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Zhang L, Shen T, Zhou Y, Xie X, Wang J, Gao H. Multidisciplinary management based on clinical nursing pathway model for the treatment of hypertensive intracerebral hemorrhage: A randomized controlled trial. Medicine (Baltimore) 2024; 103:e37644. [PMID: 38517993 PMCID: PMC10956948 DOI: 10.1097/md.0000000000037644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/23/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVE To explore the effectiveness of multidisciplinary management based on a clinical nursing pathway model for the treatment of hypertensive intracerebral hemorrhage (HICH). METHODS A total of 124 patients with HICH admitted to our hospital between February 2021 and June 2023 were selected as research subjects in this randomized, controlled, unblinded study. They were divided into Control-group and Study-group using a random number table method, with 62 cases in each group. The Control-group received routine care and the Study-group adopted a multidisciplinary management approach based on the clinical nursing pathway model. A multidisciplinary intervention group including 1 attending physician, 1 psychotherapist, 1 nutritionist, 1 rehabilitation specialist, and 4 responsible nurses was constructed. From preoperative to postoperative day, patients were provided with psychological intervention, health education, respiratory tract management, and specific care for patients who were restless. One to 3 days after operation, the patients and their family members were guided in basic postoperative care and nutrition care. From the 4th day after surgery to the 1st day before discharge, patients were guided for rehabilitation exercises. Patients also received discharge advices upon discharge. Activities of daily living, neurological function, stress response indicators, incidence of complications, and nursing satisfaction before and after the intervention were compared between the 2 groups. RESULTS After the intervention, the activities of daily living and neurological function of the 2 groups were significantly improved compared to before the intervention, and the Study-group was significantly higher than the Control-group (P < .05). After intervention, the levels of stress response indicators in both groups significantly decreased compared to before the intervention, and the Study-group was significantly lower than the Control-group (P < .05). The incidence of complications in the Study-group (3.23%) was lower than that in the Control-group (15.00%) (P < .05). Nursing satisfaction in the Study-group (95.16%) was higher than that in the Control-group (83.33%) (P < .05). CONCLUSIONS Our findings indicate that adopting a multidisciplinary management approach based on clinical nursing pathways to intervene in patients with HICH can reduce stress response levels, reduce the risk of complications, and facilitate the recovery of neurological function and activities of daily living with high patient satisfaction.
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Affiliation(s)
- Lan Zhang
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Tingting Shen
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Yan Zhou
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Xing Xie
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Jing Wang
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
| | - Haixiao Gao
- Department of Neurosurgery Ward 3, Xingtai Third Hospital, Xingtai Cardiovascular Disease Hospital, Xingtai City, Hebei Province, China
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Jin P, Jiang W, Bao Q, Wei W, Jiang W. Predictive nomogram for soft robotic hand rehabilitation of patients with intracerebral hemorrhage. BMC Neurol 2022; 22:334. [PMID: 36068493 PMCID: PMC9446740 DOI: 10.1186/s12883-022-02864-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/31/2022] [Indexed: 11/20/2022] Open
Abstract
Background Few studies focused on the risk factors for hand rehabilitation of intracerebral hemorrhage (ICH) using of soft robotic hand therapy (SRHT). The aim of this study was to establish a predictive nomogram for soft robotic hand rehabilitation in patients with ICH. Methods According to the Brunnstrom motor recovery (BMR) stage, the patients were grouped into poor and good motor function groups. The data of patient demographic information and serum level of C-terminal Agrin Fragment (CAF), S100B and neurofilament light (NfL) were collected. The logistic regression was used to analyze the risk factors for poor hand function. Results Finally, we enrolled 102 and 103 patients in the control and SRHT groups. For the SRHT group, there were 17 and 86 cases with poor and good motor function at 6-months follow-up respectively. In the good motor function group, the Fugl-Meyer Assessment-Wrist and Hand (FMA-WH score) and BMR score at admission were all better than that in the poor motor function group respectively (p < 0.001). The mean serum level of CAF, S100B and NfL in the good motor function group were 2.5 ± 0.82 ng/mL, 286.6 ± 236.4 ng/L and 12.1 ± 10.4 pg/mL respectively, which were lower than that in the poor motor function group (p < 0.001, Table 3). The multivariate logistic regression showed that hematoma volume (OR = 1.47, p = 0.007), FMA-WH score admission (OR = 0.78, p = 0.02), S100B (OR = 1.32, p = 0.04), and NfL (OR = 1.24, p = 0.003) were all significant predictors of poor motor function. Conclusions We found that Soft robotic hands therapy benefited in hand function in patients with ICH and hematoma volume, FMA-WH score admission, S100B, and NfL were all significant predictors for poor motor function of patients with ICH.
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Affiliation(s)
- Peng Jin
- Department of Neurosurgery, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213017, Jiangsu, China.,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Wei Jiang
- Department of Neurosurgery, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213017, Jiangsu, China.,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Qing Bao
- Department of Neurosurgery, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213017, Jiangsu, China.,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Wenfeng Wei
- Department of Neurosurgery, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213017, Jiangsu, China.,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu, China
| | - Wenqing Jiang
- Department of Neurosurgery, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213017, Jiangsu, China. .,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu, China.
