الملخص
Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.
الملخص
Objective To systematically evaluate the adult intraoperatively acquired pressure injury risk prediction model.Methods Related study on IAPI risk prediction model in Chinese and English databases such as CBM,CNKI,PubMed and Web of Science were searched.The language is limited to Chinese and English,and the search time is until November 4,2022.Two researchers independently screened the literature and extracted the data,and applied the bias risk assessment tool of prediction model research to analyze the bias risk and applicability of the included literature.Results 13 articles were included,including 17 models(operation time,age,diabetes,BMI and serum albumin are the most commonly used predictors).Among the 17 models,the area under the curve of 14 models was 0.616 to 0.984,and the other study did not report the AUC results.Among the 13 studies,10 had good applicability,while the remaining 3 had unclear applicability.13 studies have a high risk of bias,mainly because the included studies are retrospective studies,the predictive factors are screened based on univariate analysis,and the predictive outcomes are not defined by guidelines or standardization.Conclusions The existing IAPI risk prediction model for adults has good applicability,but the risk of bias is high,and the construction is not perfect.It is necessary to pay attention to the effectiveness of different risk assessment methods in the later construction,so as to get a better and more accurate risk prediction model and provide some reference and basis for formulating relevant prevention strategies.
الملخص
Objective To use the cognitive reinforcement comprehensive intervention program constructed by our team to intervene in patients with spinal cord injury and evaluate its clinical application effect.Methods A non-randomized trial design was adopted to select 97 patients with spinal cord injury from November 2021 to September 2022.Forty-four patients from March to September 2022 in a Grade A hospital in Hefei City were included in the experimental group,and 53 patients from November 2021 to February 2022 were included in the control group.The cognitive reinforcement comprehensive intervention program was used to intervene in the experimental group,and the conventional rehabilitation nursing was used to intervene in the control group.The intervention lasted for 12 weeks in both groups.The Changsha Montreal Scale,Social Support Rating Scale,Rehabilitation Exercise Self-efficacy Scale,Spinal Cord Injury Independence Rating Scale and Hamilton Anxiety Scale were used to measure the two groups before intervention,1 month after intervention and 3 months after intervention.Results 40 cases in the experimental group and 48 cases in the control group completed the study.Repeated measurement ANOVA showed that the temporal,interactive and intergroup effects of cognitive function scores and anxiety scores were statistically significant(P＜0.05).The time effect and interaction effect of the subjective support dimension score,coping self-efficacy dimension score of the two groups were statistically significant(P＜0.05).One month after the intervention,the cognitive function scores of test group were higher than before intervention and control group,and the anxiety scores were lower than before intervention and control group(P＜0.05).Three months after the intervention,the scores of cognitive function,subjective support dimension and coping self-efficacy dimension of experimental group were higher than those before intervention and control group,and the scores of anxiety level were lower than those before intervention and control group(P＜0.05).Conclusion Comprehensive intervention of cognitive reinforcement can improve the cognitive function of patients with spinal cord injury,delay the process of cognitive impairment,enhance self-confidence,relieve anxiety,and promote physical and mental rehabilitation of patients.
الملخص
Objectives @#To investigate the effect of sciatic nerve electrical stimulation ( SNES) on motor function recovery in rats with incomplete spinal cord injury (SCI) and its possible mechanism.@*Methods @#The incomplete SCI model was constructed by modified Allen ′s method. Forty⁃five Sprague⁃Dawley (SD) rats were randomly divided into three groups : Sham , SCI , and SNES. Electrical stimulation parameters were 1 ms pulse width and 100 Hz , with 20 mins each time , once a day for 21 days. The motor function was assessed by Basso⁃Beattie⁃Bresnahan (BBB) locomotor function scale , and the action potential conduction was detected by electrophysiology. Hematoxy⁃lin⁃eosin (HE) staining was used to observe the pathological changes in the spinal cord and the average cross⁃sectional area (CSA) of biceps femoris muscle fibers. The number of brain⁃derived neurotrophic factor (BDNF) and tropomyosin⁃related kinase B (TrkB) positive cells , relative mRNA and protein expression were analyzed by immunohistochemistry , reverse transcription polymerase chain reaction (RT PCR) and Western blot separately.@*Results@#On 21 d , the BBB score and average amplitude of action potential of SNES group were higher than those of SCI group , and the difference was statistically significant (P < 0. 05) . Compared with SCI group , the pathological injury of spinal cord tissue in SNES group was significantly improved , and the average CSA of biceps femoris muscles had a statistical difference (P < 0. 05) . The number of BDNF and TrkB positive cells in SNES group was higher than that in SCI group , and there were statistical differences (P < 0. 05) . The relative mRNA and protein expressions of BDNF and TrkB in SNES group were higher than those in SCI group , with statistical differences ( P <0. 05) . The relative mRNA and protein expressions of BDNF and TrkB in SNES group were higher than those in SCI group , with statistical differences ( P <0. 05) . @*Conclusion @#These results show that SNES contributes to alleviating spinal cord tissue injury , promoting the recovery of motor function and delaying the atrophy of muscles below the injury level. The possible mechanism is related to the increased expression of BDNF⁃TrkB proteins.
