Heat-stone massage for patients with chronic musculoskeletal pain: a protocol for multicenter randomized controlled trial.

Introduction: Chronic musculoskeletal pain bothers the quality of life for approximately 1.71 billion people worldwide. Although pharmacological therapies play an important role in controlling chronic pain, overuse of opioids, persistent or recurrent symptoms, and pain-related disability burden still need to be addressed. Heat-stone massage is using the heated stone to stimulate muscles and ligaments followed by massage for relax, which can potentially treat the chronic musculoskeletal pain. To determine the efficacy and safety of heat-stone massage for patients with chronic musculoskeletal pain is needed. Methods and analysis: This multicenter, 2-arm, randomized, positive drug-controlled trial will include a total of 120 patients with chronic musculoskeletal pain. The intervention group will receive a 2 week heat-stone massage, 3 times per week, whereas the control group will receive the flurbiprofen plaster twice per day for 2 weeks. The primary end point is the change in Global Pain Scale from baseline to the end of the 2 week intervention. The secondary outcomes include the pain severity (Numerical Rating Scale), pain acceptance (Chronic Pain Acceptance Questionnaire), self-management (Health Education Impact Questionnaire), self-efficacy (Pain Self-Efficacy Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), quality of life (Short Form-36). The intention-to-treat dataset will be used for analysis. Discussion: The pain management remains the research topic that patients always pay close attention to. This will be the first randomized clinical trial to evaluate whether heat-stone massage, a non-pharmacological therapy, is effective in the chronic musculoskeletal pain management. The results will provide evidence for new option of daily practice. Clinical trial registration: World Health Organization Chinese Clinical Trial Registry [ChiCTR2200065654; https://www.chictr.org.cn/showproj.html?proj=185403]; International Traditional Medicine Clinical Trial Registry [ITMCTR2022000104; http://itmctr.ccebtcm.org.cn/en-US/Home/ProjectView?pid=51776b6f-77b8-4811-9b5a-a0fec10f2cee].

A Randomized Controlled Comparative Study of the Three Over-Bed Techniques for Positioning and Repositioning the Lithotomy Position While Using Stirrups.

Objective: In this study, the clinical application and efficacy of three different methods for placing and repositioning patients in the lithotomy position over the bed using stirrups were evaluated. Methods: A total of 240 surgical patients who underwent surgery in Chongqing Traditional Chinese Medicine Hospital between July and November 2022 were selected as study participants. Using envelopes, they were randomly divided into three groups of 80 cases each using a randomization method. The groups included the traditional over-bed method, the postural trolley-assisted over-bed method, and the direct over-bed method. Using the Kruskal-Wallis rank-sum test, analysis of variance, and multiple linear regression equations, the placement time, over-bed repositioning time, and total time of the three methods for placing and repositioning in the lithotomy position supported by stirrups were analyzed statistically. In addition, we investigated and examined the satisfaction of nurses and doctors with the aforementioned techniques. Results: The placement time, repositioning time, and total time were significantly higher for the traditional over-bed method than for the postural trolley-assisted over-bed method and the direct over-bed method (both P < 0.01). However, there was no statistically significant difference between the postural trolley-assisted over-bed method and the direct over-bed method (P > 0.05). Nurses and doctors reported significantly higher satisfaction with the postural trolley-assisted over-bed method and the direct over-bed method compared to the traditional over-bed method (both P < 0.01). In addition, nurses were more satisfied with the direct over-bed method than the postural trolley-assisted over-bed method (P < 0.05). Conclusion: The results of this study demonstrate that the direct over-bed method is preferred for positioning and repositioning patients in the lithotomy position with the support of stirrups.

Analysis of primary nursing intervention for elderly patients with cancer pain on the improvement of potential risk and pain degree.

