Study on the Application Effect of Nursing Intervention Based on the Transtheoretical Model in the Rehabilitation Treatment of Patients with Chronic Heart Failure.

Objective: To analyze the application effect of nursing intervention based on the Transtheoretical Model in rehabilitating patients with chronic heart failure (CHF). Methods: A retrospective analysis of clinical data was conducted for 156 CHF patients admitted to our hospital from May 2019 to September 2022. All patients met the complete inclusion criteria. They were divided into two groups based on the different nursing interventions provided during their treatment. The control group (n=78) received the routine nursing intervention, while the observation group (n=78) received nursing intervention based on the Transtheoretical Model and the care provided to the control group. The treatment compliance (MMAS-8 scale), quality of life (MLHFQ questionnaire), self-care ability (ESCA scale), cardiopulmonary function [anaerobic threshold oxygen consumption (VO2AT), carbon dioxide ventilation equivalent slope (VE/VCO2), peak VO2], and rehospitalization rates were compared between the two groups. Results: Before the intervention, the two groups had no significant difference in MMAS-8 and MLHFQ scores (P > .05). After the intervention, the MMAS-8 scores in the observation group were significantly higher than those in the control group (7.25±0.64 vs. 6.32±0.98), indicating improved treatment compliance. Additionally, the MLHFQ scores were significantly lower in the observation group compared to the control group (48.61±10.42 vs. 57.43±12.15, P < .05), indicating an enhanced quality of life. Before the intervention, the two groups had no significant differences in self-care skills, self-concept, health knowledge level, and self-care responsibility level (P > .05). However, after the intervention, the observation group showed significantly higher self-care skills (33.89±6.16 vs. 28.56±5.84), self-concept (24.79±3.96 vs. 21.34±4.15), health knowledge level (57.43±6.84 vs. 49.23±7.26), and self-care responsibility level (19.67±3.83 vs. 16.47±3.72) than the control group (P < .05). Before the intervention, the two groups had no significant differences in VO2AT, VE/VCO2, and peak VO2 levels (P > .05). However, after the intervention, the observation group exhibited significantly higher VO2AT (12.79±2.42 vs. 11.68±2.43) and peak VO2 levels (19.58±2.72 vs. 18.15±2.36) compared to the control group. VE/VCO2 levels were significantly lower in the observation group compared to the control group (28.32±3.16 vs. 30.47±3.42, P < .05). The rehospitalization rate in the control group was 35.90%, while it was 10.26% in the observation group. The rehospitalization rate in the observation group was significantly lower than that in the control group (P < .05). Conclusion: The integration of nursing intervention based on the Transtheoretical Model into the rehabilitation treatment of CHF patients exhibited significantly improved treatment compliance, enhanced self-care abilities, and favorable changes in cardiopulmonary function and quality of life. These outcomes carry important implications for CHF patients' overall health and well-being, including improved medication adherence, increased exercise tolerance, and reduced rehospitalization rates. The positive outcomes suggest that integrating nursing interventions based on the Transtheoretical Model into standard care for chronic heart failure patients holds promise, with potential applications in other chronic conditions, paving the way for personalized and effective healthcare strategies.

Clinical Nursing Pathway Improves Therapeutic Efficacy and Quality of Life of Elderly Patients with Acute Myocardial Infarction.

Purposes: To clarify the impacts of clinical nursing pathway (CNP) on therapeutic efficacy and quality of life (QOL) of senile acute myocardial infarction (AMI) patients. Methods: The clinical records of 177 elderly AMI patients who received treatment in the First Hospital of Quanzhou Affiliated to Fujian Medical University were retrospectively studied. They were assigned into the control group (the Con; n = 79; from June 2019 to January 2020) and the research group (the Res; n = 98; from February 2020 to July 2020). Emergency percutaneous coronary intervention (PCI) was performed in all the cases. Additionally, the Con and the Res were given routine care and CNP, respectively. The two groups were compared in total emergency treatment time, hospital stay, medical expenses, recurrence rate of myocardial infarction (MI), overall response rate (ORR), incidence of complications, cardiac function indexes, negative mood scores, QOL, and nursing satisfaction. Results: The ORR was higher, and the incidence of complications was lower in the Res versus the Con; the Res presented significantly less emergency treatment time and hospitalization and statistically lower medical expenses and recurrence rate of MI; the Res outperformed the Con in cardiac function indexes, alleviation of negative mood, QOL, and nursing satisfaction. Conclusions: While effectively improving clinical efficacy and reducing the incidence of complications, CNP can relieve the bad mood of elderly patients with AMI and improve their cardiac function, QOL, and nursing satisfaction, which is worthy of clinical promotion.

[Molecular typing of 12 Brucella strains isolated in Guizhou province in 2010-2013].

OBJECTIVE: To identify and characterize the Brucella strains from Guizhou province in 2010-2013. METHODS: A total of 12 strains of Brucella suspicious bacteria were isolated in Guizhou province from 2010 to 2013. Four strains (GZLL3, GZLL4, GZLL11 and SH2) were isolated from goat blood samples and eight strains (SH4, GZZY, GZSQ, GZZA, BR13001, BR13004, BR13005 and BR13006) were isolated from blood samples of patient 12 Brucella suspicious strains were identified and characterized using conventional methods. Brucella genus specific gene BCSP31-based PCR (BCSP31-PCR) was used to identify the genus of Brucella and IS711 insert sequence-based PCR (AMOS-PCR) was applied to identify the species of Brucella strains. Goats and patients originated Brucella strains were comparatively analysed using Pulse-field Gel Electrophoresis (PFGE). RESULTS: Both of conventional methods and PCR identified the 12 Brucella suspicious strains as B. melitensis biotype 3. BCSP31-PCR identification results showed that a specific DNA bands (223 bp) were detected in all the 12 strains and positive control samples with no DNA band in negative samples. AMOS-PCR amplified a 731 bp-DNA bands in all the 12 strains, with 731 bp, 498 bp and 275 bp in M5, S2 and A19 strains, respectively, and no DNA band was detected in the negative control samples. PFGE analysis showed that 12 Brucella isolates from patients and goats showed consistent PFGE patterns with the digestion of restriction enzyme Xba I. CONCLUSION: The epidemic species/type of Brucella in both human and animal in Guizhou province was B. melitensis biotype 3 and goat was the main animal source of infection of brucellosis in Guizhou province.

[Identification and genetic characteristics on the bacteria isolate from a case of human Brucellosis in Guizhou province].

OBJECTIVE: A suspected Brucella (B.) strain(GZZA), isolated from a case of anti-Brucella antibody positive patient was identified and its' genetic characteristics was analyzed, to provide etiologic basis for the confirmation of patient in Guizhou province. METHODS: Conventional methods and polymerase chain reaction(PCR)were used to identify the bacteria strain, with genetic characteristics analyzed by MLVA-16. RESULTS: The bacteria strain was identified as B. melitensis biovar 3 under the conventional and PCR methods. Results from the MLVA-16 analysis indicated that the bacteria strain was closely clustered with B. melitensis biovar 3, and differences of repeated numbers at VNTR loci bruce42, bruce04, bruce09 and bruce16 were also displayed. CONCLUSION: Both traditional and molecular methods to identify one bacteria strain isolated from the human patient as B. melitensis biovar 3 and the genetic characteristics of the strain was closely related to that of B. melitensis biovar 3. Differences of repeated numbers at part of VNTR loci were also showed. The results of this study provided etiologic evidences for the confirmation of Brucella infection of the patient, also providing scientific basis for the control and prevention of Brucellosis in Guizhou province.