Whole-process case management effects on mental state and self-care ability in patients with liver cancer

BACKGROUND

Regarding the incidence of malignant tumors in China, the incidence of liver cancer ranks fourth, second only to lung, gastric, and esophageal cancers. The case fatality rate ranks third after lung and cervical cancer. In a previous study, the whole-process management model was applied to patients with breast cancer, which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.

AIM

To explore Mental state and self-care ability in patients with liver cancer: effects of whole-process case management.

METHODS

In this single-center, randomized, controlled study, 60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group (n = 30), who received whole-process case management on the basis of routine nursing measures, and a control group (n = 30), who were given routine nursing measures. We compared differences between the two groups in terms of anxiety, depression, the level of hope, self-care ability, symptom distress, sleep quality, and quality of life.

RESULTS

Post-intervention, Hamilton anxiety scale, Hamilton depression scale, memory symptom assessment scale, and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention, and the observation group had lower scores than the control group (P < 0.05). Herth hope index, self-care ability assessment scale-revision in Chinese, and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention, with higher scores in the observation group compared with the control group (P < 0.05).

CONCLUSION

Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer, alleviate symptoms and problems, and improve the level of hope, self-care ability, sleep quality, and quality of life, as well as provide feasible nursing alternatives for patients with liver cancer.

[Application and Effect of Patient Portal System in the Remote Management of Chronic Diseases for Older Adults With Coronary Heart Disease]

Objective

To investigate the application of personal health record (PHR) and chronic disease management platform established on the basis of patient portal system (PPS) in managing older adults with coronary heart disease and to examine the effect on patients' self-care ability, coping mode, and quality of life.

Methods

A total of 532 elderly patients with coronary heart disease were included in the study. All the participants enrolled were admitted to a tertiary-care hospital between January 2019 and June 2021. They were randomly assigned to the study group (269 cases) and the control group (263 cases). Patients in the control group were discharged with the routine discharge procedures and received the routine follow-up care. On the other hand, patients in the study group were discharged and followed up through the PHR and chronic disease management platform established on the basis of PPS. After 6 months, 12 months, and 18 months of patient management, the Exercise of Self-Care Agency (ESCA) Scale, Medical Coping Modes Questionnaire (MCMQ) and Seattle Angina Questionnaire (SAQ) were used to evaluate the patients' self-care ability, coping mode, and quality of life, respectively. The patient management effects of the two groups were analyzed.

Results

Before the management programs started, there was no statistically significant difference in the scores for the scales between the two groups of patients. After 6 months, 12 months, and 18 months of patient management, the ESCA scores of both groups were higher than those before patient management started (P<0.05). Facing scores in the MCMQ of both groups were higher than those before patient management started (P<0.05), while the scores for avoidance and yielding were lower than those before patient management started (P<0.05). The SAQ scores of both groups were higher than those before patient management started (P<0.05). After 6 months, 12 months and 18 months of patient management, the ESCA scores of the study group were always higher compared with those of the control group (P<0.05). The facing score of the study group was higher, while the scores for avoidance and yielding were lower compared with those of the control group (P<0.05). The SAQ scores of the study group were higher compared with those of the control group (P<0.05). The medication compliance rate in the study group (83.27%) was higher than that in the control group (69.96%) (P<0.05). The incidence of adverse cardiovascular events in the study group (4.09%) was lower than that in the control group (10.27%) (P<0.05). The average times of emergency treatment and readmission in the study group were lower compared with those of the control group (P<0.05). The patient satisfaction score of the study group was higher compared with that of the control group (P<0.05).

Conclusion

The PHR and chronic disease management platform established on the basis of PPS can increase the convenient access to medical care among elderly patients with coronary heart disease, which is conducive to improving their self-care ability, coping mode, and quality of life. In addition, the patient management effect is good.

A randomized controlled study on systematic nursing care based on health empowerment theory and its effect on the self-care and functional abilities of patients with spinal fractures

OBJECTIVE

In this study, we aimed to explore the effectiveness of systematic nursing care based on health empowerment theory on the self-care and functional abilities of patients with spinal fractures.

