Effect of nurse-physician collaboration on the incidence of complications, negative emotions and quality of life in cervical cancer patients: a randomized controlled study.

The aim of this study was to evaluate the effect of nurse-physician collaboration on the incidence of complications, anxiety and depression, quality of life, and satisfaction with nursing care among cervical cancer patients undergoing three-dimensional intracavitary brachytherapy. In this randomized, single-blinded, placebo-controlled trial, 92 eligible cervical cancer patients were equally divided into two groups upon admission. The control group was given routine nursing, and the intervention group received a nurse-physician collaboration in addition to routine care. Anxiety, depression, and health-related quality of life in both groups were assessed and compared at baseline and discharge. The intervention group had significantly fewer complications and showed marked improvements in mental health and quality of life compared to the control group. Satisfaction with nursing care was substantially greater in the intervention group. These results support the clinical adoption of a nurse-physician collaborative care model in the management of cervical cancer with three-dimensional intracavitary brachytherapy.

Effect of gestational weight gain on postpartum pelvic floor function in twin primiparas: a single-center retrospective study in China.

BACKGROUND: The effect of gestational weight gain (GWG) as a controllable factor during pregnancy pelvic floor function has rarely been investigated, and studies on twin primiparas are even less frequent. The objective of the present study was to explore the effect of GWG on postpartum pelvic floor function in twin primiparas. METHODS: We retrospectively analyzed the clinical data of 184 twin primiparas in the pelvic floor rehabilitation system of the First Affiliated Hospital of Chongqing Medical University from January 2020 to October 2021. Based on the GWG criteria recommended by the Institute of Medicine, the study subjects were classified into two groups: adequate GWG and excessive GWG. Univariate and multivariate logistic regression models were applied to explore the relationship between GWG and pelvic floor function. RESULTS: Among the 184 twin primiparas, 20 (10.87%) had excessive GWG. The rates of abnormal vaginal dynamic pressure (95% vs. 74.39%), injured type I muscle fibers (80% vs. 45.73%), anterior vaginal wall prolapse (90% vs. 68.90%), and stress urinary incontinence (50% vs. 20.12%) of twin primiparas with excessive GWG were significantly higher than those with adequate GWG. There was no significant difference between the total score of the Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20) or the scores of the Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), the Colorectal-Anal Distress Inventory 8 (CRADI-8), and the Urinary Distress Inventory 6 (UDI-6) in the two groups (P > 0.05). After adjusting for potential confounding factors, the results showed that excessive GWG was positively associated with abnormal vaginal dynamic pressure (OR = 8.038, 95% CI: 1.001-64.514), injured type I muscle fibers (OR = 8.654, 95% CI: 2.462-30.416), anterior vaginal wall prolapse (OR = 4.705, 95% CI: 1.004-22.054), and stress urinary incontinence (OR = 4.424, 95% CI: 1.578-12.403). CONCLUSION: Excessive GWG in twin primiparas was positively correlated with the prevalence of pelvic floor dysfunction but did not exacerbate pelvic floor symptoms in twin primiparas. Controlling GWG within a reasonable range is recommended for reducing the risk of PFDs in pregnant women with twins.

The prevalence and associated factors of prenatal depression and anxiety in twin pregnancy: a cross-sectional study in Chongqing, China.

