Value of refined care in patients with acute exacerbation of chronic obstructive pulmonary disease

Effectiveness of refined nursing intervention on postoperative recovery and respiratory function in lung cancer patients after thoracic surgery

To evaluate the effectiveness of refined nursing intervention versus routine nursing care in improving respiratory function and facilitating their recovery in lung cancer patients after thoracic surgery. Total 75 primary lung cancer patients (average age: 55.3 ± 10.8 years) who underwent thoracic surgery at Tangshan People's Hospital from February 2024 to July 2024 were included in the study. According to the different postoperative nursing intervention, patients were randomized into control group (CG) and observational group (OG) for evaluating the effects of refined nursing intervention on pain relief, postoperative recovery and respiratory function. Tidal volume, vital capacity, forced expiratory volume in 1 second, peak expiratory flow, and maximal voluntary ventilation were used to evaluate pulmonary function. The Medical Outcomes Study 36-Item Short-Form Health Survey and Nursing Intensive-Care Satisfaction Scale were administered at the minimum of 30 days of nursing interventions after thoracic surgery to assess quality of life and satisfaction with nursing care respectively. Bivariate correlation analysis and chi-square test (χ2) were used to analyze significant changes by using SPSS (version 27.0). About 61% (n = 46) of the patients were female. Routine nursing care was conducted in both CG and OG patients, while in OG simultaneously received refined nursing care. After a period of nursing intervention, recovery rate of heart and pulmonary was significantly higher than CG (92.31% vs 72.22%, P = .022) with a lower incidence of postoperative complications (12.82% vs 30.56%, P = .049). Pulmonary function test results revealed a significant improvement in OG patients' tidal volume (0.43 ± 0.06 vs 0.39 ± 0.07, P = .014), vital capacity (3.53 ± 0.30 vs 3.34 ± 0.32, P = .020), forced expiratory volume in 1 second (4.67 ± 0.67 vs 4.23 ± 0.58, P = .003), peak expiratory flow (4.76 ± 0.51 vs 4.36 ± 0.51, P = .001) and maximal voluntary ventilation (58.22 ± 7.86 vs 53.70 ± 6.89, P = .010) compared to CG. Postoperative moderate-to-worst pain duration in OG was significantly shortened (4.36 ± 1.56 vs 5.81 ± 1.94, P < .001), while health status value was higher (60.87 ± 5.89 vs 56.53 ± 6.22, P = .003). Moreover, OG expressed higher satisfaction with nursing care compared to CG (P = .002). Patients experienced reduced respiratory function after thoracic surgery. Refined nursing intervention might facilitate patients' postoperative recovery and improve their respiratory function and general well-being, which would be beneficial for achieving patients' satisfaction and promoting positive interaction between patients and multidisciplinary team members.

Application of Refined Nursing Combined with Comprehensive Treatment of Traditional Chinese and Western Medicine in Gastrointestinal Dysfunction after Tumor Operation

After surgical treatment, the gastrointestinal function of tumor patients is inhibited for a short time. Refined nursing is beneficial to the recovery of gastrointestinal function of tumor patients after operation. Traditional Chinese medicine and Western medicine have their own advantages in the treatment of gastrointestinal dysfunction after tumor operation and the combined application of the two is more ideal. Therefore, on the premise of refined nursing, we should carefully study the efficacy of integrated traditional Chinese and Western medicine in the treatment of postoperative gastrointestinal dysfunction in tumor patients. Fifty patients with gastrointestinal dysfunction after tumor surgery admitted to Xiamen University Affiliated Zhongshan Hospital from June 2021 to August 2022 were retrospectively selected. Twenty two of them received refined care + Western medicine (control group, CG) and the other 28 received refined care + Western medicine + moxibustion and thumb-tack needle Chinese medicine (observation group, OG). We compared the recovery of gastrointestinal function, inflammatory factors, negative emotions, sleep quality, length of stay, medical expenses, and adverse reactions. The postoperative recovery effect of gastrointestinal function in the OG was better than that in the CG. The IL-8 level and TNF -α level in OG were lower than those in CG. Relative to CG, the OG had significantly low SDS scores, SAS scores, PSQ1 scores, length of hospital stay, and medical expenses. The OG incidence of adverse reactions was 28.57%; it was significantly lower than 59.09% in the CG. Refined nursing with integrated Chinese and Western medicine therapeutic interventions can promote the recovery of gastrointestinal tract function, relieve anxiety and depression, and improve sleep quality in patients with postoperative gastrointestinal dysfunction after tumor surgery.