METHODS

We selected a total of 50 patients with spinal fractures from our hospital and randomly divided them into the control group and the observation group, with 25 patients in each group. Patients in the control group received conventional nursing care, while those in the observation group received systematic nursing care grounded in the health empowerment theory. We recorded and compared the self-care ability, functional ability, knowledge about the condition, and pain scores of patients in the two groups before and after the nursing intervention.

RESULTS

There was no significant difference in the baseline characteristics between the two groups (P > 0.05), and there was no significant difference in self-care ability, functional ability, knowledge about the condition, or the visual analog scale (VAS) score between the two groups before treatment (P > 0.05). After treatment, outcomes in the observation group in terms of self-care ability, functional ability, and knowledge about the condition were significantly better than those in the control group (P < 0.05), while the VAS score in the observation group was significantly lower than that in the control group (P < 0.05).

CONCLUSION

Compared with conventional nursing care, patients with spinal fractures who received systematic nursing inputs based on health empowerment theory reported significant improvements in pain, self-care, functional ability, and knowledge of the condition, and this is an approach that is worthy of promotion in clinical use.

Pilot testing the impact of an aerobic exercise plus rehabilitation training on respiratory function in older adults with COPD

Chronic obstructive pulmonary disease (COPD) is a chronic intractable lung disease. To investigate the therapeutic effect, older adult patients were subjected to aerobic exercise and respiratory rehabilitation (diaphragmatic breathing) for six months. At the end of six-month intervention, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), 6-minute walking distance (6 MWD), and patient activation measure scores increased; St. George's respiratory questionnaire scores and disease impact score decreased; and PaCO₂ and PaO₂ were significantly improved in both groups, particularly in the experimental group. In addition, FEV1, FEV1/FVC, 6 MWD, blood gas levels, quality of life, and self-care ability in the experimental group were significantly improved compared with those in the control group, and the improvements were significantly greater in male, younger, and less diseased patients. Our study demonstrated that aerobic exercise combined with diaphragmatic breathing significantly improves respiratory function and quality of life in older adult patients.

Better nutrition trajectory improves recovery following a hip fracture surgery for older persons with diabetes mellitus

BACKGROUND

Influences of nutritional status on hip fractured persons with diabetes mellitus (DM) following surgery have not been reported.

AIMS

To explore the trajectory groups of nutritional status and their influences on post-operative recovery for older persons with hip fracture and DM.

METHODS

A total of 169 patients with DM and hip fracture from a clinical trial were included in this analysis. Mini Nutritional Assessment was used to assess the nutritional status of the participants. Outcome variables included self-care ability, muscle strength, depressive symptoms, health related quality of life, and cognitive function, which were collected before discharge and 1-, 3-, 6-, 12-, 18-, and 24-months following hospital discharge.

RESULTS

Among hip fractured older persons with DM, within two years following surgery there were three nutritional trajectory groups: malnourished (28.3%), at-risk of malnutrition (41.9%) and well-nourished (29.8%). A decline in nutritional status, especially for the malnourished group, was seen in the second year. A better nutritional trajectory was associated with better recovery outcomes, including self-care ability, health related quality of life, cognitive function and less depressive symptoms.

DISCUSSION

Close to 30% of hip fractured persons with DM were considered to have a malnourished trajectory over 2 years following surgery. A poor nutritional trajectory was associated with poor mental health and physical recovery.

CONCLUSIONS

Continuous nutrition assessment during the first 2 years following hip fracture surgery for older persons with DM is important. Development and implementation of interventions targeting the malnourished trajectory group are suggested.

Dynamic interaction nursing intervention on functional rehabilitation and self-care ability of patients after aneurysm surgery

BACKGROUND

Nursing practices based on the dynamic interaction model have been shown to be superior to generic nursing practices. However, whether this model is effective in patients recovering from intracranial aneurysm surgery is not well studied.

AIM

To investigate the effect of nursing based on a dynamic interaction model on functional rehabilitation of patients after aneurysm surgery.

