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Fang Y, Kang Y, Teng L, Lin L, Qiu P. A qualitative study on the caregiver burden experience in home reflux enema management of infants with congenital megacolon. Int J Qual Stud Health Well-being 2024; 19:2289225. [PMID: 38055786 DOI: 10.1080/17482631.2023.2289225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE This study aims to explore the caregiver burden experience in the care of infants with congenital megacolon undergoing home reflux enema. The findings will provide a basis for developing targeted and effective nursing interventions. METHODS A phenomenological research approach was employed. From October 2022 to January 2023, semi-structured in-depth interviews were conducted with 12 caregivers of infants with congenital megacolon undergoing home reflux enema in a tertiary paediatric hospital in Fujian Province. The collected data were analysed and organized using the Colaizzi's 7-step analysis method, leading to the identification of key themes. RESULTS The analysis yielded three major themes concerning the caregiver burden experience in the care of infants with congenital megacolon undergoing home reflux enema: inadequate disease-related knowledge, presence of multiple pressures during the caregiving process, and a desire for greater support. CONCLUSIONS This study employed qualitative interviews with the caregivers of 12 children with congenital Hirschsprung's disease undergoing home reflux enema, and the feelings of caregivers of children with reflux enema at home after discharge were deeply understood. It is recommended to implement positive psychological interventions based on the PERMA model and incorporate "Internet + collaborative nursing" to provide caregivers with professional knowledge, address their pressures and needs, and promote their well-being while enhancing nursing abilities.
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Affiliation(s)
- Yuanyuan Fang
- Department of Pediatric Surgery, Nurse-in-charge, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Yulan Kang
- Department of Nursing, Associate professor, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Lingjing Teng
- Department of Pediatric Surgery, Nurse-in-charge, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Lifang Lin
- Department of Pediatric Surgery, Nurse practitioner, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Pingping Qiu
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
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Plummer K, Adina J, Mitchell AE, Lee-Archer P, Clark J, Keyser J, Kotzur C, Qayum A, Griffin B. Digital health interventions for postoperative recovery in children: a systematic review. Br J Anaesth 2024; 132:886-898. [PMID: 38336513 DOI: 10.1016/j.bja.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/15/2023] [Accepted: 01/05/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Digital health interventions offer a promising approach for monitoring during postoperative recovery. However, the effectiveness of these interventions remains poorly understood, particularly in children. The objective of this study was to assess the efficacy of digital health interventions for postoperative recovery in children. METHODS A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with the use of automation tools for searching and screening. We searched five electronic databases for randomised controlled trials or non-randomised studies of interventions that utilised digital health interventions to monitor postoperative recovery in children. The study quality was assessed using Cochrane Collaboration's Risk of Bias tools. The systematic review protocol was prospectively registered with PROSPERO (CRD42022351492). RESULTS The review included 16 studies involving 2728 participants from six countries. Tonsillectomy was the most common surgery and smartphone apps (WeChat) were the most commonly used digital health interventions. Digital health interventions resulted in significant improvements in parental knowledge about the child's condition and satisfaction regarding perioperative instructions (standard mean difference=2.16, 95% confidence interval 1.45-2.87; z=5.98, P<0.001; I2=88%). However, there was no significant effect on children's pain intensity (standard mean difference=0.09, 95% confidence interval -0.95 to 1.12; z=0.16, P=0.87; I2=98%). CONCLUSIONS Digital health interventions hold promise for improving parental postoperative knowledge and satisfaction. However, more research is needed for child-centric interventions with validated outcome measures. Future work should focus development and testing of user-friendly digital apps and wearables to ease the healthcare burden and improve outcomes for children. SYSTEMATIC REVIEW PROTOCOL PROSPERO (CRD42022351492).