Efficacy of comprehensive nursing in patients with pneumoconiosis and its influence on quality of life

OBJECTIVE

To investigate the efficacy of comprehensive nursing for patients with pneumoconiosis and its influence on patients' quality of life (QoL).

METHODS

Sixty-two patients with pneumoconiosis diagnosed and treated in the Henan Provincial Institute for Occupational Health (Henan No. 3 Provicial People's Hospital) from October 2018 to October 2019 were included in this retrospective study. According to the nursing model, patients receiving comprehensive nursing were included in the experimental group (n=31) and those receiving general care were included in the reference group (n=31). The pulmonary function (PF) indices, QoL score, emotional score and health behavior compliance were compared between the two groups before and after nursing.

RESULTS

(1) A significantly higher overall response rate was determined in the experimental group compared with the reference group (P<0.05). (2) There were no significant differences in heart rate (HR) and oxygen saturation between the two groups before nursing intervention (P>0.05). After nursing, significantly lower HR and higher oxygen saturation were observed in the experimental group compared with the reference group (all P<0.05). (3) The PF indexes also showed no significant differences between the two groups before nursing (P>0.05). After nursing, the experimental group exhibited higher forced expiratory volume in 1 second percent predicted (FEV1%_pred), forced vital capacity percent predicted (FVC%_pred), and blood oxygen partial pressure than the reference group, with statistical significance (all P<0.05). (4) The two groups showed similar QoL before nursing (P>0.05). After nursing, the experimental group scored significantly higher in physiological function, mental health, social function and vitality than the reference group (P<0.05). (5) The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores, which were not statistically different between groups before nursing (P>0.05), were significantly lower in the experimental group after nursing compared with reference group (P<0.05). (6) The compliance of medication, diet, respiratory training and home oxygen therapy was higher in the experimental group compared with the reference group, showing statistical significance (P<0.05).

CONCLUSIONS

Comprehensive nursing care for patients with pneumoconiosis can effectively enhance the curative effect, PF and QoL of patients, improve their HR, oxygen saturation and mood, and enhance their compliance with health behaviors.

Application of Precise Positioning for Sputum Expectoration in ICU Patients with Pulmonary Infection

Objective

To determine the application value of precise positioning for sputum expectoration in intensive care unit (ICU) hospitalized patients with pulmonary infection (PI).

Methods

A total of 183 patients with PI treated in the ICUs of Shengjing Hospital of China Medical University from June 2019 to June 2020 were divided into a control group (n = 91) and an observation group (n = 92), all of whom received conventional drug therapy. The control group was given routine nursing intervention, based on which, the observation group was supplemented with precise positioning for sputum expectoration. The 24-hour sputum volume, respiratory rate (RR), blood gas analysis indexes, inflammatory indicators, Clinical Pulmonary Infection Score (CPIS), Modified Medical Research Council (mMRC) dyspnea scale score, and quality of life (36-Item Short-Form Health Survey, SF-36) were observed in both arms before and after intervention. The incidence of adverse reactions was counted.

Results

The observation group showed better mMRC scores than the control group (P < 0.05). Compared with the control group, the sputum volume, RR, and CPIS score were lower, and the SF-36 score was higher in the observation group 7 days after intervention (P < 0.05). After intervention, the oxygen saturation (SaO2) and partial pressure of oxygen (PaO2) were higher, while the carbon dioxide partial pressure (PaCO2), C-reactive protein (CRP), procalcitonin (PCT), and leukocyte count were lower in the observation group compared with the control group (P < 0.05). There was no significant difference in the incidence of complications between the two arms (P > 0.05).

Conclusion

The application of precise positioning for sputum expectoration in nursing intervention of ICU patients with PI can alleviate the severity of PI and dyspnea, reduce inflammatory reaction, and improve the quality of life of patients.