Vaccination rates remain low despite the influenza vaccine's proven safety and efficacy in protecting vulnerable groups, such as individuals diagnosed with liver disease. This cross-sectional study investigated influenza vaccination coverage, attitudes, beliefs, and influencing factors among 152 patients with liver disease in Greece. Over half (53.6%) were diagnosed with hepatitis, and 40.4% with cirrhosis. Overall, 58.6% of participants received the seasonal influenza vaccine. Multivariate logistic regression showed that older age (OR = 1.07, 95% CI: 1.02-1.11, p = .002), prior pneumococcal vaccination (OR = 17.98, 95% CI: 6.66-48.52, p < .001), and COVID-19 vaccination (OR = 5.77, 95% CI: 1.17-28.46, p = .031) were significantly associated with influenza vaccination in the current season. Similarly, older age (OR = 1.09, 95% CI: 1.04-1.14, p < .001) and pneumococcal vaccination (OR = 25.75, 95% CI: 9.20-72.05, p < .001) were linked to annual influenza vaccination. About half of the participants are vaccinated yearly. These findings highlight the need for targeted public health strategies to improve vaccination rates among patients with liver disease. Gastroenterology healthcare professionals, as trusted information sources, can play a key role in promoting vaccine uptake and improving immunization coverage in this high-risk population.
The purpose of this project was to assess the feasibility and cost of high-flow nasal oxygenation therapy for gastrointestinal procedures in an endoscopy clinic. An observational, convenience sample design was used to evaluate multiple variables, including the frequency of high-flow nasal oxygenation therapy utilization, clinician satisfaction, setup duration, airway interventions, complications, procedure length, and alternative airway device use. A cost analysis compared high-flow nasal oxygenation therapy to other commonly used airway devices at this site. High-flow nasal oxygenation therapy was frequently utilized and received high clinician satisfaction ratings. The median length of gastrointestinal procedures with high-flow nasal oxygenation therapy was 30 minutes, with a median setup time of 2 minutes between cases. Although high flow nasal oxygenation therapy had a higher fixed cost than traditional airway devices, the cost was comparable to that of a nasal ventilation mask. Despite the initial expense, high-flow nasal oxygenation therapy's rapid setup and clinician preference suggest it is feasible in the endoscopy setting. The high fixed cost may be offset by increased patient volumes and sustained device utilization.
Budd-Chiari Syndrome (BCS), a rare vascular disorder of the liver characterized by obstruction of hepatic venous outflow, has an estimated prevalence of approximately 1 in 100,000 in the general population. Among its various etiologies, coagulation factor deficiencies are uncommon. This case, following Case Report (CARE) guidelines, describes a case of BCS associated with protein C deficiency resulting in a thrombus in the inferior vena cava. The patient was an unmarried Indian woman in her 40s who presented with progressive pedal edema and abdominal distension for 6 months. She was evaluated thoroughly, and other causes were excluded. Imaging showed classical features of BCS, including complete fibrotic occlusion of all three hepatic veins, intrahepatic venous and splenorenal collaterals, caudate lobe enlargement, and a 5.2 cm thrombus in the inferior vena cava. She was treated with interventional angioplasty along with anticoagulation and diuretic therapy. She is under regular follow-up and has been counseled for liver transplantation for liver cirrhosis. This case highlights the rare association of protein C deficiency with BCS and emphasizes the need for early recognition, multidisciplinary management, and supportive nursing care to improve outcomes and quality of life.
The American Cancer Society predicts 158,850 new cases of colorectal cancer and 52,230 deaths in 2026. Rates have declined for both men and women since 2011, particularly among those over age 65. This decline is likely due to reduced smoking and increased uptake of screening. Unfortunately, there has been an increase among those younger than age 55 years since the mid-1990s, likely due to the lifestyle of those born after 1950. Early-onset colorectal cancer is defined as a diagnosis before the age of 50 years. Guidelines now recommend screening for average-risk patients begin at age 45 years (formerly 50 years). High-risk patients should start screening at age 40 years, and possibly earlier. Patients need to learn about this recent change. A high index of suspicion is helpful when any patient presents with complaints of unexplained weight loss, abdominal pain, bloating, change in bowel habits, or rectal bleeding. These patients should be referred, regardless of age, for a diagnostic colonoscopy. Primary care providers can improve their practice's screening rates using evidence-based strategies. The gastroenterology nurse is in a key position to implement lead-time messaging with tailored messages to promote on-time screening and primary prevention through diet and lifestyle.
