the status of loneliness, the influential factors and the relationship between loneliness and family function among bereaved parents in disaster area of 5.12 Earthquake and to provide basis for mental and family reconstruction for those people suffering from the Earthquake. METHODS: A total 190 bereaved parents in disaster area of 5.12 Earthquake were enrolled for an across-sectional study. A face-to-face survey was conducted by following scales: General Data Scale, University of California at Los Angels Loneliness Scale, Emotional and Social Loneliness Scale and Family APGAR Index. RESULTS: The score of loneliness ranged from 24 to 69 (mean=43.58, SD=9.61), the score of emotional loneliness ranged from 5 to 24 (mean=11.95, SD=3.60) while the social loneliness ranged from 6 to 24 (mean=13.99, SD=3.69). The scores of loneliness, social loneliness and emotional loneliness were all increased among bereaved parents compared to people without loss of their child. The results of multivariate analysis showed that family function and status of fertility significantly impacted the loneliness (P< 0.05). Furthermore, there was negative correlation between family function and the loneliness, social loneliness and emotional loneliness (P< 0.05). CONCLUSION: The bereaved parents in disaster area of 5.12 Earthquake showed higher level of loneliness. The better of family function indicated the less of loneliness in bereaved parents. Measures should be taken to promote mental and family reconstruction for such people, including providing effective skills to improve emotional communication and family function and offering technical support for having another baby.

The Patients' Presupposed Distrust to Doctors in China: An Explanatory Sequential Mixed Methods Study.

Purpose: The aim of this study was to investigate the current status of patients' presupposed distrust, and to clarify the causes of high presupposed distrust. Patients and Methods: An explanatory sequential mixed methods study was conducted using a two-stage design. The first phase was a quantitative cross-sectional survey, a total of 384 patients by convenience sampling completed the survey. Study instruments including demographic and clinical characteristics sheet, patients' presupposed distrust scale. In the qualitative phase, 16 patients on the basis of their mean score for all PPDS items were higher than 4 were identified as extreme cases participated in one-to-one semi-structured interviews. Results: The total item mean score for all patients on PPDS was 3.59(3.18, 4.09), which above the median range of the PPDS (item mean score of 3). Personal income level and educational level were significant predictive influencing factors of patients' presupposed distrust, which could explain 17.347% of the variance. The reasons of high patients' presupposed distrust were as follows: moral character, health knowledge, patient perceptions, and the social circumstance. Conclusion: The level of patients' presupposed distrust was high, which needs to be further decreased. Demographic and clinical variables (personal income level, educational level) are identified to be the major contributing factors. The main causes for the formation of the high patients' presupposed distrust are patients internal factors and social circumstance.

The level of life space mobility among community-dwelling elderly: A systematic review and meta-analysis.

BACKGROUND: Multiple countries have conducted surveys on the level of life space mobility for community-dwelling elderly through the Life-Space Assessment, the results vary greatly, from 41.7 to 88.6. However, there is no meta-analysis on the current situation of community-dwelling elderly life space mobility. OBJECTIVE: To systematically assess the global level of life space mobility for community-dwelling elderly, to identify potential covariates such as geographical regions, survey years, gender, and age that contribute to the heterogeneity between the studies, and to identify the dynamic trend based on survey years. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Two reviewers searched the following 8 electronic bibliographic databases from inception until May 28, 2023: PubMed, The Cochrane Library, Web of Science, Embase, Chinese Biomedical Database, China Knowledge Resource Integrated Database, WanFang, and Weipu Database. REVIEW METHODS: This review was conducted using the Stata 14.1 and R 4.3.1. The Cochrane's Q statistical and I2 index were used to test for heterogenicity and assess the degree of heterogenicity, respectively. Studies were appraised using the Agency for Healthcare Research and Quality tool, the Newcastle-Ottawa Scale for the quality of cross-sectional studies, cohort studies, respectively. RESULTS: A total of 29 studies were selected from databases and reference lists. The pooled score of Life-Space Assessment was 66.84 (95% CI: 63.30-70.39) and the prevalence of restricted life space was 42% (95% CI: 0.27-0.57). The geographical regions, survey years, gender were found to be a significant covariate of the pooled score of life space mobility estimate in the subgroup analysis. The mean score of Life-Space Assessment gradually achieved stability after 2017. CONCLUSIONS: The life space mobility of community-dwelling elderly in the global is at a moderate level, with 42% of them experiencing restricted life space. South America, females and earlier survey years have a lower level of life space mobility. In the future, the government should identify vulnerable groups for targeted intervention to promote the level of LSM in the community-dwelling elderly. REGISTRATION: PROSPERO [CRD42023443054].

Knowledge, attitude and practice of registered nurses toward ICU patients' transfer anxiety in China: A cross-sectional study.