الملخص
Objective:To explore the mediating effect of self-efficacy and fatigue between depression and cognitive function in patients with spinal cord injury.Methods:General information questionnaire, Hamilton Depression Scale, Montreal Cognitive Scale, Rehabilitation Exercise Self-Efficacy Scale, Fatigue Revised Scale were used to investigate 256 cases of spinal cord injury patients from December 2018 to August 2020. The deviation-corrected percentile Bootstrap method was used to test the chain mediating effect of rehabilitation exercise self-efficacy and fatigue on depression and cognitive function.Results:Correlation analysis showed that depression was negatively correlated with cognitive function ( r=-0.146, P<0.01), self-efficacy of rehabilitation exercise ( r=-0.115, P<0.01), and positively correlated with fatigue ( r=0.317, P<0.01), self-efficacy of rehabilitation exercise was positively correlated with cognitive function ( r=0.903, P<0.01), and negatively correlated with fatigue ( r=-0.889, P<0.01), and fatigue was negatively correlated with cognitive function ( r=-0.217, P<0.01). The mediation model test showed that depression had a significant direct effect on cognitive function, with an effect value of -0.141 and an effect size of 50.20%. Self-efficacy of rehabilitation exercise and fatigue had a significant mediating effect between depression and cognitive function. The effect value was -0.096, -0.026, the effect size was 34.1%, 9.3%, and the chain mediation effect of rehabilitation exercise self-efficacy-fatigue was also significant, the effect value was -0.018, and the effect size was 6.4%. Conclusions:Depression in patients with spinal cord injury not only directly affects cognitive function, but also indirectly affects cognitive function through the mediating effects of self-efficacy of rehabilitation exercise and fatigue, and the chain-type mediating effect of rehabilitation exercise self-efficacy and fatigue.
الملخص
Objective To explore the effect of applying humanistic care concept in patients that were performed radical cystectomy and urinary diversion.Methods Eighty-eight patients undergoing radical cystectomy and urinary diversion in our hospital from January 2011 to May 2016 were selected.All patients were randomly divided into experiment group and control group.Of them,control group was given routine nursing care.Experiment group was administered humanistic care pattern-based nursing measures.Self-evaluation on social function was conducted in both groups 1,3 and 6 months after surgery,and the results were compared between two groups.All evaluation indexes were expressed as differences in all scales at various stages.Results Willingness score of ostomy self-nursing and score of ostomy nursing skill in experiment group upon discharge to 1 month after discharge,1 to 3 months after discharge,and 3 to 6 months after discharge,respectively,which were better than those in control group.Differences were of statistical significance(P<0.05).Anxiety score and depression score in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Evaluation score of self-nursing ability in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Score of quality of life in experiment group at those three periods were better than those in control group.All differences were of statistical significance(P <0.05).Judging from the point of view of incidence of complications 6 months after surgery,10 and 23 cases in experiment and control groups developed complications,respectively(P <0.05).Conclusions Applying humanistic care concept in clinical nursing contributes to effectively improving the postoperative recovery of social function in patients and enhancing their quality of life.It shows high application value in clinical practice.
الملخص
Objective To investigate the effect of a fast-track based clinical nursing pathway of hepatic carcinoma on patient satisfaction and job satisfaction of nurses. Methods A total of 91 primary hepatic carcinoma (PHC) patients undergoing elective hepatectomy were enrolled and were divided into two groups by admission time, namely the control group (48 cases) and the experimental group (43 cases). The patients in the control group received traditional perioperative nursing care of hepatectomy, while the cases in the experimental group participated in fast-track nursing pathway. Patient satisfaction and nurse job satisfaction were measured before and after implementation. Results Final analysis included 45 patients in the control group and 40 patients in the experimental group. In the experimental group, the total score of patient satisfaction and the scores of all dimensions (including services and techniques, concern and care, services and techniques and overall satisfaction) were (132.75 ± 13.71), (48.30 ± 6.53), (42.60 ± 4.62), (35.98 ± 3.85), (5.88 ± 0.94), while they were (122.89 ± 16.62), (44.53 ± 7.74), (39.49 ± 5.67), (33.53±4.40), (5.33±1.13) in the control group. And the scores of the experimental group were significantly higher than that of the control group (t=-2.961, t=-2.409, t=-2.753, t=-2.709, t=-2.389, P0.05) since the scores after implementation were (13.86 ± 2.12), (7.45 ± 1.57), while that of (13.18 ± 2.30)、(7.23 ± 1.41) were obtained before performance. Conclusions Application of fast- track nursing pathway in perioperative patients with PHC can contribute to promoting the level of patient satisfaction and job satisfaction of nurses and improving nursing quality. It is suggested that this nursing pathway will have more potential value for PHC patients.
