摘要:目的： 探討肝癌患者行射頻消融術圍手術期的肝功能變化情況,以及相應的護理措施。方法:對2006～2009年6月在我院接受射頻消融術治療的91例肝癌患者,監測其圍手術期的肝功能指標,如丙氨酸氨基轉移酶及總膽紅素等變化情況,分析射頻消融術對肝功能的影響,總結相應的護理措施。 結果:全組無死亡病例。射頻消融術后早期丙氨酸氨基轉移酶及總膽紅素與術前有顯著差異（P＜005）。結論: 肝癌患者行射頻消融術后早期肝功能減退,應加強護理措施,促進患者恢復。 Abstract: Objective: To explore the influence of radiofrequency ablation (RFA) on hepatic function of patients suffering hepatocelluler carcinoma and to summarize corresponding nursing measures.Methods: Ninetyone patients suffering hepatocelluler carcinoma received RFA were studied with their hepatic function preoperation and postoperation. Alanine aminotransferase (ALT) and total bilirubin (TB) were selected as the liver functional parameters,and perioperative changes of the two parameters were measured. Influence of RFA on hepatic function was analyzed and corresponding nursing measures were summarized. Results: Significant changes of ALT and TB were observed early after RFA,and there were statistical difference between preoperation and postoperation (P＜005). Conclusion: Proper nursing measures should be applied to improve hypohepatia and promote recovery of patients.
Objective To define the attributes and priorities of evidence-based nursing curriculum needs of nursing students, so as to provide operational reference for the design and development of evidence-based nursing course in the future. Methods Questionnaire was designed based on Kano model, and convenient sampling method was adopted to investigate the nursing students who had received training or had experience in evidence-based nursing from September to November 2020. According to the Kano model attribute classification method, the need attribute of evidence-based nursing curriculum was defined. Results A total of 303 nursing students were investigated. Kano model analysis showed that 11 of the needs for evidence-based nursing courses were one-dimensional quality, which belonged to the dimension of teaching resources and teaching content, and 5 were indifference quality, which belonged to the course assessment dimension. The importance-satisfaction matrix showed that the need of evidence-based nursing curriculum was concentrated in the advantage area and minor excepting improvement area. Conclusions In the future curriculum design, evidence-based nursing teachers need to continue to maintain the demand items in the advantage area and constantly improve and perfect them. They also need to pay more attention to the demand items in the minor excepting improvement area. Combined with the current problems in evidence-based nursing practice and the evidence-based needs of students, teachers need to further put forward suggestions on evidence-based nursing curriculum.
Objectives To establish the quality criteria for clinical nursing practice guidelines in China. Methods Two focus groups’ interviews for 26 clinical nursing experts and methodological experts from China were adopted to build the quality criteria for clinical nursing practice guidelines. Results The quality criteria for clinical nursing practice guidelines in China covered 5 domains and 15 items, which included scientificity/rigor, effectiveness/safety, economy, availability/feasibility, and conflict of interest. All items were from 0 to 5 scale and weighted 0.5 to 2 based on their contributions to the quality of guidelines. Conclusions The quality criteria for clinical nursing practice guidelines adopt the same framework with the quality criteria of guidelines in medical field and also integrate features of nursing. It provides the quality standard for Chinese clinical nursing practice guidelines.
Objective To explore the effect of the feed-forward control on safety nursing of ophthalmologic day surgery patients under general anesthesia. Methods A total of 623 ophthalmologic day surgery patients under general anesthesia were retrospectively selected into the control group, who adapted the routine nursing in the Ophthalmic Day Surgery Center from January to December 2015; a total of 1 210 ophthalmologic day surgery patients under general anesthesia were retrospectively selected into the observation group, who received the feed-forward control of nursing safety management on the basis of routine nursing care from January to December 2016. The incidence rate of the adverse events and potential safety hazards and satisfaction rate were compared between the two groups. Results The incidence rate of the adverse events and potential safety hazards in the observation group (0.83%, 10/1 210) was lower than that in the control group (3.37%, 21/623), the satisfaction rate in the observation group (98.67%) was higher than that in the control group (97.11%), and the differences were statistically significant (P<0.05). Conclusion The application of feed-forward control in the safety care of patients during the ophthalmologic day surgery under general anesthesia can effectively reduce the incidence of adverse events and potential safety hazards, and ensure the safety of medical care.
ObjectiveTo investigate the effect of evidence-based nursing course in undergraduate nursing students' critical thinking ability. MethodsA prospective cohort study design was performed in students from two nursing undergraduate classes, who elected evidence-based nursing course as an observation group and students lacked of the course as a control group. The Chinese Version of Critical Thinking Disposition Inventory (CTDI-CV) was used to test critical thinking ability at the beginning and the end of the semester. The scores of CTDI-CV and rank of scores were compared between the two groups using t test and rank sum test. ResultsA total of 88 students were included, of which 41 students were in the observation group and 47 students were in the control group. Compared to the control group, the observation group demonstrated significantly more improvement in the total scores (MD=22.29, 95%CI 13.477 to 31.114), the search for truth (MD=2.81, 95%CI 0.211 to 5.410), open-minded (MD=3.37, 95%CI 1.280 to 5.471), analysis capabilities (MD=3.41, 95%CI 1.351 to 5.481), systematicity (MD=3.39, 95%CI 1.447 to 5.336), confidence critical thinking (MD=2.83, 95%CI 0.512 to 5.152), curiosity (MD=4.53, 95%CI 2.273 to 6.786) and cognitive maturity (MD=1.93, 95%CI -0.502 to 4.377). The level of total scores, the search for truth, analysis capabilities, systematicty, confidence critical thinking, and curiosity in the observation group were significantly improved. ConclusionEvidence-based nursing course learning can improve the undergraduate nursing students' critical thinking skill.