METHODS

A total of 86 cases in our hospital with intracranial aneurysm from April 2019 to April 2021, were selected and divided into the study group and the control group, with 43 patients in each group. The control group received routine nursing, and the research group received nursing intervention based on a dynamic interaction model. The daily living ability (activities of daily living, ADL), cognitive function (Simple Intelligent Mental State Scale, MMSE), quality of life (Generic Quality of Life Inventory-74, GQOL-74), self-care ability (Exercise of Self-Care Agency scale), incidence of complications, and nursing satisfaction were recorded before and after intervention.

RESULTS

Before intervention, ADL (52.09 ± 6.44), MMSE (18.03 ± 4.11), and GQOL-74 (53.68 ± 4.34) scores in the study group were not significantly different from those in the control group (ADL: 50.97 ± 7.32, MMSE: 17.59 ± 3.82, GQOL-74: 55.06 ± 3.98) (P > 0.05). After intervention, ADL (86.12 ± 5.07), MMSE (26.64 ± 2.66), and GQOL-74 (83.13 ± 5.67) scores in the study group were higher than those in the control group (ADL: 79.81 ± 6.35, MMSE: 24.51 ± 3.00, and GQOL-74: 77.96 ± 6.27) (P < 0.05). Before intervention, self-concept (17.46 ± 4.44), self-care skills (25.22 ± 4.20), self-care knowledge (22.35 ± 4.74), and self-care responsibility (15.06 ± 3.29) scores in the study group was similar to those in the control group (self-concept: 16.89 ± 5.53, self-care skills: 24.59 ± 4.46, self-care knowledge: 21.80 ± 3.61, and self-care responsibility: 14.83 ± 3.11) (P > 0.05). After the intervention, self-concept (26.01 ± 3.18), self-care skills (37.68 ± 6.05), self-care knowledge (45.56 ± 5.83), and self-care responsibility (22.01 ± 3.77) scores in the study group were higher than those in the control group (self-concept: 22.97 ± 3.46, self-care skills: 33.02 ± 5.65, self-care skills knowledge: 36.81 ± 5.54, and self-care responsibility: 17.97 ± 3.56 points) (P < 0.05). The incidence of complications in the study group (4.65%) was lower than that in the control group (18.60%) (P < 0.05). Nursing satisfaction in the study group (95.35%) was higher than that in the control group (81.40%) (P < 0.05).

CONCLUSION

Nursing intervention based on a dynamic interaction model can improve postoperative cognitive function, daily living ability, self-care ability, quality of life, and patient satisfaction, while reducing the risk of complications.

Systematic nursing interventions in gastric cancer: A randomized controlled study

BACKGROUND

Scientific and effective nursing methods can effectively mitigate negative emotions in patients. Related studies have shown that systematic nursing interventions are beneficial in enhancing the self-efficacy and self-care abilities of patients and improving their physical and mental state, thereby alleviating their fatigue and improving their quality of life.

AIM

To explore the effects of systematic nursing intervention on cancer-related fatigue, self-efficacy, self-nursing ability, and quality of life in gastric cancer (GC) patients during the perioperative period.

METHODS

In this study, sample size was based on the multivariable scale. The sample size was 10 times the acceptable variable, with an additional 20% added to account for an expected loss of patients in follow-up for a final sample size of 168 patients. Conventional nursing measures were used in the control group, while the systematic nursing intervention Adopted Cancer Fatigue Scale (CFS), General Self-Efficacy Scale-Schwarzer (GSES), Self-Care Agency Scale (ESCA), and simple health scale (SF-36) were used in the observation group. The questionnaires were administered on admission and discharge.

RESULTS

At admission, there was no statistically significant difference in the scores on each scale between the groups. At discharge, the CFS and GSES scores in the observation group were 21.56 ± 2.24 and 51.16 ± 11.71, while those in the control group were 29.61 ± 3.48 and 41.58 ± 8.54, respectively, with statistically significant differences. The ESCA score in the observation and control groups was 112.09 ± 11.72 and 97.87 ± 9.26, respectively. Moreover, the scores in all dimensions (self-concept, self-responsibility, health knowledge level, and self-care skills) in the observation group were higher than those in the control group, with statistically significant differences. The SF-36 score in the observation and control groups was 75.51 ± 3.63 and 63.24 ± 3.41, respectively, with statistically significant differences. The scores in all dimensions (mental health, vitality, physical function, physical pain, social function, emotional function, and overall health level) in the observation group were higher than those in the control group, with statistically significant differences.

