Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas.

BACKGROUND: This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs. Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer. However, the ileostomy is susceptible to peri-stoma skin complications, as well as fluid, electrolyte, and nutritional imbalances, posing challenges to effective management. The successful self-management of patients is intricately linked to their adjustment to temporary colostomy; nonetheless, there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront. AIM: To investigate the lived experiences, perceptions, and care requirements of temporary colostomy patients within their home environment, with the ultimate goal of formulating a standardized management protocol. METHODS: Over the period of June to August 2023, a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai, China. Employing a phenomenological research approach, a semi-structured interview guide was developed, and qualitative interviews were conducted using in-depth interview techniques. The acquired data underwent coding, analysis, organization, and summarization following Colaizzi's seven-step method. RESULTS: The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes: Firstly, Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression; secondly, patients exhibit limited self-care capabilities and face information deficits, resulting in heightened reliance on healthcare professionals; thirdly, patients demonstrate the potential for internal motivation through proactive self-adjustment; and finally, patients express a significant need for emotional and social support. CONCLUSION: Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens, inadequate self-care abilities, informational deficits, and emotional needs. Identifying factors influencing patients' self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

Psychological risk and protective factors associated with depression among older adults in mainland China: A systematic review and meta-analysis.

BACKGROUND: Although geriatric depression is a public health concern in mainland China, findings about its psychological risk and protective factors have been inconsistent, and its prevention programmes have been deficient. To improve interventions for geriatric depression, we designed a study to systematically estimate the effect size of those factors. METHODS: To identify psychological risk and protective factors of geriatric depression, we conducted two independent literature searches in English- and Chinese-language databases, and we used a random effects model to analyse effect sizes. RESULTS: We identified 15 psychological risk and protective factors in 66 studies. The pooled effect sizes between the factors and geriatric depression ranged from 0.129 to 0.567. Self-esteem displayed a large effect size with depression (r = -0.567), whereas medium-to-large effect sizes emerged between geriatric depression and negative perceptions of age (r = 0.452), resilience (r = -0.426), rumination (r = 0.432), neuroticism (r = 0.381), extraversion (r = -0.363), self-efficacy (r = -0.357), sense of control (r = -0.343), and negative coping strategies (r = 0.315). The sample's mean age, the percentage of women sampled, and the research quality of the studies significantly moderated certain associations. LIMITATIONS: Large heterogeneity, the inexplicability of causal relationships between the factors and geriatric depression, and the lack of generalisability to special groups limit our findings. CONCLUSIONS: Self-esteem and perceptions of age are potential targets for improving interventions for geriatric depression in mainland China, which should continue to be developed and assessed for their effectiveness.

Prevalence of depression among older adults living in care homes in China: A systematic review and meta-analysis.

OBJECTIVES: Despite the large number of older adults living in care homes in China, the reported prevalence of depression in such settings has varied greatly, while its pooled overall prevalence has remained unknown. In response, our systematic review and meta-analysis were designed to provide accurate, comprehensive evidence of the prevalence of geriatric depression in care homes in China. METHODS: Literature searches were conducted independently by two investigators in English- and Chinese-language databases from database inception through January 2020. The prevalence of depressive symptoms in late life was analyzed with a random effects model. RESULTS: In 69 studies addressing older adults living in care homes in China, the pooled overall prevalence of depressive symptoms was 36.8% (95% CI, 32.7%-41.1%). Respective estimates for mild and moderate-to-severe depressive symptoms were 29.1% (95% CI, 25.2%-32.7%) and 9.1% (95% CI, 7.5%-11.0%). Subgroup analyses revealed significant differences in the prevalence of late-life depression in care homes according to the type of care home, the individual's socioeconomic status, and the measurement instrument(s) used. Meta-regression analysis indicated that the prevalence of late-life depression among older adults living in care homes generally rose from 1991 to 2019. CONCLUSIONS: Given the high prevalence of geriatric depression in China's care homes, future studies should examine its risk and protective factors in those settings.

Prevalence of depressive symptoms among older adults in mainland China: A systematic review and meta-analysis.

BACKGROUND: To date, the reported prevalence of late-life depression in China has varied considerably, and the pooled overall prevalence of depressive symptoms among older adults in China and the tendency of the rate to change in the past 30 years have remained unknown. Thus, our study was designed to form an accurate and comprehensive picture of the recent prevalence of depressive symptoms among older adults in China. METHODS: Literature searches were conducted independently by two investigators in English- and Chinese-language databases from database inception to January 2020. The prevalence of depressive symptoms was analysed with a random effects model. RESULTS: In the 81 eligible studies (n = 261,697) identified, the pooled overall prevalence of depressive symptoms among older adults in China was 20.0% (95% CI, 17.5%-22.8%), with high heterogeneity, Q = 22,947.0, I2 = 99.7%, p < .001. Subgroup analyses revealed significant differences in the prevalence of late-life depression depending upon gender, marital status, socio-economic status, and measurement scale(s) used. Meta-regression indicated that the prevalence of depressive symptoms among older adults in China increased from the 1990s to the 2000s but slightly decreased from the 2000s to the 2010s. LIMITATIONS: Significant heterogeneity among the studies reviewed was unavoidable, and the findings was not generalisable to all regions in China. CONCLUSIONS: Depressive symptoms are common among older adults in China, and policies should be developed that consider vulnerable older adults in particular.

Factors associated with failure of Enhanced Recovery After Surgery (ERAS) in colorectal and gastric surgery.

Background: The Enhanced Recovery After Surgery (ERAS) pathway is widely applied in the perioperative period of stomach and colorectal surgery, and can decrease the length of hospital stay of the patients without compromising the safety of the patients. However, some patients are removed from this pathway for various reasons. Here we found some factors that taking the patients out from the procedures. Methods: A retrospective analysis of collected data of 550 patients over a 3-year period was conducted, with 292 in the ERAS group and 258 in the conventional care group. Then various basic elements were analyzed to explore the reasons for the failure to complete the ERAS program. Results: Total length of hospital stay after surgery was significantly shorter in the ERAS group, and a similar incidence of complication rates were observed in the two groups. In this study, the significant factors that associated with complications were advanced age (OR 2.18; p = .031), history of abdominal surgery (OR 2.03; p = .04), incomplete gastrointestinal obstruction (OR 3.42; p < .001), laparoscopic surgery (OR 0.39; p = .004) and intraoperative neostomy (OR 2.37; p = .006). Conclusions: We found that advanced age (>80 years old), history of abdominal surgery, gastrointestinal obstruction and stoma formation were the risk factors. We anticipated to design a risk assessment system upon the high-risk patients from the present ERAS pathway, and make a modified ERAS pathway for those patients.