Effects of the hospital-community-family ternary linkage continuous nursing model on compliance, cognitive function, resilience, and quality of life for children with epilepsy: a retrospective study

Promoting medication compliance in epileptic children: a cross sectional survey

BACKGROUND

Compliance with medication is crucial for the favorable prognosis of children with epilepsy. The objective of this study was to assess the determinants of medication compliance and to construct a predictive model for the risk of non-compliance among pediatric epilepsy patients.

METHODS

The study included children diagnosed with epilepsy and treated at our hospital between February 1 and September 30, 2023. We evaluated the demographic characteristics and medication compliance profiles of these patients. The predictive model's performance was assessed using the receiver operating characteristic (ROC) curve to determine its sensitivity and specificity.

RESULTS

A total of 168 children with epilepsy were analyzed. The rate of non-compliance with medication was found to be 32.74% (55 out of 168). Logistic regression identified the educational level of parents (OR = 2.844, 95% CI: 2.182-3.214), monthly household income (OR = 1.945, 95% CI: 1.203-2.422), the number of medications taken (OR = 1.883, 95% CI: 1.314-2.201), and the level of epilepsy knowledge received (OR = 2.517, 95% CI: 1.852-3.009) as significant factors influencing non-compliance (all p < 0.05). A total score threshold of 6 was set for the predictive model. The area under the ROC curve was 0.713 (95% CI: 0.686-0.751), indicating the model's discriminative ability.

CONCLUSIONS

The compliance to medication regimens among children with epilepsy is suboptimal and influenced by a multitude of factors. This study has developed a predictive model for medication compliance, which could serve as a valuable tool for clinical assessment and intervention planning regarding medication compliance in pediatric epilepsy patients.

Effects of a Nurse-Led Cognitive Behavioral Intervention for Parents of Children With Epilepsy

BACKGROUND

This study aimed to evaluate the effects of a nurse-led cognitive behavioral intervention for parents of children with epilepsy (CWE).

METHODS

The study recruited 238 CWE from the neurology ward of Xiangya Hospital from March 2019 to August 2022. According to the interventions after discharge, the children and their parents were randomly divided into 117 parent-child dyads in the intervention group and 121 parent-child dyads in the control group. The seizure severity and treatment compliance in CWE as well as the parents' psychological states and satisfaction with the care provided by nurses were compared before and after intervention.

RESULTS

The follow-up six months after discharge showed that the seizure frequency among CWE in the intervention group was significantly less than the controls (P = 0.048). Compared with the controls, the intervention group also reported fewer symptoms of anxiety and depression, better sleep quality, and more positive attitudes toward epilepsy, as well as higher nursing satisfaction (P < 0.001). The correlation analysis indicated the correlation of CWE's seizure severity was correlated with the compliance, parents' psychological states, and parents' satisfaction with the care provided by nurses.

CONCLUSIONS

The adoption of the nurse-led cognitive behavioral intervention on parents of CWE can improve the parents' mental health status and their satisfaction with the nurses, which can have a positive association with the seizure severity of CWE. In light of this information, this nursing intervention may be a new method for the long-term disease management of CWE.

Parenting self-efficacy and parenting stress mediates the effects of the association of perceived social support and readiness for discharge among parents of children with primary nephrotic syndrome

PURPOSE

To investigate the level of readiness for discharge among parents of children with primary nephrotic syndrome and to explore the mediating role of parenting self-efficacy and parenting stress between perceived social support and readiness for discharge.

DESIGN AND METHODS

A cross-sectional study was conducted in five large tertiary general hospitals in Hunan, China. Data related to demographics, perceived social support, parenting self-efficacy, parenting stress, and readiness for discharge were collected from 350 parents of children diagnosed with primary nephrotic syndrome. Path analysis was used to determine the mediating roles of parenting self-efficacy and parenting stress in the relationship between perceived social support and readiness for discharge.