Exoskeleton nursing robot is a typical human-machine co-drive system. To full play the subjective control and action orientation of human, it is necessary to comprehensively analyze exoskeleton wearer’s surface electromyography (EMG) in the process of moving patients, especially identifying the spatial distribution and internal relationship of the EMG information. Aiming at the location of electrodes and internal relation between EMG channels, the complex muscle system at the upper limb was abstracted as a muscle functional network. Firstly, the correlation characteristics were analyzed among EMG channels of the upper limb using the mutual information method, so that the muscle function network was established. Secondly, by calculating the characteristic index of network node, the features of muscle function network were analyzed for different movements. Finally, the node contraction method was applied to determine the key muscle group that reflected the intention of wearer’s movement, and the characteristics of muscle function network were analyzed in each stage of moving patients. Experimental results showed that the location of the myoelectric collection could be determined quickly and efficiently, and also various stages of the moving process could effectively be distinguished using the muscle functional network with the key muscle groups. This study provides new ideas and methods to decode the relationship between neural controls of upper limb and physical motion.
Objective To explore the nursing quality standards of joint surgery based on “structure-process-outcome” three-dimensional quality evaluation model, and provide a reference for improving the quality of joint surgery nursing. Methods From March to July 2023, based on the “structure-process-outcome” three-dimensional quality structure model as the theoretical framework, combined with systematic literature review and semi-structured interviews, the quality standards of joint surgery specialist nursing were preliminarily formulated. The Delphi method was used for screening, demonstration, and correction, then the analytic hierarchy process was used to determine the weights. Results The recovery rates of the two rounds of expert letter consultation were 93.75% and 100.00%, respectively. The expert authority coefficients of both rounds were 0.95. The positive coefficients of experts in the two rounds were 0.93 and 1.00, respectively. The coefficients of variation after the second round of correspondence were 0-0.20. In the second round of correspondence inquiry, the Kendall harmony coefficients of primary standards, secondary standards and tertiary standards were 0.156, 0.115 and 0.285, respectively, with statistical significance (P<0.05). Finally, the quality standards of joint specialty nursing included 3 primary standards, 23 secondary standards and 99 tertiary standards. Conclusion The construction process of nursing quality standards of joint surgery specialty based on “structure-process-outcome” three-dimensional quality structure model is scientific and reliable, the index evaluation results are less volatile, and the opinions are concentrated, which can provide a basis for comprehensively, accurately and pertinently improving the quality of joint surgery specialty nursing.
ObjectiveTo explore the nursing intervention effect on pre-hypertension. MethodsA total of 240 prehypertension patients in our community from July 2012 to January 2013 were randomly divided into observation group and control group with 120 patients in each group. No intervention was carried out for the control group. Blood pressure profile was established for the observation group and health education, exercise intervention, diet and body weight intervention measures were also given to the patients in this group. The improvement of life behavior and blood pressure control, and the awareness of hypertension health knowledge were compared between the two groups. ResultsAwareness of the disease knowledge, risk factors, complications, prevention and treatment in the observation group was significantly better than those in the control group (P<0.05). After intervention, the improvement scores of diet control, exercise increase, smoking quitting and alcohol drinking control in the observation group were significantly higher than those in the control group (P<0.05). The systolic blood pressure, diastolic blood pressure and body mass index after intervention in the observation group were significantly lower than those in the control group (P<0.05). ConclusionCommunity nursing intervention can increase the health knowledge in pre-hypertensive patients, help patients establish a good way of life and control blood pressure effectively, and reduce the incidence of hypertension.
ObjectiveTo investigate the effect of PDCA circulation management on pain, psychology and prognosis of patients with thoracic aortic aneurysm in the perioperative period.Methods The clinical data of seventy-six patients with thoracic aortic aneurysm who received perioperative nursing based on PDCA circulation management from April 2016 to March 2017 were retrospective analyzed and these patients were selected as the study group, including 44 males, 32 females, aged 23–65 (47.27±5.87) years. At the same time, 72 patients with thoracic aortic aneurysm who received routine perioperative nursing from April 2015 to March 2016 were selected as the control group, including 41 males, 31 females, aged 24–67 (48.30±5.26) years. The nursing effects of the two groups were compared and analyzed.ResultsThe operation time (t=11.342, P<0.05) and hospitalization time (t=5.986, P<0.05) of the study group were significantly shorter than those of the control group. The visual analogue scale (VAS) scores of the two groups had no significant difference before nursing (t=0.914, P=0.361), but the VAS scores in the study group after nursing were obviously lower than those in the control group (t=5.475, P<0.05). The self-rating depression scale (SDS, t=1.026, P=0.307) and self-rating anxiety scale (SAS) scores (t=7.866, P<0.05) of the two groups had no significant difference before nursing, while the SDS (t=7.657, P<0.05) and SAS (t=7.866, P<0.05) scores in the study group after nursing were obviously lower than those in the control group. The incidence of adverse reactions in the study group was significantly lower than that in the control group (χ2=4.292, P=0.038).ConclusionPDCA circulation management used in patients with thoracic aortic aneurysm in the perioperative period can effectively relieve patients' pain, depression and anxiety, reduce the incidence of adverse reactions, and the prognosis is good.