Internet+Continuous Nursing Mode in Home Nursing of Patients with T-Tube after Hepatolithiasis Surgery

Impact of a visual mobile terminal-based continuity of care model on caregiver competence of children with enterostomies

BACKGROUND

Children with critical acute abdominal conditions often undergo intestinal stoma surgery.

AIM

To explore the impact of a visual mobile terminal-based extended care model on caregiver competence for children with enterostomies.

METHODS

One hundred twenty children with enterostomies and their caregivers in a children's hospital in Beijing were divided into a control group and a study group. The control group (60 cases) received traditional telephone follow-up for continuity of care, while the study group (60 cases) used a visualization mobile terminal-based care model. The incidence of stoma-related complications, caregiver burden scale, and competence scores of children with stoma were compared between the two groups.

RESULTS

The primary caregiver burden score in the study group (37.22 ± 3.17) was significantly lower than that in the control group (80.00 ± 4.47), and the difference was statistically significant (P < 0.05). Additionally, the caregiving ability score of the study group (172.08 ± 3.49) was significantly higher than that of the control group (117.55 ± 4.28; P < 0.05). The total incidence of complications in the study group (11.7%, 7/60) was significantly lower compared to the control group (33.3%, 20/60; χ² = 8.086, P = 0.004).

CONCLUSION

The visual mobile terminal-based care model reduces caregiver burden, improves home care ability, lowers the incidence of complications and readmission rates, and supports successful second-stage reduction surgery for children with enterostomies.

Platform-Based Patient-Clinician Digital Health Interventions for Care Transitions: Scoping Review

BACKGROUND

Care transitions are complex and can make patients vulnerable to adverse events. Poor communication among clinicians, patients, and their caregivers is a critical gap during these periods of transition. Technology solutions such as platform-based patient-clinician digital health interventions (DHIs) can provide support and education to patients.

OBJECTIVE

The aims of this scoping review were to explore the literature on platform-based patient-clinician DHIs specific to hospital-to-home care transitions and identify the barriers to and enablers of the uptake and implementation of these DHIs.

METHODS

A scoping review was conducted. A total of 4 databases (MEDLINE, CINAHL, Embase, and the Cochrane Central Register of Controlled Trials) were searched on July 13, 2022. Studies involving patients aged >18 years who used platform-based DHIs during their hospital-to-home transition were included. In total, 2 reviewers independently screened the articles for eligibility using a 2-stage process of title and abstract and full-text screening. Eligible studies underwent data extraction, and the results were analyzed using descriptive and narrative methods.

RESULTS

We screened 8322 articles, of which 97 (1.17%) met our inclusion criteria. DHIs were implemented using a mobile app (59/97, 61%), a web-based platform (28/97, 29%), or a combination of both (10/97, 10%). The 2 most common health conditions related to the DHIs were cardiac disease (22/97, 23%) and stroke (11/97, 11%). Outcomes varied greatly but were grouped by health care use, complications, and wellness outcomes. The top 2 barriers were lack of interest (13/97, 13%) and time constraints to use the DHIs (10/97, 10%), and the top 2 enablers were the ability to use the DHIs (17/97, 18%) and their ease of use (11/97, 11%). The main conflicting theme was access (enabler; 28/97, 29%) or limited access (barrier; 15/97, 15%) to technology or the internet.

CONCLUSIONS

Platform-based DHIs could help improve communication, coordination, and information sharing between clinicians and patients during transition periods. Further research is needed to assess the effectiveness of these platform-based DHIs on patient outcomes.

Impact of Ahmadi Continuing Nursing Model on self-care ability, stoma complications and quality of life of colostomy patients

OBJECTIVE

To analyze the effects of Ahmadi Continuing Nursing Model (ACNM) on the self-care ability, stoma complications and life quality in colostomy patients.

METHODS

The clinical data of 120 patients who underwent postoperative colostomy in our hospital from June 2020 to June 2023 were retrospectively analyzed. The patients were divided into control group (n = 60, treated with routine nursing) and observation group (n = 60, treated with the ACNM on the basis of routine nursing) according to different nursing methods. Postoperative recovery of gastrointestinal function, ostomy adaptability, self-care ability, and life quality before and after nursing were compared. The probability of complications before and after nursing was recorded between the two groups.

