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Objective:To construct an anticipatory grief intervention scheme for family caregivers of advanced cancer patients based on narrative theory, and to provide reference for anticipatory grief nursing intervention.Methods:From October 2022 to May 2023, through literature research, semi-structured interview and brainstorming method, the first draft of nursing intervention plan was constructed, the Delphi method was used to conduct 2 rounds of correspondence consultation with 15 experts, and the indicators at all levels were modified according to the opinions of experts, and the final draft of intervention plan was formed.Results:The experts were all female, aged (49.67 ± 5.83) years old. The authority coefficient of the two rounds of experts was 0.87. The Kendall coordination coefficients of the first, second, and third level indicators after the first round of expert inquiry were 0.195, 0.113, and 0.093, respectively. The Kendall coordination coefficients of the first, second, and third level indicators after the second round of expert inquiry were 0.200, 0.119, and 0.101, respectively. The differences were statistically significant ( χ2 values were 8.76-107.21, all P<0.05).Finally, a nursing intervention plan based on narrative theory was formed, which included 4 primary indicators, 19 secondary indicators and 72 tertiary indicators. Conclusions:The anticipatory grief intervention scheme for family caregivers of advanced cancer patients is scientific, practical and feasible, and can be used for psychological nursing of family caregivers.
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ObjectiveTo explore the influencing factors of anticipatory grief among family caregivers of terminal-stage cancer patients,and provide a reference for formulating intervention programs for anticipatory grief. MethodsAn interview outline was designed,and the descriptive qualitative research method was used.The aim was to select 11 family narrative caregivers of patients in the Department of Medical Oncology,Nanfang Hospital,Southern Medical University for semi-structured in-depth interviews.Based on the social ecology model,using the narrative theory of life and health as the framework,the content analysis method was adopted to analyze the data. ResultsA total of 3 themes and 12 sub-themes were extracted,including the influencing factors at the individual level (narrative literacy,cognitive level towards death,and sense of self-worth),the influencing factors at the interpersonal level (patient’s disease situation,education level,economic status,family narrative connection,peer narrative connection,and narrative connection between doctors and family members),and the influencing factors at the cultural policy level (social culture,physical environment of the ward,and policy level). ConclusionAnticipatory grief was affected by multiple factors,and multi-dimensional narrative connection should be constructed from individual,interpersonal,family,social,and other levels to prevent caregivers from falling into a narrative lock of single caregiver identity,alleviate the impact of anticipatory grief on caregivers,and improve their quality of life.
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Objective To explore the early diagnosis value of insulin ,C peptide ,blood glucose detection in diabetic patients with liver damage .Methods A total of 120 cases of diabetic patients were selected from January 2014 to January 2016 ,all of them were divided into 53 cases of diabetes mellitus complicated with liver injury group (Study Group 1) and 67 cases of diabetes with normal liver function group (Study Group 2) ,and 50 cases healthy people in the same period were selected as the control group .fasting blood glucose (FBG) ,2 Hours Postprandial Blood Glucose (2hPG) ,Glycosylated Hemoglobin (HbA1c) ,fasting insulin (FINS ) ,2 h postprandial fasting insulin (P2INS) ,homeostasis model assessment-insulin resistance index (HOMA-IR) ,c-peptide (CP) and (2 hour postprandial fasting C peptide) P2CP levels of every group were detected ,and the correlation with indexes and liver damage was analyzed .Results FBG ,2hPG ,HbA1c ,FINS ,P2INS ,HOMA-IR ,CP ,P2CP levels in Study group 1 and Study Group 2 were significantly higher than those in the control group (P<0 .05) ,and each index level in Study group 1 was significantly higher than that in study Group 2(P<0 .05);correlation analysis showed that the diabetes mellitus combined with liver damage was positively correlated with FBG ,2hPG ,HbA1c ,FINS ,P2INS ,CP ,P2CP levels (r=0 .274 ,0 .190 ,0 .220 ,0 .230 ,0 .195 ,0 .083 ,0 .289 ,0 .724 re-spectively ,P<0 .05) .Conclusion Pancreatic islet function and blood glucose metabolism play an important role in diabetic patients with liver damage ,and three indexes combined detection can be used as early diagnosis of diabetes mellitus combined with liver damage .
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Objective To analyze the molecular epidemiology characteristic of neonatal deafness susceptibility genes .Methods Hearing screening and deafness susceptibility genes screening were performed in 1 674 cases of newborn to analyze the epidemiolog‐ical characteristics .Results Among 1 674 cases of neonatus ,37 cases were with deafness susceptibility gene abnormalities ,inclu‐ding 2 cases of 176 del 16 mutations ,5 cases of 299 del AT heterozygous mutation ,16 cases of 235 del C mutation ,9 cases of IVS7‐2A>G heterozygous mutations ,1 case of 2168A> G mutation ,2 cases of 538C> T heterozygous mutation ,2 cases of 1494C> T mutation ,and the positive rate was 2 .21% .Conclusion Hearing screening combined with deafness susceptibility gene screening could detect possible hearing loss children from molecular level ,providing favorable reference for the early detection ,predict and in‐terventions .