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Affiliation(s)
- Karin Plummer
- School of Nursing and Midwifery, Menzies Health Institute, Griffith University, Gold Coast, QLD, Australia; Department of Anaesthesia and Pain, Queensland Children's Hospital, South Brisbane, QLD, Australia.
| | - Japheth Adina
- Parenting and Family Support Centre, School of Psychology, Brisbane, QLD, Australia
| | - Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, Brisbane, QLD, Australia; Griffith Centre for Mental Health, Griffith University, Brisbane, QLD, Australia; Midwifery and Social Work, School of Nursing, The University of Queensland, Brisbane, QLD, Australia
| | - Paul Lee-Archer
- Department of Anaesthesia and Pain, Queensland Children's Hospital, South Brisbane, QLD, Australia; Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QLD, Australia
| | - Janelle Keyser
- Department of Anaesthesia and Pain, Queensland Children's Hospital, South Brisbane, QLD, Australia
| | - Catherine Kotzur
- Department of Anaesthesia and Pain, Queensland Children's Hospital, South Brisbane, QLD, Australia
| | - Abdul Qayum
- Department of Critical Care, Queensland Children's Hospital, South Brisbane, QLD, Australia
| | - Bronwyn Griffin
- School of Nursing and Midwifery, Menzies Health Institute, Griffith University, Gold Coast, QLD, Australia; Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, South Brisbane, QLD, Australia
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Sui Y, Kor PPK, Li M, Wang J. Effects of a Social Media-Based Mind-Body Intervention Embedded With Acupressure and Mindfulness for Stress Reduction Among Family Caregivers of Frail Older Adults: Pilot Randomized Controlled Trial. JMIR Form Res 2023; 7:e42861. [PMID: 36804167 PMCID: PMC9989915 DOI: 10.2196/42861] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/16/2022] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Family caregivers of frail older adults experience high levels of stress. Mind-body interventions (MBIs) focused on caregiver stress are often limited in teaching approaches, difficult to practice, and costly. A social media-based MBI embedded with mindfulness meditation (MM) and self-administered acupressure (SA) may be effective for family caregivers, offer greater usability, and lead to greater adherence. OBJECTIVE The aim of this study was to test the feasibility and preliminary effects of a social media-based MBI embedded with MM and SA on family caregivers of frail older adults and to investigate the preliminary effects of the intervention using a pilot randomized controlled trial. METHODS A 2-arm randomized controlled trial design was adopted. Family caregivers of frail older adults (n=64) were randomized into either the intervention group (n=32), receiving 8 weeks of social media-based MM and SA, or the control group (n=32), receiving brief education on caregiving for people with frailty. The primary outcome (caregiver stress) and secondary outcomes (caregiver burden, sleep quality, and mindfulness awareness and attention) were measured using a web-based survey at baseline (T0), immediately after the intervention (T1), and at the 3-month follow-up (T2). RESULTS The feasibility of the intervention was established with a high attendance rate (87.5%), high usability score (79), and low attrition rate (1.6%). The generalized estimating equation results showed that participants in the intervention group at T1 and T2 experienced a significant improvement in stress reduction (P=.02 and P=.04, respectively), sleep quality (P=.004 and P=.01, respectively), and mindful awareness and attention (P=.006 and P=.02, respectively) compared with the control group. There were no substantial improvements in caregiver burden at T1 and T2 (P=.59 and P=.47, respectively). A focus group session conducted after the intervention had 5 themes: impact on the family caregivers, difficulty in practicing the intervention, the strength of the program, the limitations of the program, and perception of the intervention. CONCLUSIONS The findings support the feasibility and preliminary effects of social media-based MBI embedded with acupressure and MM on reducing stress among family caregivers of frail older people and enhancing sleep quality and mindfulness levels. A future study with a larger and more diverse sample is proposed to evaluate the longer-term effects and generalizability of the intervention. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100049507; http://www.chictr.org.cn/showproj.aspx?proj=128031.