CONCLUSION

Systemic nursing intervention for GC patients during the perioperative period could alleviate cancer-related fatigue, improve self-efficacy and self-nursing ability, and improve quality of life, which all have clinical value.

Impact of TTM-oriented health promotion and education method based on WeChat platform on positive emotions, negative emotions, and self-care ability of patients with ulcerative colitis

BACKGROUND

Ulcerative colitis (UC) has a long course and is prone to recurring attacks, which affects the emotional state and quality of life of patients. Improving the disease awareness and self-care ability of UC patients has an important role in the prevention and treatment of UC. At present, the WeChat platform is commonly used clinically as a medium to carry out health education and education for discharged patients, but the content is mostly limited to basic nursing, and the effect of the education is not satisfactory.

AIM

To investigate the impact of WeChat platform-based health education method based on the transtheoretical model and stages of change (TTM) on the positive emotions, negative emotions, and self-care of patients with UC.

METHODS

A total of 63 UC patients admitted to our hospital between January 2019 and February 2020 were selected and divided into a control group of 31 cases and an observation group of 32 cases according to the random number table method. In the control group, the WeChat platform was used for regular health education, and the WeChat platform-based TTM-oriented health education method was used in the observation group. The scores of positive and negative emotions, self-care ability, quality of life, bloody stool, and recurrence were compared between the two groups before intervention and 24 wk after intervention.

RESULTS

After the intervention, the positive emotion scores of the two groups increased, while the negative emotion scores decreased. The positive emotion scores were higher and the negative emotion scores were lower in the observation group than in the control group (P < 0.05). After the intervention, the total score and scores of all dimensions of the Self-Care Ability Scale (ESCA) increased in both groups; the increases in the observation group were higher than those of the control group (P < 0.05). The total score and scores of all dimensions of inflammatory bowel disease quality of life questionnaire (IBDQ) increased in both groups after intervention; and the increases in the observation group were higher than those of the control group (P < 0.05). The bloody stool recurrence rate (6.25% vs 29.03%) and UC recurrence rate (0 vs 22.58%) in the observation group within 24 wk were lower than those of the control group, and the times to bloodless stool recurrence and UC recurrence were longer than those of the control group (P < 0.05).

CONCLUSION

The TTM-oriented health education method based on the WeChat platform can enhance the positive emotions, reduce the negative emotions, improve the self-care ability, improve the quality of life, and reduce the risk of recurrence in UC patients.

Supporting health literacy using an interactive app for symptom management during radiotherapy for prostate cancer

OBJECTIVE

Patients' ability to self-monitor symptoms and engage in self-care activities is dependent upon their level of health literacy. Health literacy and self-care ability was compared in men with prostate cancer undergoing radiotherapy that used an app for symptom management with a control group.

METHODS

Included were an intervention group (n = 66), who used an app for symptom reporting and support for self-care, and a control group (n = 64). Outcomes were Functional Health Literacy, Communicative and Critical Health Literacy and Appraisal of Self-Care Agency (ASA-A).

RESULTS

The intervention group had improved regarding "ability to select information needed from a variety of information sources" (p = .020), "ability to determine the information credible" (p = .041), and "being able to plan and decide what to do to improve health" (p = .004). No inter-group difference was found for ASA-A.

CONCLUSIONS

With the support of an app for reporting and managing symptoms, important advanced health literacy skills of selecting, determining, and judging information credible may improve.

PRACTICE IMPLICATIONS

Patients undergoing treatment for prostate cancer may benefit from an individualized approach, such as an app, for communication with health care providers and as a source of health information to make decisions about their own health.

The mediating role of perceived stress on the relationship between perceived social support and self-care ability among Chinese enterostomy patients

PURPOSE

Enterostomy patients were exposed to various stressors, and self-care ability played an important role in their daily lives. This study aimed to examine the relationship between perceived social support and self-care ability among Chinese enterostomy patients and to explore whether perceived stress mediated this relationship.

