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Objective:To integrate the best evidence of non-drug intervention of urinary incontinence in elderly women and to formulate practical recommendations.Methods:In this systematic review study, using “elderly woman”,“urinary incontinence”,“bladder training”,“pelvic floor muscle training”,“enuresis”,“leakage of urine” as the key words, the 6S evidence resource pyramid model was used to search in British Medical Journal best practice, Uptodate, World Health Organization, Guidelines International Network, National Institute for Health and Care Excellence, Chinese Medical Association, Scottish Intercollegiate Guideline Network, Registered Nurses Association of Ontario, Cochrane Library, The Joanna Briggs Institute (JBI), New Zealand Guidelines Group, Polish Society of Gynecologists and Obstetricians, PubMed, Embase, Medline, Web of Science, SinoMed, China National Knowledge Infrastructure, WanFang Data, etc. The evidence retrieved included evidence-based knowledge base resources, clinical practice guidelines, expert consensus, systematic review, etc. Data were retrieved from January 1, 2017 to May 1, 2022, and collated from May 2, 2022 to May 25, 2022. Two researchers independently evaluated the quality of literature and extracted data using the AGREE Ⅱ and JBI evidence-based health care center assessment tools. The JBI evidence-based health care center′s evidence pre-rating system and evidence recommendation rating system were applied to rank the evidence; and under the guidance of the evidence structure of JBI, the strength of evidence recommendation was determined and the best evidence was extracted and summarized in combination with the study group discussion and expert opinion.Results:A total of 9 articles were retrieved, including 7 guidelines and 2 systematic reviews; and 6 guidelines were classified as Grade A and 1 as grade B; both 2 systematic reviews were rated as Grade A; 84% (27/32) of the items were evaluated as “Yes”. Evidence were summarized as 34 pieces of best evidence from 6 dimensions, including “overall recommendation, evaluation of type and degree of urinary incontinence, lifestyle change, behavioral therapy, prevention of precipitating factors, intervention in special population”; the flow chart of screening, evaluation, special symptoms, life style and behavior therapy was combed, and the practical suggestions were formed.Conclusions:The overall quality of the literature on non-drug intervention of urinary incontinence in elderly women is high, and the level of evidence is high. Early identification of urinary incontinence types and assessment of disease severity, lifestyle changes, avoidance of predisposing factors and behavioral therapy are the key to non-drug treatment of urinary incontinence in those patients.
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Objective:To explore the effect of medical care, elderly care and nursing management mode on self-care ability and blood pressure management in elderly patients with hypertension.Methods:From July 2018 to June 2019, 164 elderly patients with hypertension admitted into the outpatient department of the ZhejiangHospital were selected as the study objects by convenience sampling method, and randomly divided into the control group and the experimental group, 82 cases in each group. Routine hypertension management mode was given in the control group and medical care, elderly care and nursing management mode was given in the experimental group for 6 months. The Exercise of Self-Care Agency Scale (ESCA) scores and blood pressure control of the two groups were compared before and after intervention.Results:The ESCA total score and self-concept, self-care responsibility, self-care skills, and health knowledge scores of the experimental group were higher than those before intervention [(123.3±17.2) vs. (88.3±10.4) points, (26.8±3.7) vs. (20.6±3.0) points, (22.3±4.2) vs. (16.6±2.1) points, (29.3±4.1) vs. (17.6±2.4) points, (44.9±5.4) vs. (33.5±4.5) points], and higher than those of the control group [(90.0±10.2) points, (21.2±3.2) points, (16.1±2.1) points, (18.2±2.5) points, (34.5±4.2) points] (all P<0.05). The systolic blood pressure and diastolic blood pressure of the two groups after the intervention were lower than those before the intervention [control group: (142.5±7.8) vs. (161.6±8.5) mmHg (1 mmHg=0.133 kPa), (91.3±6.2) vs. (98.6±10.2) mmHg, experimental group: (132.2±8.5) vs. (160.6±8.1) mmHg, (84.2±7.4) vs. (98.1±10.3) mmHg], and the experimental group was lower than the control group (all P<0.05). The blood pressure control rate of patients in the experimental group was 88.8%, which was higher than the control group of 48.6% ( P<0.05). The satisfaction rate of quality of life in the experimental group was higher than that in the control group (28.8% vs. 18.1%), and the dissatisfaction rate was lower than in the control group (18.8% vs. 34.7%) ( P<0.05). Conclusion:The medical care, elderly care and nursing management mode can effectively improve the self-care ability and blood pressure management ability of elderly patients with hypertension.
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Objective To investigate the glucocorticoid treatment of nephrotic syndrome curative effect and the effect of psychological intervention on the patients. Methods From June 2015 to May 2016 in our hospital treated 110 cases of patients with nephrotic syndrome, patients were randomly divided into two groups, control group patients with routine treatment and nursing measures, observation group of patients on the basis of conventional treatment nursing glucocorticoid treatment and nursing intervention measures for nursing, completion of treatment, compared two groups of patients with therapeutic effect and recurrence. Results In terms of treatment, observation group of patients treatment effectiveness 94.55％, control group patients treatment effective rate was 81.82％, the observation group of patients treatment effectiveness is significantly higher than patients with the control group (P<0.05); In terms of relapse, observation group after treatment in patients with recurrence rate was 3.64％, the control group after treatment in patients with recurrence rate 9.09％, observation group of patients with recurrence rate was significantly lower than patients with the control group (P<0.05). Conclusion By glucocorticoid treatment of nephrotic syndrome curative effect and psychological intervention on the patients, can significantly improve the effect of treatment of nephrotic syndrome patients, reduce the occurrence of patients relapse, help patients recover better, worthy of popularization and application in clinic.
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Objective To investigate the expressions of Survivin and high risk-human papillomavirus (HR-HPV) in cervical carcinoma and premalignant lesion,and explore their roles in the pathogenesis of cervical carcinoma.MethodsEighty-two patients of cervical intraepithelial neoplasia(CIN)and cervical carcinoma were enrolled,including 25 CIN Ⅰ,23 CIN Ⅱ -Ⅲ and 34 cervical carcinoma.Twenty normal cervicals were chosen as control.The expression of Survivin was examined by immunohistochemical assay(SP),and the infection of HR-HPV was measured by polymerase chain reaction (PCR).ResultsExpressions of Survivin and HR-HPV of patients with cervical carcinoma [ 85.3％(29/34)and 88.2％ (30/34) ]were higher than those in CIN [ 52.1％ (25/48) and 54.2％ (26/48) ](P ＜ 0.05 ),CIN were higher than those in normal cervicals [ 0 and 10.0％ ( 2/20 ) ](P ＜ 0.05 ),CIN Ⅱ - Ⅲ [ 65.2％ ( 15/23 ) and 73.9％ ( 17/23 ) ]were higher than those in CIN Ⅰ [ 32.0％ ( 8/25 ) and 28.0％ (7/25) ](P ＜ 0.05 ).Survivin positive expression in cervical carcinoma was correlation with histological grade,but was no correlation with (P ＜ 0.05),age,clinical stage and pathology typing (P ＞ 0.05 ).HR-HPV infection was no correlation with age,clinical stage,histological grade and pathology typing (P ＞ 0.05).Positive correlation between the Survivin positive expression and HR-HPV infection was observed in cervical carcinoma(r =0.403,P ＜0.05).ConclusionIt suggests that Survivin may play an important role in the occurrence and development of cervical carcinoma together with HR-HPV.