BACKGROUND: Pregnant women expecting twins are more likely to experience stress, which can lead to anxiety and depression. Our aim was to investigate the prevalence of prenatal anxiety and depressive symptoms in women with twin pregnancies and the associated factors. METHODS: In a cross-sectional survey, 210 women with twin pregnancies who satisfied the inclusion and exclusion criteria in two tertiary centers in Southwestern China were asked to complete a basic information form, the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). To compare statistics with normal distribution in distinct characteristic groups, a paired t-test, and one-way ANOVA were utilized. Binary logistic step regression was used to analyze the associated factors of antenatal anxiety and depressive symptoms. RESULTS: The 210 women with twin pregnancies (age = 30.8 ± 4.2 years) were between 7 and 37 gestational weeks (29.2 ± 1.2 weeks), were typically well-educated (72.4% had a post-high-school degree), and reasonably affluent (88.1% were above the low-income cutoff). Among them, 34.8% had symptoms associated with clinical levels of anxiety, and 37.1% had symptoms indicating possible depression. The prevalence of co-morbid anxiety and depressive symptoms was 24.3%. Binary stepwise logistic regression analysis showed that previous health status and sleep disturbance during pregnancy were the associated factors of anxiety symptoms in women with twin pregnancies (P < 0.05), whereas age, previous health status, negative life events, and physical activity during pregnancy were the associated factors of depressive symptoms in women with twin pregnancies (P < 0.05). CONCLUSION: About one-third of women with twin pregnancies had symptoms of anxiety or depression; these were most strongly predicted by some modifiable factors, suggesting that early preventive mind-body interventions may be a promising strategy to protect against mental health issues for women with twin pregnancies.

The relationship among pregnancy-related anxiety, perceived social support, family function and resilience in Chinese pregnant women: a structural equation modeling analysis.

BACKGROUND: Accumulating evidence suggests that pregnancy-related anxiety (PRA) has adverse impacts on maternity health and infant development. A substantial body of literature has documented the important influence of family function, perceived social support and resilience on PRA. However, research identifying the mediating mechanisms underlying this relationship in China are still lacking. Therefore, the current study aimed to investigate the prevalence of PRA under the three-child policy in China, and also explore the interrelationships among perceived social support, family function, resilience, and PRA. METHODS: In this cross-sectional study, a convenient sampling method was used to select 579 pregnant women who underwent prenatal examination at the maternity outpatient departments of the First Affiliated Hospital of Chongqing Medical University in China from December 2021 to April 2022. Participants were required to complete the following questionnaires: the demographic form, the Chinese Pregnancy-related Anxiety scale, the 10-item Connor-Davidson Resilience Scale, the APGAR Family Care Index Scale, and Multidimensional Scale of Perceived Social Support. Pearson correlation analysis was utilized to examine the rudimentary relationship among the study variables. Bootstrapping analyses in the structural equation modeling were applied to identify the significance of indirect effects. RESULTS: There were 41.4% of pregnant Chinese women indicating PRA. Correlational analyses indicated that perceived social support, family function and resilience were negatively associated with PRA (r = - 0.47, P < 0.01; r = - 0.43, P < 0.01; r = - 0.37, P < 0.01, respectively). The results of bootstrapping analyses demonstrated significant indirect effects of perceived social support (ß = - 0.098, 95% CI [- 0.184, - 0.021]) and family function (ß = - 0.049, 95% CI [- 0.103, - 0.011]) on PRA via resilience. CONCLUSIONS: Chinese pregnant women are suffering from high levels of PRA. Better family function and perceived social support might reduce the occurrence of PRA, as well as by the mediating effects of resilience. Healthcare providers must be concerned about PRA and perform corresponding actions to reduce it. By strengthening social support and improving family function, antenatal care providers could effectively reduce or prevent PRA. And more importantly, implementing resilience-promoting measures are also essential to relieve anxiety and support mental health in pregnant women.

The prevalence and predictors of fear of childbirth among pregnant Chinese women: a hierarchical regression analysis.

