The Effect of Individual Nursing on Anxiety and Depression in Patients with Temporomandibular Disorders.

Objective: This study aimed to explore the effects of individualized nursing in patients with temporomandibular disorders (TMD). Methods: From June 2019 to April 2021, 80 patients with TMD were admitted to the First Affiliated Hospital of Wenzhou Medical University. Among them, 40 patients (control group, CG) received routine nursing and 40 patients (experimental group, EG) received individualized nursing. Functional exercise compliance, pain score, maximum mouth opening, nursing satisfaction questionnaire, self-rating anxiety scale, and self-rating depression scale were investigated. Results: From June 2019 to April 2021, 81 patients with TMD were admitted to the First Affiliated Hospital of Wenzhou Medical University. Among them, 40 patients (control group) received routine care and 41 patients (experimental group) received individual care. There were no significant differences in mouth opening and pain score between the two groups before surgery (P > 0.05), but there were significant differences in mouth opening and pain score between the two groups 3 weeks after surgery. Patients' anxiety and depression were assessed by the SAS and SDS scores. Before nursing, the control group and experimental group (P < 0.05) had no significant difference. After nursing, the score of both groups decreased (P < 0.05). However, the score was lower in the experimental group, compared to the control group (P < 0.01). Conclusion: In summary, individualized nursing can improve patients' physical condition and reduce negative emotions and complications. In light of this, the study needs further verification by a large sample randomized controlled trial.

Efficacy of comprehensive unit-based safety program to prevent ventilator associated-pneumonia for mechanically ventilated patients in China: A propensity-matched analysis.

Background: Ventilator-associated pneumonia (VAP) is the most common healthcare-associated infection (HAI) in patients with mechanical ventilation. VAP is largely preventable, and a comprehensive unit-based safety program (CUSP) has effectively reduced HAI. In this study, we aim to comprehensively investigate the effect of implementing the CUSP in patients requiring mechanical ventilation. Methods: In this uncontrolled before-and-after trial conducted in two intensive care unit (ICU) settings in China, patients requiring invasive mechanical ventilation were enrolled. Patients were divided into two groups based on the implementation of CUSP. The primary outcome was the incidence of VAP. The secondary outcomes were the time from intubation to VAP, days of antibiotic use for VAP treatments, rate of other infection, length of stay (LOS) in ICU, hospital LOS, and safety culture score. Joinpoint regression analysis was used to test the changes in trends of VAP rate for statistical significance. Propensity score matching (1:1 matching) was used to reduce the potential bias between CUSP and no CUSP groups. Univariate and multivariate logistic/linear regression analyses were performed to evaluate the association between the use of CUSP and clinical outcomes. This study was registered at the Chinese Clinical Trial Registry (chictr.org.cn), registration number: ChiCTR1900025391. Results: A total of 1,004 patients from the transplant ICU (TICU) and 1,001 patients from the surgical ICU (SICU) were enrolled in the study from January 2016 to March 2022. Before propensity score matching, the incidences of VAP decreased from 35.1/1,000 ventilator days in the no CUSP group to 12.3/1,000 ventilator days in the CUSP group in the TICU setting (adjusted odds ratio [OR], 0.30; 95% confidence interval [CI], 0.15-0.59). The results of the joinpoint regression analysis confirmed that the implementation of CUSP significantly decreased the incidences of VAP. After propensity score matching in TICU setting, the CUSP group reported a lower incidence of VAP (30.4 vs. 9.7‰, P = 0.003; adjusted OR = 0.26, 95% CI: 0.10-0.76), lower wound infection (3.4 vs. 0.9%, P = 0.048; adjusted OR = 0.73, 95% CI: 0.50-0.95), shorter ICU LOS [3.5(2.3-5.3) vs. 2.5(2.0-4.5) days; P = 0.003, adjusted estimate = -0.34, 95% CI: -0.92 to -0.14], and higher safety culture score (149.40 ± 11.74 vs. 153.37 ± 9.74; P = 0.002). Similar results were also observed in the SICU setting between the no CUSP and CUSP group. Conclusions: The implementation of CSUP for patients receiving mechanical ventilation could significantly reduce the incidences of VAP, and other infections, prolong the time until the VAP occurrence, reduces the days of antibiotic use for VAP, shorten the ICU and hospital LOS, and enhance the awareness of safety culture.