RESULTS

Parents of children with nephrotic syndrome in China experienced low perceived social support, low readiness for discharge, and high parenting stress. Factors influencing readiness for discharge include the child's age, duration of illness, first episode or relapse, parental literacy and marital status. Parenting self-efficacy and parenting stress mediated the effects of the association of perceived social support and readiness for discharge.

CONCLUSION

Perceived social support influences the readiness of parents of children with nephrotic syndrome. Parenting self-efficacy and parenting stress have a chain mediating effect of the association of perceived social support and readiness for discharge.

PRACTICE IMPLICATIONS

This study emphasizes the mediating role of the psychological state of the child's parents. Nurses should take steps to increase perceived social support and parenting self-efficacy of the child's parents and to reduce parenting stress in order to improve readiness for discharge.

Perceptions of transitional care services among patients with percutaneous transhepatic biliary drainage and multicentre health professionals: A qualitative study

BACKGROUND

Patients with percutaneous transhepatic biliary drainage (PTBD) need regular drainage tube care after discharge, and transitional care can help solve this problem. However, few studies have focused on the quality of transitional care, the perceptions of patients with drainage tubes after discharge and those of healthcare professionals.

AIM

This study is aimed at exploring the real experience and perceptions of transitional care services among healthcare professionals and PTBD patients who have been discharged with tubes and at providing references for future transitional care service development.

DESIGN

The study uses a qualitative descriptive design. The reporting method followed Consolidated Criteria for Reporting Qualitative Research guidelines.

METHODS

Semistructured interviews were conducted with PTBD patients who had been discharged with tubes and multicentre healthcare professionals using the purpose sampling method. The thematic analysis method was used for analysis.

RESULTS

Thirteen PTBD patients from one hospital and 12 healthcare professionals from three hospitals were interviewed. The analysis of the patient interview data revealed three themes, namely, recognition of the value of transitional care services, patients have some unmet needs and perception of transitional care service pathways. Six subthemes were also identified. The analysis of the interview data of healthcare professionals revealed two themes, namely, harvest and challenges in transitional care services work and expectations for future development of transitional care services. Four subthemes were also identified.

CONCLUSIONS

The transitional care of discharged patients with PTBD tubes deserves the attention of clinical workers, and a series of measures should be taken to improve transitional care services.

PATIENT/PUBLIC CONTRIBUTION

Patients were involved in the formulation of interview questions for this study, and during the interviews, patients presented their suggestions for transitional care services. Healthcare professionals participated in this study as interviewees, and no members of the public were involved in this study.

Serum neuronal pentraxin 2 is related to cognitive dysfunction and electroencephalogram slow wave/fast wave frequency ratio in epilepsy

BACKGROUND

Cognitive dysfunction in epileptic patients is a high-incidence complication. Its mechanism is related to nervous system damage during seizures, but there is no effective diagnostic biomarker. Neuronal pentraxin 2 (NPTX2) is thought to play a vital role in neurotransmission and the maintenance of synaptic plasticity. This study explored how serum NPTX2 and electroencephalogram (EEG) slow wave/fast wave frequency ratio relate to cognitive dysfunction in patients with epilepsy.

AIM

To determine if serum NPTX2 could serve as a potential biomarker for diagnosing cognitive impairment in epilepsy patients.

METHODS

The participants of this study, conducted from January 2020 to December 2021, comprised 74 epilepsy patients with normal cognitive function (normal group), 37 epilepsy patients with cognitive dysfunction [epilepsy patients with cognitive dysfunction (ECD) group] and 30 healthy people (control group). The mini-mental state examination (MMSE) scale was used to evaluate cognitive function. We determined serum NPTX2 levels using an enzyme-linked immunosorbent kit and calculated the signal value of EEG regions according to the EEG recording. Pearson correlation coefficient was used to analyze the correlation between serum NPTX2 and the MMSE score.