BACKGROUND: Fear of childbirth (FOC) occurs before, during and after pregnancy and is harmful to both the pregnant woman and the fetus. Identifying the prevalence and predictors of FOC can help us generate strategies for alleviating women's FOC. METHODS: A cross-sectional study was conducted among a convenience sample of 646 pregnant women receiving antenatal care at a subordinate hospital of a university in China. Data were collected using a basic information form, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the 10-item Connor-Davidson Resilience Scale. The minimum and maximum total scores of the Childbirth Attitude Questionnaire are 16 and 64, respectively, with higher scores reflecting a greater degree of FOC. We conducted hierarchical regression analysis to explore the predictors of FOC and used a structural equation model to further examine the direct and indirect associations between FOC, resilience and childbirth self-efficacy. RESULTS: The total prevalence of FOC was 67.1%. The percentages of women with mild (score of 28-39), moderate (40-51), and severe FOC (52-64) were 45.4, 19.5, and 2.2%, respectively. The average score on the Childbirth Attitude Questionnaire was 32.49, indicating mild FOC. The final regression analysis revealed six variables predicting FOC that explained 64.5% of the variance in FOC: age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy. Furthermore, childbirth self-efficacy mediated the relationship between resilience and FOC, and the mediation effect rate was 53.5%. CONCLUSIONS: A high prevalence of FOC among pregnant Chinese women was found in this study. Age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy were predictors of FOC. It is suggested that healthcare professionals should pay close attention to FOC and implement targeted interventions in accordance with these predictors, especially resilience and childbirth self-efficacy.

Exploring Nursing Undergraduates' Experiences with a Redesigned Blended Learning Course: A Descriptive Qualitative Study.

AIM: To explore the experience of nursing undergraduates with a blended course, that was redesigned using the Community of Inquiry framework. DESIGN: The Obstetrics and Gynaecology Nursing Course was redesigned using blended learning pedagogy, which starts from the creation of teaching presence, plays the intermediary role of social presence and aims at realizing cognitive presence. METHODS: After the course completion, we conducted a qualitative descriptive study and collected data using focus group interviews and field notes. RESULTS: The findings comprised three main themes including role promotion, passive and selective learning and recommendations. Teachers and peers reportedly played the supervisors, facilitators and coordinators in learning promotion. Some students experienced difficulties in adapting to the blended learning environment due to passive learning habits, character flaws and academic pressure. However, a majority of them supported the application of the model.

Successful inguinal interstitial brachytherapy in metastatic cervical carcinoma: a case report.

Background: Treatment of metastatic cervical cancer is a tricky issue. Currently, the National Comprehensive Cancer Network (NCCN) guideline recommends chemotherapy combined with bevacizumab for recurrent or metastatic cervical cancer. Still, the recurrence rate is high and the survival rate is low after standard treatment. We urgently need to achieve a multimodal therapy approach for recurrent or metastatic cervical cancer. Case description: We report the case of a patient with stage IB2 cervical squamous carcinoma who developed multiple metastases within a short term after receiving first-line standard treatment, and she underwent interstitial brachytherapy after systemic therapy with an encouraging outcome. The patient developed suspected inguinal lymph node metastases after 9 months at the end of first-line therapy and multiple metastases in the inguinal lymph nodes, anterior abdominal wall, and right lung after 17 months. As the patient had residual inguinal lymph nodes after systemic therapy, she received 3D-printed template-guided interstitial brachytherapy to the inguinal lymph nodes and maintenance therapy. By Sep 2023, she had achieved a good treatment outcome with a progression-free survival (PFS) of 36 months. Conclusion: Based on our patient response, when multiple metastases develop in the short term in early-stage cervical squamous carcinoma after first-line therapy, we may consider implementing local therapy combined with systemic therapy.

Application of obstetric nursing-sensitive quality indicators in continuous quality improvement.