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Objective To explore the diagnostic value of serum procalcitonin ,C‐reactive protein and white blood cell count in children with different diseases .Methods Retrospective analysis 94 cases of pathogenic infectious children from June 2013 to May 2014 in our hospital ,according to the results of pathogen detection was divided into bacterial infection 36 cases ,mycoplasma infec‐tion group 28 cases ,30 cases of viral infection ,detection and analysis serum PCT ,CRP and WBC levels .Results Bacterial infection group serum PCT ,CRP and WBC were (2 .41 ± 0 .94)ng/mL ,(47 .91 ± 18 .26)mg/L and (13 .18 ± 6 .03) × 109/L ,significantly higher than the mycoplasma infection and viral infection group (F=133 .4 ,F=60 .1 ,F=8 .5 ,P<0 .05);diagnosis of bacterial in‐fections ,PCT sensitivity and specificity were 92 .11% and 91 .05% ,positive and negative predictive value of 89 .84 % and 94 .01%were significantly higher than CPR and WBC ,Mycoplasma infection as the control group ,PCT ,CRP and WBC in the diagnosis of bacterial infections ,the area of under the ROC curves were 0 .816 ,0 .728 and 0 .614 ,respectively .Conclusion Serum PCT for the i‐dentification of bacterial infections has a high diagnostic value ,worth generalizing and applying .
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Objective To assess the reliability and validity of the Pittsburgh sleep quality index (PSQI) .Methods The cross-sectional survey was conducted in the outpatient department of this hospital .544 insomnia and non-insomnia voluntary participants (18-65 years old) from July to October 2011 were assessed with PSQI and the insomnia severity index (ISI) ,which were randomly delivered to them .Results The test-retest reliability of PSQI was 0 .994 .The split-half reliability coefficient of PSQI was 0 .824 . The overall Cronbach′s alpha coefficient was 0 .845 .The confirmatory factor analysis showed that the fitting indicators for the χ2/df ,root mean square error of approximation(RMSEA) ,non-normed fit index(NNFI) ,comparative fit index(CFI) and goodness-of-fit index(GFI) were 4 .83 ,0 .09 ,0 .96 ,0 .98 and 0 .97 respectively .The correlation coefficient between the PSQI and ISI was 0 .842 . The correlations coefficients between PSQI with the questionnaire type ,interview date and interview department were -0 .046 , 0 .276 and -0 .331 .Grouping by individuals with or without insomnia ,the area under the receiver operator characteristic curve (ROC) for PSQI was 0 .944(95% CI:0 .925-0 .963) .Conclusion PSQI has good reliability and validity ,and could be used for the sleep quality comprehensive evaluation in the patients with insomnia .
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This study was aimed to explore the efficacy of establishing and implementing individual healthy di-ets on patients with early diabetic nephropathy ( DN ) . A total of 120 patients with early DN of our hospital were randomly divided into two groups , which were the experimental group and the control group . There were 60 cases in each group . All patients received routine treatment . The fasting blood glucose and 24-hour uri-nary protein were measured pre-treatment , 2-week , 2-month , and 6-month after treatment . Patients in the experimental group were required to receive individual healthy diet therapy as well as routine treatment . The fasting blood glucose of both groups was compared in each stage . The fasting blood glucose of the experimental group was lower than that of the control group after 2-week treatment . After 6-month treatment , the fasting blood glucose of the experimental group was lower than that of pre-treatment . However , there was no obvious difference in the control group compared to that of pre-treatment . There were significant differences on the number of cases with fasting blood glucose below the level of 7.0 mmol/L in different stages of both groups. The 24-hour urinary protein of both groups was also compared in each stage . After 2-week treatment , there was no distinct difference on the 24-hour urinary protein in each stage of both groups . However , after 6-month treatment , the urinary protein of the experimental group , compared to pre-treatment , indicated striking difference , while the control group did not show any difference . It was concluded that individual healthy diet has a significant efficacy in the treatment of early DN , especially in reducing and controlling fasting blood glucose. After carrying out the treatment for 6 months, healthy diet also takes on distinct effects in cutting down 24-hour urinary protein and keeping the glycosylated hemoglobin below 6 . 5%.
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Objective:To observe clinical therapeutic effect of Deng Tietao's Yuzu Recipe on hypertension.Methods:240 cases of inpatients of hypertension were randomly divided into a trial group and a control group,establishing database,and descriptive analysis,t-test,x~2 test and rank test methods were adopted.Results:(1)There was significant difference between the two groups in the decreasing effect of blood pressure(P