RESULTS

The serum NPTX2 level in the control group, normal group and ECD group were 240.00 ± 35.06 pg/mL, 235.80 ± 38.01 pg/mL and 193.80 ± 42.72 pg/mL, respectively. The MMSE score was lowest in the ECD group among the three, while no significant difference was observed between the control and normal groups. In epilepsy patients with cognitive dysfunction, NPTX2 level had a positive correlation with the MMSE score (r = 0.367, P = 0.0253) and a negative correlation with epilepsy duration (r = -0.443, P = 0.0061) and the EEG slow wave/fast wave frequency ratio value in the temporal region (r = -0.339, P = 0.039).

CONCLUSION

Serum NPTX2 was found to be related to cognitive dysfunction and the EEG slow wave/fast wave frequency ratio in patients with epilepsy. It is thus a potential biomarker for the diagnosis of cognitive impairment in patients with epilepsy.

Effectiveness of the Hospital-Community-Family Nursing Model in Breast Cancer Patients Discharged with PICC Lines

PURPOSE

To investigate the effectiveness of the hospital-community-family nursing model in breast cancer patients discharged with PICC lines. To investigate the effectiveness of the hospital-community-family nursing model in breast cancer patients discharged with PICC lines.

DESIGN

A randomized controlled study.

METHOD

A total of 160 breast cancer patients who had been discharged from the hospital with PICC lines were enrolled in the study and divided into observation and control groups, each consisting of 80 patients. The control group received conventional nursing care and education, while the observation group received care under the "hospital-community-family" tertiary linkage nursing model.

FINDINGS

The results of this study suggest that the adoption of the hospital-community-family tertiary linkage nursing model can improve compliance and quality of life in breast cancer patients with PICC lines. Additionally, the model can also reduce the likelihood of complications for patients.

CONCLUSION

This study highlights the importance of promoting the application of the hospital-community-family triple linkage nursing model in breast cancer patients with PICC lines to improve the therapeutic effect.

CLINICAL EVIDENCE

The hospital-community-family triple linkage nursing model is an effective strategy to improve the effectiveness of home nursing.

Effects of family centered nursing model on children with primary nephrotic syndrome: A systematic review and meta-analysis

BACKGROUND

Family-centered nursing model has been widely used in the care of children patients, but there is still a lack of research on the care of children with primary nephrotic syndrome (PNS). Therefore, the aim of this study was to comprehensively evaluate the effects of family-centered nursing on children with PNS.

METHODS

The electronic databases included China National Knowledge Internet, Wanfang Data Knowledge Service Platform, VIP, PubMed, Web of Science, Cochrane Library, and Embase, were searched to collect randomized controlled trials on family-centered nursing model in the treatment of children with PNS. Fixed effect models or fixed effect models were used to analyze the outcomes. The primary outcomes were length of hospital stay and nursing satisfaction, and the second outcomes were quality of life (QoL) and behavioral problems.

RESULTS

A total of 12 studies involving 996 pediatric patients were included, of which 500 children received family centered care and 496 children received routine care. The results showed that family centered nursing model could significantly improve the QoL of children with PNS (P < .05), increase the nursing satisfaction of family members (P < .0001, SMD = 7.37, 95%CI = 4.15-13.08), reduce the time of hospitalization (P < .0001, standard mean difference [SMD] = -2.30, 95%CI = -2.57 to -2.03), and decrease the scores of psychosomatic disorders and impulsivity hyperactivity in children with PNS (P < .0001, SMD = -3.13, 95%CI = -4.12 to -2.15; P < .0001, SMD = -3.29, 95%CI = -4.29 to -2.28). However, there was no significant statistical difference in the impact on the scores of conduct problems, learning problems, anxiety, and hyperactivity (P > .05).

CONCLUSION

Family-centered nursing model can improve the QoL of children with PNS, increase the nursing satisfaction of family members and reduce the length of hospital stay, but further research need to verify its impact on behavioral problems.

The application of the county medical community HCH model in postoperative nutrition management for patients with advanced gastrointestinal carcinoma

OBJECTIVE

To investigate the application effect of the county medical community Hospital-Community health service organization-Home (HCH) model in nutritional management of patients with advanced gastrointestinal cancer after surgery.