METHODS

A sample of 410 enterostomy patients aged 59.68 ± 12.95 years old were recruited in the study. Participants completed a set of questionnaires including demographics, perceived stress scale, perceived social support scale, and ostomy self-care ability scale.

RESULTS

A total of 392 valid questionnaires were finally used in the data analyses among 410 questionnaires; the effective response rate was 95.6%. Results demonstrated that the scores of perceived social support were positively correlated with scores of self-care ability scores and negatively with perceived stress scores. And the effect of perceived social support on self-care ability was partially mediated by perceived stress (51.53%).

CONCLUSIONS

This study explained the mediating model that connects perceived social support with self-care ability through perceived stress, which enhances our understanding about the mediating role of perceived stress. Thus, when focusing on the self-care ability of enterostomy patients, perceived stress was as important as perceived social support.

Psychometric properties of the Iranian version of self-care ability scale for the elderly

BACKGROUND

Measuring self-care ability in elderly people needs specific instruments. The Self-care Ability Scale for Elderly (SASE) is one of the common instruments used for assessing self-care ability. The aim of this study was to assess the psychometric properties of the SASE among Iranian elderly population.

METHODS

This cross-cultural adaptation study was carried out at Shahid Chamran and Shadpour Health Complex in Tabriz, Iran. The forward-backward procedure was applied to translate the SASE from English into Persian. Then, it was completed to 220 elderly people. A systematic random sampling method was used for sampling. Content validity was calculated through modified Kappa coefficient (modified CVI) based on clarity and relevance criteria. Reliability was measured by internal consistency and test-retest analysis. The construct validity also was assessed using Exploratory Factor Analysis (EFA). All the statistical analyses were performed using SPSS 21 statistical software package.

RESULTS

The mean of self-care ability was 61.14 ± 21.08. The CVI and modified kappa were 0.91 and 0.92 for relevance and clarity, respectively. The Cronbach's alpha coefficient was 0.73 and Intra-class correlation coefficient was 0.97. The results of EFA revealed a three-factor solution ('ability to take care of personal responsibility', 'ability to take care for the goals', and 'ability to take care of the health') that jointly explained for 64.61% of the total variance.

CONCLUSION

Results of the study showed that the Iranian version of the SASE has good psychometric properties and can be used in assessing the self-care ability of elderly people.

Stereotactic body radiotherapy for elderly patients (≥ 75 years) with early-stage non-small cell lung cancer

PURPOSE

Stereotactic body radiotherapy (SBRT) is the primary treatment method for early-stage non-small cell lung cancer (NSCLC) considered inoperable due to medical comorbidities. However, the application of SBRT in patients aged ≥ 75 years has not been adequately studied. This retrospective study aimed to investigate the effectiveness and safety of SBRT in early-stage NSCLC patients aged ≥ 75 years, and the impact of treatment on nutritional status and self-care ability.

METHODS

Histopathologically confirmed early-stage (T1-3N0M0) NSCLC patients aged ≥ 75 years treated with SBRT between 2013 and 2018 at our center were identified from the electronic database. Treatment efficacy, treatment toxicities, impact of treatment on nutritional status, and self-care ability were retrospectively analyzed. Toxicities were evaluated according to the Common Terminology Criteria for Adverse Event (CTCAE) (Common 2010) version 4.0. Nutritional status was assessed by Nutritional Risk Screening 2002 criteria, and self-care ability by Barthel index and fall risk index.

RESULTS

A total of 68 patients were enrolled. Median follow-up duration was 46.3 (3.9-80.1) months. The 1-, 3-, and 5-year overall survival rates were 92.6%, 77.2%, and 59.1%, respectively, and the 1-year, 3-year and 5-year local control rates were 95.6%, 88.9% and 85.6%, respectively. Grade 1-2 and grade 3 radiation pneumonitis occurred in 60/68 (96.8%) and 1/68 (1.5%) patients, respectively. Fall risk at 3 months after treatment was not significantly different from that before treatment (P = 0.22). Barthel index increased significantly after treatment (P < 0.001).