Introduction: Transfer anxiety has effect many critically ill patients in ICU around the world. Nurses must take care of the psychological adjustments that patients and families face when ICU patients transferred to general ward. During this period, basic knowledge, positive attitude, and correct practice are necessary for nurses to address the issue of transfer anxiety and seek to reduce it whenever possible. However, there were few investigations have been performed the knowledge, attitudes, and practice of registered nurses toward ICU patients' transfer anxiety. Aim: The purpose of the paper is to explore the level and influencing factors of knowledge, attitude and practice of registered nurses toward ICU patients' transfer anxiety in China. Methods: From February 1 to March 17, 2023, a cross-sectional study was adopted in China. An electronic questionnaire was used to collect data. Registered nurses' knowledge, attitudes and practice toward ICU patients' transfer anxiety were assessed using The Knowledge, Attitude and Practice Questionnaire for Chinese Registered nurses in ICU regarding the prevention of transfer anxiety. In the end, in this study involved 381 registered nurses from Lanzhou University Second Hospitals in China. SPSS 26.0 for mac, independent T-test, one-way ANOVA test, Scheffe's test, Pearson correlation coefficient and multiple linear regression tests were used for data analysis. Results: The scores of total KAP, knowledge, attitude, and practice are 135.21 ± 24.504, 45.58 ± 13.903, 56.94 ± 10.690 and 32.87 ± 6.393 separately. Study results show that there was a statistically significant correlation among the three variables. According to the results of independent t-test or one-way ANOVA test, there is a correlation between gender(P = 0.001), highest educational attainment (P = 0.005) and knowledge; type of department(P = 0.003) and attitude; gender (P = 0.003), marital status (P = 0.002), clinical work experience (P = 0.002), type of department (P = 0.005) and practice. According to the results of linear regression analysis in this study, the variables of gender (P = 0.006), highest educational attainment (P = 0.032), scores of attitudes (P = 0.006), and scores of practice (P = 0.000) were associated with the scores of knowledge; the variables of scores of knowledge (P = 0.004), and scores of practice (P = 0.000) were associated with the scores of attitudes; the variables of scores of knowledge (P = 0.000), and scores of attitudes (P = 0.000) were associated with the scores of practice. Conclusion: The findings of the study emphasize that comprehensive measures of knowledge, attitude and practice should be taken to improve nurses' knowledge, attitudes, and practices regarding transfer anxiety in intensive care unit patients in order to reduce its adverse effects on ICU patients.

Perceived family functioning and depression in bereaved parents in China after the 2008 Sichuan earthquake.

This study examined perceived family functioning and depression in bereaved parents 18 months after the 2008 Sichuan earthquake. This was a cross-sectional study with 190 bereaved parents sampled using a multistage stratified sampling method. The instruments used in the study included Family APGAR Index and Hamilton Depression Rating Scale-17. The results indicated that the prevalence of family dysfunction was 59.5%. All the respondents experienced depression with 79.5% of the respondents reporting very severe depression. Being female, being at an advanced age, being divorced or widowed, being directly exposed to the death of their children, not having another baby after the earthquake, and poorer family functioning were significant predictors for more severe depression. Strategies can be designed in post-disaster recovery programs for bereaved parents at high risk for more severe depression, particularly for those with poorer family functioning.

[Family function among the bereaved in hard-hit areas 1 year after Wenchuan earthquake].

OBJECTIVE: To investigate the family function among the bereaved in hard-hit areas 1 year after Wenchuan earthquake and to provide basic information for family reconstruction. METHODS: A cross-sectional study was used to survey 264 bereaved who were selected according to the criteria in hard-hit areas after Wenchuan earthquake. RESULTS: The scores of family care function of the bereaved in hard-hit areas after Wenchuan earthquake were 6.52±2.65. Fifty percent of the participants' family kept in good state. The scores of the bereaved family cohesion ranged from 28 to 83 (64.22±9.18), and the scores of family adaptability ranged from 21 to 62 (41.84±6.62). There was no significant difference in the score of family cohesion between the bereaved family and the non-bereaved family (P>0.05). But the score of the family adaptability of the bereaved family was significantly lower than that of the non-bereaved family (P<0.05). The bereaved family types were as follows: 22.0% balanced type, 53.8% middle type and 24.2% extreme type. In the 16 family types, the "intimate-rigid" (24.6%), "intimate-regular" (19.7%) and "disengaged-rigid" (19.3%) type ranked the top three. CONCLUSION: The family care function of the bereaved in hard-hit areas after Wenchuan earthquake is damaged to different degrees. The main type of family is the middle type. The loss of relatives reduces the participant family adaptability. In the late intervention, we should help the bereaved improve and enhance family function, and promote family reconstruction of the bereaved.

Whole-course care in photodynamic therapy of colorectal cancer: A short communication.