METHODS

This is a retrospective study. A total of 100 postoperative malnutrition patients with advanced gastrointestinal malignant tumors admitted to Lanxi People's Hospital from January 2022 to August 2022 were selected as subjects. All patients were divided into an observation group (n=50) or control group (n=50) according to the different methods of intervention. Patients in the observation group underwent care according to our county medical community HCH model, while those in the control group received routine perioperative nutrition management. The nutritional risk screening scores (NRS2002), Patient-Generated Subjective Global Assessment (PG-SGA) scores, body mass index (BMI), triceps skinfold thickness (TSF), upper arm circumference (AC); a well as levels of serum albumin (ALB), prealbumin (PA), transferrin (TRF), retinol binding protein (RBP), creatinine (Cr) and Free fatty acid (FFA); levels of immunoglobulin G (IgG), immunoglobulin M (IgM) and immunoglobulin A (IgA); and the levels of sodium (Na+), potassium (K+), calcium (Ca+) and lactic acid, and quality of life were recorded and compared between two groups.

RESULTS

Compared with those before intervention, NRS2002 scores, PG-SGA score, BMI, TSF and AC after intervention were significantly improved in both groups. Compared with those after intervention in the control group, the NRS2002 score, PG-SGA score, BMI, TSF and AC of the patients in the observation group were significantly improved (all P<0.001). Compared with those before intervention, the levels of ALB, PA, TRF, RBP, Cr, FFA, IgG, IgM and IgA in the two groups were significantly higher after intervention. The levels of ALB, PA, TRF, RBP, Cr, FFA, IgG, IgM and IgA after intervention in the observation group were significantly higher than those in the control group (all P<0.05). Compared with those before management, the levels of Na+, K+ and lactic acid in the two groups were significantly decreased and the level of Ca+ was significantly increased after intervention. Compared with those after intervention in the control group, the patients in the observation group had significantly lower levels of Na+, K+ and lactic acid, and higher levels of Ca+ (all P<0.05). Compared with those before intervention, the scores of mental status, appetite, sleep quality, daily life and family understanding and cooperation in patients from the two groups after intervention were significantly higher. Compared with those after intervention in the control group, the patients in the observation group had significantly higher scores of life quality (P<0.05).

CONCLUSION

The county medical community HCH model has a good effect in the nutritional management of patients with advanced gastrointestinal cancer surgery. The HCH model can effectively improve the nutritional status, enhance the immune function, and increase the quality of life. Thus it is worthy of clinical application.

Application of hospital-community-family health education to family caregivers of nasal fed patients under the background of a regional medical association

BACKGROUND

Patients with nasogastric tube (NTG) nutrition after discharge still need to be transferred to community hospitals for continued care. Effective health education is conducive to raising the level of knowledge of caregivers to promote the rehabilitation of patients.

METHODS

Clinical data of 65 caregivers of stroke patients in Putuo Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2020 to December 2020 were retrospectively analyzed. These caregivers were divided into an observation group (33 cases, hospital-community-family education model) and a control group (32 cases, routine nursing health education). We used questionnaires to assess the knowledge, attitudes, and practice levels of caregivers before and after education, and recorded the occurrence of complications in patients within 12 weeks.

RESULTS

The scores of the knowledge questionnaire and practice questionnaire of caregivers in the observation group were higher than those in the control group at 2, 4 and 12 weeks after intervention (P<0.05). The scores of caregivers' attitudes questionnaire were higher in the observation group than in the control group at 4 and 12 weeks after intervention (P<0.05). But 2 weeks after intervention, there was no significant difference between the two groups (P>0.05). Within 12 weeks after intervention, the probability of complications in observation group was lower than that in the control group (P<0.05). Logistic regression analysis showed that the hospital-community-family health education helped the outcome.

CONCLUSION

For the main caregivers of NTG nutrition patients, the implementation of a hospital-community-family health education model based on regional medical consortium can improve the level of knowledge, attitude and practice of caregivers' NTG nutrition skills and reduce complications in patients.