RESULTS

The time of first exhaust was 3.65 ± 0.82 d, the time of first meal was 1.83 ± 0.65 d, and the first bowel sound recovery was 1.47 ± 0.53 d in the observation group, which were shorter than those in the control group (4.38 ± 1.20 d, 3.12 ± 1.15 d, 2.39 ± 1.06 d, P < 0.001). After intervention, the positive emotions in the ostomy adaptation score were 32.09 ± 5.03 points, negative emotions were 31.41 ± 5.70 points, social life adaptation were 27.12 ± 4.98 points, and the total score was 90.78 ± 5.98 points in the observation group, which were significantly higher than those in the control group (26.32 ± 4.52 points, 24.25 ± 6.02 points, 20.25 ± 4.02 points, 67.25 ± 6.09 points, P < 0.001). The self-willingness was 34.18 ± 4.02 points, self-care skill was 10.57 ± 2.23 points, self-care knowledge was 18.59 ± 3.10 points, and the total score was 63.18 ± 4.98 points in the observation group, which were significantly higher than those in the control group (25.25 ± 3.08 points, 8.72 ± 2.13 points, 15.26 ± 2.70 points, 45.69 ± 4.09 points, P < 0.001). The physical function was 79.74 ± 2.81 points, psychological function was 76.71 ± 3.05 points, social function was 78.11 ± 3.50 points, and material life status was 60.06 ± 2.98 points in the quality of life in the observation group, which were significantly higher than those in the control group (75.36 ± 2.68 points, 69.72 ± 2.93 points, 72.33 ± 3.42 points, 51.23 ± 3.08 points, P < 0.001).

CONCLUSION

ACNM effectively promoted the recovery of gastrointestinal function after surgery in colostomy patients by improving patients' stoma adaptability, self-care ability and life quality and reducing the occurrence of complications, which was worthy of promotion.

Effect of adding individualized health education for patients with brain metastasis of lung cancer undergoing radiotherapy, as measured by MRI and cognitive testing

OBJECTIVE

To explore the clinical efficacy of individualized health education (IHE) and care mode based on magnetic resonance imaging (MRI) combined with Mini-Mental State Examination (MMSE) for lung cancer patients with brain metastases undergoing radiotherapy.

METHODS

This retrospective study involved 50 lung cancer patients with brain metastases. Patients were divided into a control group (n=25, conventional care) and an intervention group (n=25, individualized health education (IHE) care) according to their nursing model. Both groups underwent enhanced brain MRI scans. The patients were assessed using the Mini Mental State Scale (MMSE) before and at 1 month after radiotherapy. At the same time, Montreal Cognitive Assessment (MoCA) was used to assess the degree of cognitive impairment in both groups before and after the intervention. Finally, the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) questionnaire was used to evaluate the overall health status and quality of life (QOL) (including physical function, emotional function, and social function) of the two groups of patients after radiotherapy. The patients' self-care ability in daily life was assessed using Alzheimer's Disease Collaborative Study Activities of Daily Living (ADCS-ADL).

RESULTS

Following intervention, there was no significant difference in MMSE total scores between the control and intervention groups (P > 0.05), or in physical function scores (P > 0.05). However, the intervention group had significantly higher overall QOL scores compared to the control group (P < 0.05), particularly in emotional and social function (P < 0.05). There was no significant difference in total MoCA scores between the two groups (P > 0.05), but the intervention group showed superior scores in visual-spatial, executive function, naming, and attention compared to the control group (all P < 0.05). Following intervention, the intervention group demonstrated better ADCS-ADL scores than the control group (P < 0.05).

CONCLUSION

The IHE mode effectively improved emotional and social functions and enhanced QOL in lung cancer patients with brain metastases undergoing radiotherapy.

Effects of a new continuous nursing program on the short-term and long-term low back pain in patients after UBED: a retrospective study based on 282 patients

Background

Unilateral biportal endoscopic discectomy (UBED) is a widely accepted minimally invasive surgery for the treatment of lumbar degenerative diseases. However, some patients continue to have persistent low back pain (LBP) symptoms in the short and long term after surgery, which may be related to improper postoperative nursing and rehabilitation of patients. Further research is needed to determine whether continuous nursing can improve the symptoms of patients after UBED.

Methods

This study retrospectively enrolled 282 lumbar disc herniation (LDH) patients who underwent UBED in our hospital from January 2019 to January 2022. The patients were divided into two groups according to whether they accepted the continuous nursing program: 147 patients in the traditional nursing group and 135 patients in the continuous nursing group. Demographic characteristics, radiological parameters, and follow-up data of the patients were collected. Finally, the risk factors of LBP after UBED were analyzed.

