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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.
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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.
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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.
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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.
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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.
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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 .
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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 .