OBJECTIVE: To analyze the effect of primary nursing on the improvement of potential risk and pain degree in elderly patients with cancer pain. METHODS: Altogether 187 patients with cancer pain from June 2018 to November 2019 were selected as the research participants and grouped into two groups according to different nursing intervention methods, including 102 cases in the research group (RG) and 85 cases in the control group (CG). The pain relief and medication compliance were evaluated. General Self-efficacy Scale (GSES) and Exercise of Self-Care Agency (ESCA) were used to evaluate the self-efficacy and self-care ability. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to evaluate the anxiety and depression. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. SF-36 Quality of Life Scale was used to evaluate the quality of life. Self-made nursing satisfaction questionnaire was used to evaluate the nursing satisfaction. RESULTS: The improvement of pain relief in the RG was evidently higher than that in the CG. The scores of SAS and SDS in the RG after intervention were evidently lower than those in the CG. GSES and ESCA scores of patients in the RG after intervention were evidently higher than those in the CG. The compliance of patients in the RG after intervention was evidently higher than that in the CG. The PSQI scores of patients in the RG after intervention were evidently better than those in the CG. The scores of SF-36 and nursing satisfaction in the RG were evidently higher than those in the CG. CONCLUSION: The implementation of primary nursing intervention for elderly patients with cancer pain can effectively relieve their pain and improve their bad psychological state and medication compliance, thus improving patients' quality of life.

Bowel symptoms and self-care strategies of survivors in the process of restoration after low anterior resection of rectal cancer.

BACKGROUND: The purpose of this research is to identify the bowel symptoms and self-care strategies for rectal cancer survivors during the recovery process following low anterior resection surgery. METHODS: A total of 100 participants were investigated under the structured interview guide based on the dimensions of "symptom management theory". RESULTS: 92% of participants reported changes in bowel habits, the most common being the frequent bowel movements and narrower stools, which we named it finger-shaped consistency stools. The 6 most frequently reported bowel symptoms were excessive flatus (93%), clustering (86%), urgency (77%), straining (62%), bowel frequency (57%) and anal pendant expansion (53%). Periodic bowel movements occurred in 19% participants. For a group of 79 participants at 6 to 24 months post-operation, 86.1% reported a significant improvement of bowel symptoms. Among 68 participants of this subgroup with significant improvements, 70.5% participants reported the length of time it took was at least 6 months. Self-care strategies adopted by participants included diet, bowel medications, practice management and exercise. CONCLUSIONS: It is necessary to educate patients on the symptoms experienced following low anterior resection surgery. Through the process of trial and error, participants have acquired self-care strategies. Healthcare professionals should learn knowledge of such strategies and help them build effective interventions.

[Analysis on risk factors of drug resistance for tuberculosis in Sichuan and Anhui Provinces].

OBJECTIVE: To investigate the risk factors associated with secondary drug resistance for Tuberculosis (SDR-TB). METHODS: A total of 1489 patients with TB were recruited in this study, among which 875 sought medical attentions from the institute of TB control and prevention of Sichuan province; 614 sought medical attentions from the institute of TB control and prevention of Anhui province; 356 of the patients were identified as SDR-TB. Questionnaire surveys and Logistic Regression Analysis were undertaken to investigate the social behavioral risk factors associated with SDR-TB. RESULTS: The length of suffering, incomplete directly observed treatment (DOTS), poor patient compliance, unsatisfied supply of medicines, floating population, interruption of treatment, and alcohol drinking were identified as major social behavioral risk factors of SDR-TB. The Odds Ratios (OR) and Confidence Intervals (CI) for the above factors were 0.279 (6.842-17.663), 9.880 (6.743-16.672), 4.683 (2.335-10.523), 3.859 (1.584-9.218), 5.030 (1.683-9.891), 4.938 (2.162-9.982) and 2.338 (1.284-7.116) respectively. CONCLUSION: The results of this study has implications for improving the prevention and control of TB, in particular, for the SDR-TB.

[Study on socio-behavioral risk factors of acquired drug resistance of tuberculosis in Sichuan province].

OBJECTIVE: To explore the socio-behavioral risk factors on acquired drug resistance of tuberculosis (ADR-TB). METHODS: Using pair matched case control study, 316 ADR-TB samples from 949 cases and 316 controls (pair matched for age and sex) were selected by systematical sampling method and studied through questionnaires. All the study subjects were selected from outpatients of the institute of TB control and prevention,between June 2002 and June 2005 in Sichuan province. Socio-behavioral risk factors were analyzed with conditional logistic regression and estimated with adjusted odds ratios (OR) and confidence interval (CI). RESULTS: Data showed that the major socio-behavioral risk factors were associated with low economic status, incomplete DOTS, poor compliance and interruption during treatment with adjusted OR and CI as 5.623 (3.462-9.386), 8.875 (6.136-15.442), 6.467(3.942-10.622) and 4.906 (2.477-10.654) respectively. CONCLUSION: ADR-TB could be controlled by taking effective measures against the socio-behavior risk factors.