Results

The visual analog scale (VAS) score of LBP in the continuous nursing group was 0.97 ± 1.159 at 3 months and 0.61 ± 0.954 at 12 months after operation, and VAS of leg pain was 0.23 ± 0.421 at 12 months after operation, which were better than those in the traditional nursing group (1.51 ± 1.313, 1.10 ± 1.076, 0.68 ± 0.788, respectively, p < 0.001) The Oswestry disability index (ODI) score of the continuous nursing group was lower than that of the traditional nursing group at 12 months after operation (7.36 ± 6.526 vs. 12.43 ± 6.942, p < 0.001). The rehabilitation completion (7.98 ± 1.857), efficacy satisfaction (9.13 ± 1.101), and re-herniation worry scores (1.97 ± 1.217) in the continuous nursing group were better than those in the traditional nursing group (4.14 ± 3.066, 8.28 ± 1.240, 2.79 ± 1.973, respectively, P < 0.001). The re-herniation rate within 1 year was similar between the two groups (3/135 vs. 2/147, p = 0.673). No incision infection occurred. Multivariate regression analysis showed that risk factors for persistent LBP at 3-month follow-up were degenerative disc [odds ratio (OR): 2.144, CI: 1.306-3.519, p = 0.03], Pfirrmann grade (OR: 3.073, CI: 1.427-6.614, p = 0.04), and surgical time (OR: 0.969, CI: 0.937-1.003, p = 0.74). At the 12-month follow-up, the risk factors for persistent LBP were preoperative VAS of the legs (OR: 1.261, CI: 1.000-1.591, p = 0.05) and Pfirrmann grade (OR: 3.309, CI: 1.460-7.496, p = 0.04).

Conclusion

Continuous nursing programs can improve the symptoms of short-term and long-term persistent LBP in patients after UBED, enhance the completion of rehabilitation training after UBED, alleviate patients' concerns about recurrence, and improve patients' satisfaction.

The effectiveness of a web-based information-knowledge-attitude-practice continuous intervention on the psychological status, medical compliance, and quality of life of patients after coronary artery bypass grafting surgery: a parallel randomized clinical trial

BACKGROUND

Coronary artery disease (CAD) patients who have undergone coronary artery bypass grafting (CABG) often experience a severe psychological burden for a long period of time, which can adversely affect their post-operative prognosis. Therefore, this study aimed to evaluate the effect of a web-based Information-Knowledge-Attitude-Practice (WIKAP) continuous intervention on the psychological status, medical compliance, and quality of life (QoL) in patients with CAD after CABG surgery.

METHODS

A parallel randomized clinical trial enrolled 174 CAD patients who underwent CABG at our hospital between January 2018 and December 2019. The participants were randomly divided into the Control and WIKAP group and received intervention for 12 months. The scores for anxiety, depression, medical compliance, and QoL were assessed on the first day (M0), 3rd month (M3), 6th month (M6), 9th month (M9) and 12th month (M12) after discharge. Furthermore, the occurrence of major adverse cardiac and cerebrovascular events (MACCE) was analyzed using the Kaplan-Meier curve and Cox proportional regression models for an additional 24-month follow-up period without any intervention.

RESULTS

After the 12-month intervention, the scores of anxiety and depression were significantly reduced in the WIKAP group at M9 and M12 compared to those in the Control group (all P < 0.05). Additionally, the scores of medical compliance in the WIKAP group were remarkably elevated at M6, M9, and M12 compared with those scores in the Control group (all P < 0.05). Furthermore, the QoL scores were lower in the WIKAP group at M6, M9, and M12 compared to the Control group (all P < 0.05). However, the MACCE-free survival showed no significant difference between the two groups (P > 0.05). Cox proportional regression analysis also showed that the nursing intervention (Control vs. WKIAP) was not associated with the incidence of MACCE.

CONCLUSION

WIKAP nursing intervention effectively improved the psychological health, medical compliance, and QoL in CAD patients who underwent CABG operation, but it did not prolong MACCE-free survival.

TRAIL REGISTRATION

The study is registered in isrctn.org: ISRCTN13653455.

Effectiveness of continuity of care after robot-assisted laparoscopic adrenalectomy under ambulatory mode: a single-center intervention study

To investigate the effectiveness of continuity of care after robot-assisted adrenal tumor resection under ambulatory mode. Patients who underwent robot-assisted laparoscopic adrenalectomy (RALA) in the ambulatory surgery department and urology department of our hospital from January 2022 to January 2023 were selected as study subjects. Among them, 50 patients in the Department of Urology as the control group were given routine care. The 50 patients in the ambulatory surgery department as the observation group were given continuity of care on the basis of routine care. Observation indexes include: wound healing, blood pressure, blood potassium, renal function impairment, self-care ability in daily life, medication compliance, follow-up rate, and patient satisfaction. There were no remarkable discrepancies between the two groups in terms of demographic data and basic preoperative conditions of the patients. Compared with the control group, the observation group significantly improved the patients' wound healing, postoperative blood pressure and blood potassium and kidney function (P value all < 0.05). Compared with the control group, the observation group significantly improved postoperative patients' ADL scores, follow-up rates within three months after surgery, and patient satisfaction scores (P value all < 0.05). For patients receiving ambulatory mode robot-assisted laparoscopic adrenalectomy, continuity of care can effectively reduce postoperative complications, improve patients' postoperative self-care ability in daily life, medication compliance and follow-up rate, and improve patient satisfaction, which is worthy of promotion and application by nursing workers.