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Affiliation(s)
- Yufang Sui
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Patrick Pui Kin Kor
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Mengli Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Jingjing Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
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Growth and Development in Preterm Infants and Maternal Parenting Stress after WeChat-Based Extended Care. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9987891. [PMID: 35800015 PMCID: PMC9256392 DOI: 10.1155/2022/9987891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022]
Abstract
Objective WeChat-based extended care has been widely applied in clinical practice such as preoperative assistance in children with congenital heart disease and children with ventricular septal defect. In this study, we aimed to explore the impacts of WeChat-based extended care on the growth and development of preterm infants (PIs) and the nursing satisfaction of their family members. Methods From June 2019 to August 2021, 85 PIs and their mothers were selected as the research participants. Among them, 46 pairs receiving WeChat-based extended care were served as the WeChat group, and 39 pairs receiving routine extended care were taken as the control group. After 6 months of intervention, the two groups of PIs were compared in terms of physical development, IQ, and neurological and gastrointestinal functions. For mothers, their psychological states were assessed after intervention using the self-rating anxiety/depression scale (SAS/SDS), and the nursing satisfaction was counted. Results After nursing intervention, better physical and IQ development of PIs were observed in the WeChat group compared with the control group (P < 0.05). The WeChat group also had notably reduced level of neuron-specific enolase (NSE) and s100β protein related to nerve function than that in the control group and exhibited significant higher levels of serum gastrin (GAS) and motilin (MTL) associated with gastrointestinal function (P < 0.05). Besides, the WeChat group presented lower SAS and SDS scores and higher nursing satisfaction than the control group in delivery women (P < 0.05). Conclusion WeChat-based extended care can effectively improve the growth and development and various physical functions of PIs. At the same time, it is helpful to improve maternal psychological states and nursing satisfaction of delivery women, which is worth of clinical application.
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Telemedicine in Surgical Care in Low- and Middle-Income Countries: A Scoping Review. World J Surg 2022; 46:1855-1869. [PMID: 35428920 PMCID: PMC9012517 DOI: 10.1007/s00268-022-06549-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 12/11/2022]
Abstract
Background Access to timely and quality surgical care is limited in low- and middle-income countries (LMICs). Telemedicine, defined as the remote provision of health care using information, communication and telecommunication platforms have the potential to address some of the barriers to surgical care. However, synthesis of evidence on telemedicine use in surgical care in LMICs is lacking. Aim To describe the current state of evidence on the use and distribution of telemedicine for surgical care in LMICs. Methods This was a scoping review of published and relevant grey literature on telemedicine use for surgical care in LMICs, following the PRISMA extension for scoping reviews guideline. PubMed-Medline, Web of Science, Scopus and African Journals Online databases were searched using a comprehensive search strategy from 1 January 2010 to 28 February 2021. Results A total of 178 articles from 53 (38.7%) LMICs across 11 surgical specialties were included. The number of published articles increased from 2 in 2010 to 44 in 2020. The highest number of studies was from the World Health Organization Western Pacific region (n = 73; 41.0%) and of these, most were from China (n = 69; 94.5%). The most common telemedicine platforms used were telephone call (n = 71, 39.9%), video chat (n = 42, 23.6%) and WhatsApp/WeChat (n = 31, 17.4%). Telemedicine was mostly used for post-operative follow-up (n = 71, 39.9%), patient education (n = 32, 18.0%), provider training (n = 28, 15.7%) and provider-provider consultation (n = 16, 9.0%). Less than a third (n = 51, 29.1%) of the studies used a randomised controlled trial design, and only 23 (12.9%) reported effects on clinical outcomes. Conclusion Telemedicine use for surgical care is emerging in LMICs, especially for post-operative visits. Basic platforms such as telephone calls and 2-way texting were successfully used for post-operative follow-up and education. In addition, file sharing and video chatting options were added when a physical assessment was required. Telephone calls and 2-way texting platforms should be leveraged to reduce loss to follow-up of surgical patients in LMICs and their use for pre-operative visits should be further explored. Despite these telemedicine potentials, there remains an uneven adoption across several LMICs. Also, up to two-thirds of the studies were of low-to-moderate quality with only a few focusing on clinical effectiveness. There is a need to further adopt, develop, and validate telemedicine use for surgical care in LMICs, particularly its impact on clinical outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s00268-022-06549-2.
