Nursing Implication of People Treated by Radical Cystectomy Postsurgery and Rehabilitation

Influence of hyperbaric oxygen therapy-specialized care on limb motor function and mental state of cerebral infarction patients with hemiplegia

BACKGROUND

Currently, cerebral infarction (CI) is mainly treated by emergency craniotomy or conservative treatment. However, some studies have questioned the functional recovery of patients after hyperbaric oxygen therapy (HBOT)-specialized care.

OBJECTIVE

This paper mainly explores the influence of HBOT-specialized care on limb motor function (LMF) and mental state of CI patients with hemiplegia.

METHODS

The medical records of 113 CI patients with hemiplegia treated in our hospital from March 2020 to March 2022 were collected. Of these, 53 received routine care nursing (conventional group) and 60 cases were given HBOT-specialized care (research group). Patient general data, scores of Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Self-rating Anxiety/Depression Scale (SAS/SDS) and Barthel Index (BI), and nursing efficiency were comparatively analyzed.

RESULTS

The two groups showed comparability in general data. FMA and BI scores were increased in the research group after rehabilitation treatment, higher than the baseline and those of the conventional group, while NIHSS, SAS, and SDS scores were reduced, lower compared with baseline and those of the conventional group. In addition, significantly higher nursing efficiency was determined in the research group.

CONCLUSION

HBOT-specialized care has beneficial effects on LMF, mental state, negative emotions and self-care ability of CI patients with hemiplegia and can enhance nursing efficacy, which deserves clinical popularization.

Effects of Nursing Care for the Treatment of Patients with Bladder Cancer: A Systematic Review and Meta-analysis

Purpose. In this study, a systematic review and meta-analysis were used to examine the effectiveness of nursing care in the treatment of bladder cancer patients. The platforms of PubMed, Embase, Cochrane Library, and Web of Science were used to conduct a thorough literature search. Methods. The searching approach was used to find the fundamental characteristics of 5 studies. Sample size ranged from 52 to 131,852, and total sample size was 151,166. The study was looked up in PubMed, Embase, and Web of Science, with the most recent search being done in July 2022. Utilizing a standardized form, two independent reviewers gathered pertinent information from research that qualified as literature (17). Review Manager 5.3 used the data to examine the literature. Statistics were deemed significant at $p<0.05$ . Results. We discovered that more bladder cancer patients with T1+T2 tumor stages were receiving nursing care than those with T1+T2 tumor stages were receiving control care (mean difference =1.27, 95% CI: 1.20-1.35, $p<0.00001$ ). The proportion of bladder cancer patients with T3+T4 tumor stage in the nursing care group was lower than the proportion of patients with T3+T4 tumor stage in the control group (mean difference = 1.07; 95% CI: 1.01-1.14; $p<0.00001$ ). The difference between the number of bladder cancer patients receiving radiotherapy in the nursing care group and the control group was not statistically significant (mean difference = 1.07, 95% confidence interval [CI]: 0.99-1.16, $p=0.11$ ). There were fewer patients with bladder cancer receiving chemotherapy in the nursing care group than that in the control group (mean difference = -0.02, 95% CI: -0.0-0.02, $p<0.00001$ ). The incidence rate of patients with bladder cancer with major complications in nursing care group was lower than that of patients with bladder cancer with major complications in control group (mean difference = 0.41 95% CI: 0.18-0.93, $p=0.03$ ). When compared to patients with bladder cancer who had serious complications in the control group, the hospital death rate for nursing care patients had a greater incidence of bladder cancer patients (mean difference = 4.64 95% CI: 4.46-4.82, $p<0.00001$ ). Conclusion. This study demonstrated that the effects of nursing care reduced the incidence rate of chemotherapy and the frequency of severe problems in bladder cancer patients.

From Fast-track to Enhanced Recovery after Surgery (ERAS) in Radical Cystectomy Pathways –a Nursing Perspective

Objective

The purpose of this narrative review is to summarize existing knowledge and evidence about the establishment of enhanced recovery after surgery (ERAS) pathways with emphasize on radical cystectomy (RC), and the emerging and prominent role of nursing within the ERAS pathway. The current status of implementation and adherence to ERAS protocol in RC is discussed and the impact on primary outcomes according to ERAS is summarized.

Methods

The review was conducted based on a focused search in PubMed and CINAHL.

Results

The goal of a modern RC enhanced recovery protocols (ERPs) anno 2022 is to have a positive impact on patient care from diagnosis throughout recovery with focus on the quality, rather than speed, of recovery. This may be more in alignment with the patient's needs and preferences.

Conclusions

Nursing has been in the forefront since the establishment of ERAS, and the nurse-coordinator must be skilled in evidence-based medicine and have excellent communicative competencies to support the patient journey. Implementation of ERAS have reduced hospitalization by improved minimal surgery, optimized anesthetic regimes without increasing readmission rates. It is not known which items can reduce post-operative complications. In the future, nurses should seek a more prominent and leading role during the implementation process and take responsibility for continued education of the staff. Likewise, future nursing interventions will focus on early identification of modifiable risk factors, and a deeper exploration of the patients personally needs and preferences to upcoming surgery could optimize adherence throughout the pathway, which may add to positive outcomes.