الملخص
Objective The medical code of biology-psychology-societyplays a vital role in modern treatment .The arti-cle aimed to investigate the clinical value of He-Ne laser combined with psychological intervention in the treatment of acute herpes and zoster. Methods Retrospective analysis was made on the clinical data of 81 patients with acute herpes and zoster in our hospital from Jan 2015 to Jan 2016 .The patients were divided into 3 groups randomly .Patients in group A were treated with antiviral and neu-rotrophic medication , psychological intervention and analgesic drugs . Patients in group B were treated with antiviral and neurotrophic medi-cation, psychological intervention and He-Ne laser.Patients in group C were treated with antiviral and neurotrophic medication , psychologi-cal intervention, analgesic drugs and He-Ne laser.Visual analogue scale ( VAS) was evaluated before treatment in hospital on the 3rd day, the 5th day of treatment, and telephone follow -up after 4 weeks of treatment.VAS and average length of stay were analyzed . Results No difference was found as to VAS before treatment in hospital among three groups (8.1 ±1.1, 8.1 ±0.9 vs 7.9 ±1.0, P<0.05).VAS was decreased in all groups after nursing propaganda , psychological intervention and placebo (P<0.05).Compared with the VAS before treatment, VAS in three groups decreased significantly on the 3rd day and the 5th day of treatment.From the re-sults on the 5th day and telephone follow -up after 4 weeks of treatment , VAS was still at a low level in group A and group B , on the contrary, VAS was decreased continuously in group C . Conclusion Combined treatment of antiviral , neurotrophic, analgesic drugs and He-Ne laser can relieve pain , decrease VAS and shorten the average length of stay for patients with acute herpes and zoster .
الملخص
To observe local inflammation reaction and vein thrombosis on rabbit ear vein with methotrexate , ceftri-axone sodium and normal saline .With the extension use of drugs , the numbers of inflammation reaction and throm-bosis in each group were increased , and antibiotic and chemotherapy drug group had a higher rate than the normal saline group .There was a statistically significant difference of the inflammation reaction between the three test groups on the 3rd and 7th day (P<0.05), and a statistically significant difference of thrombosis between the three test groups on the 7 th day ( P<0.05 ) .The physical-chemical properties of drugs and use of time were factors in-fluencing inflammation reaction and thrombosis .
الملخص
Objective To explore the effect of telephone intervention on discharged patients after total hip replacement. Methods 214 participants were assigned to the intervention group including 104cases receiving 6 months of telephone intervention and the control group including 110 cases receiving routine nursing by random number table method. The intervention were taken at 1,2 week and 1,2,3,6 month after patients discharged. The outcome measurements were the self-designed questionnaire of functional exercise compliance and Harris scale at 1, 3, 6 month patients discharged. Results The scores of self-designed questionnaire of functional exercise compliance were (42.24±4.58), (38.55±5.84), (36.98±5.41) at 1, 3, 6 month discharge from hospital in the intervention group, while in the control group was (38.79 ± 5.98), (35.45 ± 6.44), (32.45 ± 6.04) respectively. There were significant between two groups, t value was 3.290, 2.567 and 4.024 respectiveliy, P<0.05. There was no significant of Harris scale′s scores between two groups when they discharged. The scores of Harris scale were (66.51±6.64), (75.30± 6.65), (89.44±4.98) at 1, 3, 6 month discharge from hospital in the intervention group, while in the control group was (61.31 ± 6.68), (70.56 ± 8.01), (81.18 ± 6.13) respectively, and it has significant between two groups, t value was 4.232, 3.509 and 8.076, P<0.05. Besides, the scores of self-designed questionnaire of functional exercise compliance were decline and the scores of Harris scale were up along the time patients discharged in two groups(P < 0.05). Conclusions Telephone as a simple, convenient, efficient tool could enhance patients functional exercise compliance and hip function after total hip replacement.