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Observation on the Effect of Solution-Focused Approach Combined with Family Involvement in WeChat Platform Management on Inpatients with Intracerebral Hemorrhage. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:9951374. [PMID: 35345652 PMCID: PMC8957417 DOI: 10.1155/2022/9951374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 11/17/2022]
Abstract
Objective. To explore the effect of the solution-focused approach combined with family involvement in the WeChat platform management on inpatients with intracerebral hemorrhage (ICH). Methods. A total of 80 ICH patients hospitalized in our hospital from June 2018 to June 2021 were split into the control group (CG) and the study group (SG) according to the clinical nursing modes, with 40 cases in each group. Both groups received routine intervention, while SG additionally received the solution-focused approach combined with family involvement in the WeChat platform management to compare the self-care ability, psychological status, and hope levels between the two groups after intervention. Results. No significant differences in general data were observed between the two groups (
). The SAS and SDS scores before intervention showed mild depression and anxiety in both groups, which improved after intervention. In addition, the SAS and SDS scores after intervention were remarkably lower in SG than in CG (
). After intervention, the scores of ICH-related knowledge, self-care skills, self-care responsibility, and rehabilitation knowledge in SG were notably higher compared with CG (
). After intervention, the Herth scores of both groups increased, with a higher score in SG than in CG (
). After intervention, SG had higher quality of life (QOL) scores in general health, physiological function, physiological role, body pain, vitality, social function, emotional role, and physiological health than CG (
). Conclusion. The implementation of the solution-focused approach combined with family involvement in the WeChat platform management for ICH inpatients can effectively improve their psychological status, enhance their self-care ability and hope levels, promote body recovery, and improve their QOL after intervention.
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Wang H, Liu Y, Shen J, Du T. Personalized nursing improves physical condition and life quality of patients undergoing interventional therapy for liver cancer. Am J Transl Res 2021; 13:14220-14228. [PMID: 35035768 PMCID: PMC8748081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/12/2021] [Indexed: 06/14/2023]
Abstract
Interventional therapy, which can prolong the survival of patients with liver cancer (LC), is an important means to treat the disease. During interventional therapy for LC, it is essential to make a targeted and detailed nursing plan to ameliorate the prognosis. The purpose of this study was to determine the application significance of personalized nursing in patients undergoing interventional therapy for LC. We retrospectively analyzed 136 patients with LC undergoing interventional therapy. Among them, 70 cases receiving personalized nursing were assigned to the observation group (OG), and the remaining 66 cases receiving routine nursing were the control group (CG). After nursing, sleep time of patients in the OG was significantly longer than that in CG. In addition, time to ambulation and hospital stay were shorter in the OG than in the CG. Furthermore, the OG exhibited significantly lower scores of visual analogue scale (VAS) and self-rating anxiety scale (SAS), as well as significantly reduced incidence of adverse reactions than the CG. Compared with the CG, the levels of serum alanine aminotransferase (AST), aspartate aminotransferase (ALT), and total bilirubin (TBIL) were significantly lower in the OG after nursing, while the level of albumin (ALB) was significantly increased. Moreover, patients in the OG showed significantly higher nursing satisfaction and quality of life scores than those in the CG. Therefore, personalized nursing has good prospects for usein interventional therapy for LC.
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Affiliation(s)
- Hui Wang
- Department of Interventional Therapy, Shanxi Provincial People's Hospital Taiyuan 030012, Shanxi Province, China
| | - Yu'e Liu
- Department of Interventional Therapy, Shanxi Provincial People's Hospital Taiyuan 030012, Shanxi Province, China
| | - Jing Shen
- Department of Interventional Therapy, Shanxi Provincial People's Hospital Taiyuan 030012, Shanxi Province, China
| | - Tian Du
- Department of Interventional Therapy, Shanxi Provincial People's Hospital Taiyuan 030012, Shanxi Province, China
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Zhao Z, Tian Q, Zhang B. Effects of rehabilitation nursing care on deep vein thrombosis of the lower limbs following spinal fractures. Am J Transl Res 2021; 13:1877-1883. [PMID: 33841714 PMCID: PMC8014431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the preventive effect of rehabilitation nursing care for deep vein thrombosis (DVT) of the lower limbs following spinal fractures, and to analyze its influence on the hemorheology of patients. METHODS A total of 99 patients with spinal fractures were allocated into a study group (n=50) and control group (n=49), and they were treated with internal fixation plus vertebroplasty. Afterwards, patients in the control group were given routine care and postoperative rehabilitation, and those in the study group received rehabilitation nursing care on the day after surgery, including posture guidance, massage of both lower limbs, and functional training. The functional training was consecutively performed until free movement of the legs was possible. All patients were reexamined after three months. The incidence of low-limb DVT, pain, and swelling, as well as the degree of swelling, hemorheology, quality of life, and patient satisfaction were compared between the two groups. RESULTS The study group had less frequent low-limb DVT, pain and swelling than the control group (all P<0.05). In the study group, the degree of swelling was significantly reduced, with earlier return to normal activity and shorter hospital stay (all P<0.05). After intervention, plasma viscosity, whole blood low/high shear viscosity and erythrocyte aggregation (EA) decreased in both groups, especially in the study group (all P<0.05). Although GQOL-74 scores increased in both groups, there was a more significant increase that occurred in study group (all P<0.001). Patients in the study group were more satisfied with nursing services than those in the control group (P<0.05). CONCLUSION Rehabilitation nursing care contributes to the improvement of hypercoagulable states and the prevention of lower-limb DVT for surgically treated patients with spinal fractures, and it is effective in relieving pain and swelling of the lower limbs, thereby enhancing quality of life and patient satisfaction.
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Affiliation(s)
- Zhijuan Zhao
- Department of Rehabilitation Medicine, Linyi Central Hospital Linyi, Shandong Province, China
| | - Qifeng Tian
- Department of Rehabilitation Medicine, Linyi Central Hospital Linyi, Shandong Province, China
| | - Benyan Zhang
- Department of Rehabilitation Medicine, Linyi Central Hospital Linyi, Shandong Province, China
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