CONCLUSIONS

SBRT appears to be effective and safe for NSCLC patients aged ≥ 75 years, with no adverse impact on nutritional status and self-care ability.

Diabetic neuropathies influence recovery from hip-fracture surgery in older persons with diabetes

BACKGROUND/OBJECTIVES

To explore the impact of diabetic peripheral neuropathy (DPN) on the recovery of older persons with diabetes mellitus (DM) after hip-fracture surgery.

DESIGN, SETTING, PARTICIPANTS

Secondary data for this study came from a clinical trial on the effectiveness of a DM-specific care model for 176 older persons (age ≥ 60) with DM over 2 years following hip-fracture surgery at a medical center in Taiwan. In the original trial, the experimental group (n = 88) received DM-specific care comprising diabetes care plus subacute care, and the control group (n = 88) received only usual care.

MEASUREMENTS

DPN was assessed using the Michigan Neuropathy Screening Instrument. Outcomes of self-care ability in activities of daily living (ADL), health-related quality of life (HRQoL), and depressive symptoms were assessed 1, 3, 6, 12, 18, 24 months following hospital discharge using the Chinese Barthel Index and Chinese-version instrumental ADL (IADL) scale; the SF-36 Taiwan version; and the Chinese-version Geriatric Depression Scale, short form, respectively.

RESULTS

After controlling for covariates, participants with DPN had 8.38 fewer points in ADL performance, 0.49 fewer points in IADL performance, and 2.33 fewer points in the physical component summary (PCS) of HRQoL than participants without DPN at 3 months following discharge. During the first year following discharge, the rate of improvement increased less for PCS (β = -0.45, p < 0.05), but more for the mental component summary (β = 0.49, p < 0.05) for those with DPN than for those without. During the second year, the rate of decline in physical function-related HRQoL increased slightly more for those with DPN than for those without (β = 0.03, p < 0.05).

CONCLUSION

DPN adversely affected ADL performance, IADL performance, and physical function-related health outcomes for older persons recovering from hip-fracture surgery. These results suggest that older patients with DM recovering from hip-fracture surgery should be assessed and managed for DPN.

Self-care Ability of Older People Living in Urban Areas of Northwestern Iran

BACKGROUND

Self-care ability was considered as a mechanism to improve the quality of life and reducing the high costs of medical services for elder people. Iran is experiencing increased elder people and healthy aging is one of the challenges. This study aimed to investigate self-care ability of elder people in Shahid Chamran and Dr. Shadpour health complexes, Tabriz- Iran.

METHODS

This was a cross-sectional study done in 2015. "The Self-care Ability Scale for the Elderly (SASE)" valid and reliable questionnaire (Persian version) was used for data collection. Totally, 220 samples were selected using G-Power 3.1.5 software. Sampling was conducted through systematic random method. Data were analyzed using SPSS 21 software. Descriptive statistics and independent t-test, one-way ANOVA, Mann-Whitney, Kruskal-Wallis test and Kolmogorov-Smirnov test were used.

RESULTS

The mean of self-care ability in elder people was calculated as 56.69± 15.07 (out of 100). 96.8% of participating elderlies, had poor self-care ability. Significant relations were found between elder people self-care ability and their educational level, life status, employment status, and marital status (P<0.05). However, gender, income source, and insurance status had no relations with self-care ability of the elder people (P>0.05).

CONCLUSION

Self-care ability of elder people in Tabriz was at weak level. Regarding, health providers must employ the programs to promote older people self-care ability including improving self-esteem, receiving family help, improved nutrition and mental health improving elderly's quality of life.

Effect of continuity nursing on wound healing, complications, and self-care ability in patients after gastrointestinal surgery for colorectal cancer

AIM

To evaluate the influence of continuity nursing on self-care ability, complications, and wound healing in patients with colorectal stoma after gastrointestinal surgery.