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Wang M, Pang W, Zhou L, Ma J, Xie S. Effect of Transumbilical Single-Port Laparoscopic-Assisted Duhamel Operation on Serum CRP and IL-6 Levels in Children with Hirschsprung's Disease. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:8349851. [PMID: 35281524 PMCID: PMC8906944 DOI: 10.1155/2022/8349851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/17/2022]
Abstract
Objective To explore the clinical intervention effect of transumbilical single-port laparoscopic-assisted Duhamel operation on children with Hirschsprung's disease (HD) and to analyze the effect of treatment on children with serum C-reactive protein (CRP) and interleukin-6 (IL-6) effects. Methods Retrospectively select 80 children with HD who underwent surgery in our hospital from May 2017 to May 2020 as the research subjects and they are classified as group A according to the difference of the children's surgical procedures (receiving transumbilical single-port laparoscopic-assisted Duhamel surgery, 40 cases) and group B (receiving conventional laparoscopic surgery, 40 cases), compare the perioperative period (operating time, intraoperative blood loss, surgical posthospitalization, and postoperative gastrointestinal function recovery time), early postoperative complications (perianal dermatitis, urinary retention, enterocolitis, and anastomotic leakage), and late postoperative complications (anastomotic stenosis, dirty stool, recurrence of constipation, and enterocolitis), compare the differences in the levels of CRP and IL-6 between the two groups of children before and after the operation, and conduct a 1-year follow-up of the two groups of children to compare the long-term defecation status. Results The surgical time of children in group A, postoperative hospitalization time, and postoperative gastrointestinal function recovery time were significantly shorter than those of group B, and the differences between groups were statistically significant (P < 0.05). A group of patients: the total incidence of postearly complications was 5.00% lower than 22.50% (P < 0.05) in group B (P < 0.05), and the total incidence of previous complications after group A of patients was 10.00% lower than 27.50% of group B (P < 0.05). The two groups of serum CRP and IL-6 in two groups were not statistically significant (P > 0.05), and the serum CRP and IL-6 levels of children in group A after surgery were 3 days. It is obviously lower than those in group B, and the differences between groups have statistical significance (P < 0.05). At 1 month after surgery, the average bowel movement time in group A is significantly lower than those of group B (P < 0.05); during the 1-12 months, the difference between the defecation frequency group of the group A and group B did not have statistically significance (P > 0.05). Conclusion Transumbilical single-port laparoscopic assistant Duhamel operation of HD has a good intervention effect, compared to traditional laparoscopic surgery, the operation time, postoperative hospitalization time, and postoperative gastrointestinal function recovery time, and also help to reduce postoperative near-long complications The incidence improves the stress reactions and long-term defecation functions in children.
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Affiliation(s)
- Miao Wang
- Xingtai People's Hospital, Hebei, Xingtai 054000, China
| | - Wenshuai Pang
- Xingtai People's Hospital, Hebei, Xingtai 054000, China
| | - Lixia Zhou
- Xingtai People's Hospital, Hebei, Xingtai 054000, China
| | - Jiansu Ma
- Xingtai People's Hospital, Hebei, Xingtai 054000, China
| | - Shasha Xie
- Xingtai People's Hospital, Hebei, Xingtai 054000, China
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Opportunities and pitfalls of social media research in rare genetic diseases: a systematic review. Genet Med 2021; 23:2250-2259. [PMID: 34282302 DOI: 10.1038/s41436-021-01273-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/25/2021] [Accepted: 06/30/2021] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Social media may be particularly valuable in research in rare genetic diseases because of the low numbers of patients and the rare disease community's robust online presence. The goal of this systematic review was to understand how social media is currently used in rare disease research and the characteristics of the participants in these studies. METHODS We conducted a systematic review of six databases to identify studies published in English between January 2004 and November 2020, of which 120 met inclusion criteria. RESULTS Most studies were observational (n = 114, 95.0%) and cross-sectional (n = 107, 89.2%), and more than half (n = 69, 57.5%) utilized only surveys. Only 101 rare diseases were included across all studies. Participant demographics, when reported, were predominantly female (70.1% ± 22.5%) and white (85.0% ± 11.0%) adult patients and caregivers. CONCLUSION Despite its potential benefits in rare disease research, the use of social media is still methodologically limited and the participants reached may not be representative of the rare disease population by gender, race, age, or rare disease type. As scholars explore using social media for rare disease research, careful attention should be paid to representativeness when studying this diverse patient community.
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