OBJECTIVE: To verify the effect of obstetric nursing-sensitive quality indicators for continuously improving nursing quality. METHODS: We retrospectively analyzed the obstetric nurse quality in the First Affiliated Hospital of Chongqing Medical University and University-Town Hospital of Chongqing Medical University from October 2019 to September 2020. Nurses and patients in the Obstetrics Department of the First Affiliated Hospital of Chongqing Medical University and University-Town Hospital of Chongqing Medical University were respectively assigned into an experimental group and a control group. High-quality nursing services were provided to patients in both groups. In addition to the high-quality nursing services, the obstetric nurses in the experimental group received training on obstetric nursing-sensitive quality indicators based on the knowledge-attitude-practice model. An obstetric nursing quality evaluation was conducted between the two groups. Continuous quality improvement was achieved using the plan-do-check-act (PDCA) cycle. The nursing quality was reflected by 14 obstetric nursing-sensitive quality indicators and the nurses' job satisfaction was compared between the experimental group and the control group before and after intervention. RESULTS: The information regarding the nurses and parturients, and the nurses' job satisfaction were not significantly different between the two groups before intervention (P>0.05). Except for information regarding the lateral perineotomy at vaginal delivery, there was no significant difference in other obstetric nursing-sensitive quality indicators between the two groups before the intervention. In the experimental group, the rates of early skin-to-skin contact between mothers and infants, early sucking with exclusive breastfeeding during hospitalization, parturient satisfaction with the nurses' work, and nurses' job satisfaction after intervention were better than before (P<0.05). In the experimental group, the rates of neonatal asphyxia/severe neonatal asphyxia and postpartum hemorrhage following vaginal delivery after intervention was significantly lower than before (P<0.05). The experimental group had better outcomes than the control group in the rates of early skin-to-skin contact between mothers and infants, early sucking with exclusive breastfeeding during hospitalization, parturient satisfaction with the nurses' work, and nurses' job satisfaction (P<0.05). CONCLUSION: Obstetric nursing-sensitive quality indicators can be used to improve the nursing quality in continuous quality improvement, which is worthy of promotion in clinics.

Influence of humanistic care based on Carolina care model for ovarian cancer patients on postoperative recovery and quality of life.

OBJECTIVE: Our aim was to explore the influence of humanistic care based on Carolina care model on postoperative recovery and quality of life in patients with ovarian cancer (OC). METHODS: In this prospective study, we selected 85 OC patients and randomly divided them into the Carolina group (n = 43) given humanistic care based on Carolina care model and the control group (n = 42) given routine nursing intervention. The postoperative recovery and Functional Assessment of Cancer Therapy-Ovary Cancer (FACT-O) scores were compared between the two groups. RESULTS: After intervention, the time of first flatus and defecation after surgery, the time of first ambulation and the length of average postoperative hospital stay were much shorter, and the pain score, total complication rate, self-rating anxiety scale and self-rating depression scale scores as well as Cortisol, C-reactive protein and fasting blood glucose levels at 48 hours postoperatively were significantly lower in the Carolina group than in the control group. The nursing satisfaction in the Carolina group was markedly higher than that in the control group (97.67% vs. 78.57%, P<0.01). After 3 months of follow-up, the Carolina group showed higher dimension scores of FACT-O than the control group (all P<0.001). CONCLUSION: Humanistic nursing care based on Carolina care model can significantly ameliorate the recovery of OC patients, reduce the physical and psychologic stress response, and effectively enhance the nursing satisfaction and quality of life.

Applying the Carolina care model to improve nurses' humanistic care abilities.

PURPOSE: To study the application of the Carolina Care Model to improve nurses' humanistic care abilities in the Department of Obstetrics and Gynecology. METHODS: From December 2019 to April 2020, 40 nursing staff and 80 patients in the Department of Obstetrics and Gynecology in our hospital were recruited as the study cohort and randomly placed in an intervention group or a control group. The intervention group underwent the Carolina Care Model to complete the clinical nursing work. The control group underwent hospital routines to complete clinical nursing work. RESULTS: After the training, the humanistic care ability scores and the scores of various dimensions in the intervention group were significantly higher than the scores in the control group (P<0.05). The patient care perception scores in the intervention group were higher than they were in the control group (P<0.05). The patients' nursing satisfaction scores in the intervention group were significantly higher than they were in the control group (P<0.05). CONCLUSION: Carrying out a humanistic care nursing practice based on the Carolina Care Model can improve the humanistic care abilities of the nurses in the Department of Obstetrics and Gynecology, patient care perception and satisfaction, and the quality of the nursing service.