METHODS

We selected 120 patients who were diagnosed with colorectal cancer and underwent Miles surgery from May 2016 to May 2017 at Traditional Chinese Medicine Hospital of Zhuji City. These patients were randomly divided into an observation group and a control group, with 60 cases in each group. Both groups were given routine nursing care, and the observation group was additionally given continuity nursing care. The ESCA self-care scale was used to evaluate the self-care ability of patients in the two groups, the QLO-C30 life scale was used to score the daily life, and postoperative complications and stoma healing were also evaluated.

RESULTS

The self-care ability scores were significantly better in male patients than in females (P < 0.05), and self-care ability did not correlate with living conditions (P > 0.05). The self-concept, self-care, responsibility, self-care skills, health knowledge, and ESCA score of the observation group were significantly better than those of the control group at 4.5 mo after the operation (P < 0.01). In the control group, the incidence of complications such as stoma edema, stoma stenosis, stoma loss, and dermatitis around the stoma was significantly higher in the control group than in the observation group (P < 0.05). The scores of cognitive function, role function, physical function, and social function of the observation group were significantly higher than those of the control group at 4.5 mo after the operation (P < 0.01).

CONCLUSION

Continuity nursing care can effectively improve the self-care ability, reduce the incidence of postoperative complications, and improve quality of daily life in patients after Miles colostomy for colorectal cancer.

Effect of high quality nursing combined with hyperbaric oxygen therapy on self-care ability and survival in patients with Helicobacter pylori positive peptic ulcer

AIM

To investigate the effect of high quality nursing combined with hyperbaric oxygen therapy on the self-nursing ability and survival status in patients with Helicobacter pylori (H. pylori) positive peptic ulcer.

METHODS

A total of 92 patients with H. pylori positive peptic ulcer treated from October 2015 to August 2017 at our hospital were selected and randomly divided into a control group (n = 46) and a study group (n = 46). Both groups were treated with omeprazole + amoxicillin + bismuth citrate potassium + levofloxacin. On this basis, both groups were treated with hyperbaric oxygen + routine nursing, and the study group was additionally treated with high quality nursing. The intervention lasted 4 wk in both groups. Clinical efficacy, time to ulcer healing, length of hospitalization, self-nursing ability (ESCA), survival status (NHP), and satisfaction with nursing care were compared between the two groups.

RESULTS

The total effective rate of the study group (93.48%) was higher than that of the control group (76.09%; P < 0.05). The time to ulcer healing and length of hospitalization in the study group were significantly shorter than those of the control group (P < 0.05). After intervention, the ESCA scores were higher and the NHP scores were lower than those before intervention in both groups, and the changes in ESCA and NHP scores were more significant in the study group than in the control group (P < 0.05). The rate of satisfaction with nursing was significantly higher in the study group than in the control group (95.65% vs 78.26%, P < 0.05).

CONCLUSION

High quality nursing combined with hyperbaric oxygen therapy can promote ulcer healing, shorten hospitalization time, improve the patients' self-care ability and survival status, and increase patients' satisfaction with nursing in patients with Helicobacter pylori positive peptic ulcer.

A survey of outcomes and management of patients post fragility fractures in China

We found that the fragility hip and vertebral fractures caused excess mortality rates in this Chinese female population, which was unexpectedly lower than those in western countries and other Asian countries. This was the first nationwide survey relating to post-fracture outcomes conducted among Chinese population in Mainland China.

INTRODUCTION

This study aimed to investigate the mortality, self-care ability, diagnosis, and medication treatment of osteoporosis following fragility hip and vertebral fractures through a nationwide survey among female patients aged over 50 in Mainland China.

METHODS

This was a multicenter, retrospective cohort study based on medical chart review and patient questionnaire. Female patients aged 50 or older admitted for low-trauma hip or vertebral fractures and discharged from Jan 1, 2008 to Dec 31, 2012 were followed.