Photodynamic therapy is now widely used in different oncologic fields. It is feasible for the treatment of early, non-surgical and non-obstructive cancers. Also, in gastroenterology, where it was a few attempts to treat both the premalignant lesion and advanced colorectal cancer. Photodynamic therapy provides a new treatment option for advanced colon cancer patients with severe obstruction and elderly patients whose cardiopulmonary function cannot tolerate surgery, and effective nursing support throughout the treatment is the key to ensure successful treatment. This study reported the effect of whole-course care for colorectal cancer patients undergoing photodynamic therapy in the Department of Surgical Oncology, Lanzhou University Second Hospital, Lanzhou, China.

Prevalence and associated factors of alexithymia in intensive care unit nurses.

AIMS: The aim of this study was to investigate the incidence of alexithymia in intensive care unit nurses and determine the associated factors. DESIGN: A multi-center, cross-sectional study. METHODS: In total, 485 nurses in intensive care unit were recruited from 53 hospitals in China. Data collection tools used in the study included demographic characteristics, the Social Support Rating Scale (SSRS), Emotional Intelligence Scale (EIS), and the 20-item Toronto Alexithymia Scale (TAS-20). SPSS 25.0 software (Corp., Armonk, NY, USA) was used to preform data analysis. RESULTS: About 43.7% of intensive care unit nurses were classified as alexithymia in the whole sample (males: 50%, females: 43%). The median TAS-20 score was 60 (interquartile range = 9). The study found that alexithymia was significantly associated with marital status, whether living alone, working years, and social support (Adjusted R Squared = 0.194, F = 6.466, p < 0.01), while emotional intelligence was not statistically significant with alexithymia. CONCLUSIONS: Alexithymia is a psychological problem with high incidence in intensive care unit nurses. In this study, being unmarried or divorced, living alone, and having fewer years of work (≤5 years) were associated with a higher risk of alexithymia. Interventions that strengthen social support may also help improve the mental health of ICU nurses.

[Family function and depression in relatives of earthquake victims: a survey conducted one year after China's Wenchuan Earthquake].

BACKGROUND: The Wenchuan Earthquake that hit Sichuan, China in 2008 not only caused huge losses in terms of human life and economic damage. It also caused psychological trauma in survivors, especially those who had lost relatives and close friends (bereaved). In the aftermath of earthquakes, bereaved individuals require family and spiritual renewal in addition to material assistance. PURPOSE: This study investigated the status of and relationship between family function and depression in bereaved individuals living in areas devastated by the Wenchuan Earthquake. Results provide baseline information for post-disaster family reconstruction. METHODS: This cross-sectional study surveyed 264 qualified bereaved individuals who lived in an area hard hit by the Wenchuan Earthquake. Face-to-face interviews were administered based on the family APGAR(adaptation, partnership, growth, affection, resolve) index and Hamilton depression (HAMD) scale. RESULTS: The mean family function score for participants was 6.52 ± 2.65. Results for half (50.0%) of participants indicated "good" family function. Results indicated marital status, family structure and status of having another baby as factors that significantly influence family function (p < .05). Participants' mean depression score was 40.41 ± 9.35, with all (100%) of participants demonstrating symptoms of depression. The 5 most prevalent depressive symptoms were: depressed mood, decreased interest in work, mental anxiety, diminished capacity and agitation. Results showed marital status, leisure frequency, economic status, and having another baby as factors that significantly influenced family function (p < .05). A Pearson's correlation analysis indicated no significant relationship between level of depression and family function (p >.05). CONCLUSION: Family functions of the bereaved living in areas hard hit by the Wenchuan Earthquake were all undermined to varying degrees. Although participants all exhibited depressive symptoms, this study found no affect of such symptoms on family functions. Interventions delivered in the months and years after an earthquake should be tailored to address each individual's depression status. Interventions should also help these individuals learn to improve and enhance family functions to effectively reduce negative behaviors and reactions in order to better promote physical and mental health.

Treatment of Severe Congenital Scoliosis with Type ІI Respiratory Failure.

We report a case of a 14-year girl with severe congenital scoliosis (CS) and type ІІ respiratory failure (RF), who underwent preoperative halo-gravity traction in combination with intraoperative orthopaedic surgery on the spine based on the results of physical examination, pulmonary function tests (PFTs), computed tomography (CT), and blood gas analysis. The patient's coronal and sagittal Cobb's angles changed from 100° to 45° and 40°, respectively, and RF changed from type ІІ to type І after treatment. Scoliosis was corrected well, and RF was improved. During follow-up for nearly 3 years, no loss of deformity correction and no serious complications occurred, and the patient showed a good clinical outcome and balanced spine. Key Words: Congenital scoliosis, Halo-gravity traction, Respiratory failure.