RESULTS

Total of 1151 subjects of hip fracture and 842 subjects of vertebral fracture were included. The mean age was 73.4 ± 10.0, and the median of duration from index fracture to interview was 2.6 years. The overall 1-year, 2-year, 3-year, 4-year, and 5-year cumulative mortality rates were 3.5, 7.0, 11.2, 13.1, and 16.9 %, respectively. The first year mortality rates in hip (3.8 %, 95% CI 3.3-4.4 %) and vertebral fracture (3.1 %, 95% CI 2.5-3.7 %) were significantly higher than that in the general population (1.6 %). Impaired self-care ability was observed in 33.2, 40.6, and 23.8 % of overall, hip fracture, and vertebral fracture group, respectively. The overall diagnosis rate of osteoporosis was 56.8 %, and bone mineral density (BMD) measurement had never been conducted in 42.0 % among these women. After the index fracture, 69.6 % of them received supplements and/or anti-osteoporotic medications, among which 39.6 % only received calcium with/without vitamin D supplementation.

CONCLUSIONS

The osteoporotic hip and vertebral fractures caused excess mortality rates in this population of Mainland China. The current diagnosis and medical treatment following the fragility fractures is still insufficient in Mainland China.

Effect of nursing intervention on mental and physical health in patients with rectal cancer after Miles operation

AIM: To explore the effect of nursing intervention on mental and physical health in patients with rectal cancer after Miles operation.

METHODS: One hundred and six patients with rectal cancer were randomly divided into two groups. The control group received routine nursing intervention, and the experiment group received comprehensive nursing intervention on the basis of routine nursing intervention. Three and six months after discharge, patients were assessed using the exercise of self-care agency (ESCA) scale and the symptom checklist 90 scale.

RESULTS: The scores of ESCA, self-care skills, self-nursing responsibility, self-concept and the scores of health knowledge in the two groups were significantly higher at 6 mo after discharge than at 3 mo (experiment group: 127.71 ± 14.17 vs 96.01 ± 13.33, 33.99 ± 3.66 vs 26.98 ± 4.11, 21.96 ± 3.68 vs 17.89 ± 3.12, 25.65 ± 3.71 vs 18.63 ± 4.20, 35.09 ± 7.58 vs 30.95 ± 5.39; control group: 121.06 ± 11.27 vs 91.30 ± 10.18, 29.86 ± 2.13 vs 21.09 ± 3.16, 18.96 ± 2.00 vs 14.73 ± 2.09, 21.96 ± 4.15 vs 16.38 ± 3.03, 31.94 ± 4.79 vs 26.33 ± 4.05, P < 0.05 for all); these parameters at 3 and 6 mo were significantly higher in the experiment group than in the control group (P < 0.05 for all). The scores of somatization, obsessive-compulsive symptoms, interpersonal relationship, depression, anxiety, sensitivity, terror, bigotry and psychotic symptom in the two groups were significantly lower at 6 mo after discharge than at 3 mo (experiment group: 1.48 ± 0.45 vs 3.32 ± 0.47, 1.54 ± 0.59 vs 3.05 ± 0.52, 1.38 ± 0.77 vs 2.92 ± 0.75, 1.57 ± 0.46 vs 3.06 ± 0.48, 1.44 ± 0.52 vs 2.95 ± 0.66, 1.29 ± 0.51 vs 2.49 ± 0.50, 1.20 ± 0.53 vs 2.74 ± 0.55, 1.38 ± 0.41 vs 2.66 ± 0.44, 1.28 ± 0.42 vs 2.71 ± 0.47; control group: 1.86 ± 0.28 vs 4.34 ± 0.43, 1.98 ± 0.56 vs 4.05 ± 0.49, 1.68 ± 0.66 vs 3.91 ± 0.68, 2.07 ± 0.62 vs 4.03 ± 0.57, 2.03 ± 0.73 vs 3.94 ± 0.69, 1.67 ± 0.47 vs 3.47 ± 0.48, 1.64 ± 0.45 vs 3.72 ± 0.46, 1.59 ± 0.56 vs 3.67 ± 0.59, 1.68 ± 0.36 vs 3.72 ± 0.38, P < 0.05 for all); these scores at 3 and 6 mo were significantly lower in the experiment group than in the control group (P < 0.05 for all).

CONCLUSION: Comprehensive nursing intervention can improve self-care skills and mental and physical health in patients with rectal cancer after Miles operation.