Enterobius vermicularis is a common intestinal parasite affecting a large proportion of the global population. It typically inhabits the terminal ileum and cecum without causing significant damage to the intestinal mucosa. However, several studies and case reports have documented instances of mucosal invasion. The pathogenesis of such invasion remains a matter of debate. It is not yet clear whether pre-existing mucosal injury is a prerequisite for invasion or whether mucosal damage can occur primarily as a direct consequence of E. vermicularis infection. Here, we present a case of terminal ileitis caused by E. vermicularis that was successfully treated with antiparasitic therapy.
This study aimed to identify factors influencing intention to undergo colonoscopy reexamination regardless of the colonoscopy results based on Pender's Health Promotion Model. The study included 152 individuals who had undergone colonoscopy at Chonnam National University Hospital in Gwangju City, South Korea. Data using structured self-administered questionnaires were collected from participants who were alert after the completion of the procedure. The factors associated with the intention to undergo colonoscopy reexamination were perceived benefits ( β = 0.33, p < .001, 95% CI = 0.10 to 0.30), perceived self-efficacy ( β = 0.19, p = .021, 95% CI = 0.02 to 0.18), employment status ( β = 0.18, p = .010, 95% CI = 0.25 to ~1.83), and marital status ( β = 0.16, p = .018, 95% CI = -1.87 to -0.17). These variables explained 33.9% of the variance in the intention to reexamine. The study revealed that individuals who perceived benefits and had high self-efficacy related to colonoscopy were more likely to have an intention to undergo colonoscopy reexamination. It is essential to emphasize the benefits of colonoscopy and to encourage and support examinees' confidence in undergoing colonoscopy, thereby increasing the intention and actual rate of colonoscopy reexamination every 5-10 years.
Three million deaths worldwide are attributed to alcohol use each year. Primarily, the liver is most impacted. Chronic liver disease patients have a significant relapse risk. Seven out of 10 start drinking again, a process that appears to be influenced by multiple factors. The aim of this study was to explore the factors of alcohol relapse in chronic liver disease patients. The study was conducted in a tertiary hospital using Q-methodology, a mixed-method that aids statistically rigorous examination of subjective expressions. Forty consenting participants matching the eligibility criteria purposively were enrolled. Data was gathered by sorting 25-statements (CVI 0.98-1; r = 0.88) about alcohol relapse on a Q-grid, developed after two Delphi rounds. Principal component analysis and varimax rotation were performed in PQ software. Post-interviews validated the Q-sorting. Three-factor analysis explained 43% of variance with 30 significant sorts (13 for factor 1, 7 for factor 2, 10 for factor 3), 0 confounded, and 10 non-significant. Factors were labeled as alcohol craving and dependence, intrapersonal and interpersonal influences, and ineffective coping strategies in high-risk situations. Knowledge of the factors of relapse among cirrhotic patients can inform nurses to render targeted interventions to the individual needs of the patients while supporting them through their recovery.
Flexible endoscopes used in gastrointestinal procedures possess long, narrow channels that complicate decontamination and high-level disinfection. Infections may occur even with proper execution of all reprocessing stages, particularly as the endoscope ages or in the presence of biofilm. Effective reprocessing improves when the nurses and associates handling endoscopes are knowledgeable and well-trained, have sufficient time to complete all steps correctly, and work in a clean environment equipped with the right tools. Audits evaluate endoscope reprocessing to confirm the presence of necessary conditions and verify the correctness of procedures. This article details the implementation of endoscope reprocessing audits in five clinical sites, which resulted in an increase of all audited items being compliant in 296 out of 325 audits to 317 out of 325 audits. A consistent improvement in the audit compliance score through audit and feedback indicates the project's moderate influence on overall endoscope reprocessing, consistent with the anticipated impact described in the literature.
Endoscopy departments tend to prioritize task efficiency, which may sometimes limit individualized and patient-centered nursing care. Structured workflows and time constraints can make it challenging for nurses to fully address patients' needs and ethical concerns. However, the ethical issues specific to endoscopic nursing remain largely unexplored. This study aims to clarify ethical issues perceived by nurses involved in endoscopic practices. A qualitative study was conducted with 14 nurses working in departments performing endoscopic practices in 3 hospitals in Japan. Data were collected using semi-structured interviews and analyzed using qualitative content analysis. Eight key ethical issues emerged: (1) Lack of Ethical Consideration in Physical Restraints; (2) Unalleviated Patient Pain; (3) Undervalued Patient Autonomy; (4) Disregard for Patient Dignity and Privacy; (5) Involvement Amid Professional Uncertainty and Ethical Concerns; (6) Inability to Provide Ideal Nursing Care; (7) Lack of Respect for Nurses; and (8) Inequity in Patient-Centered Care Delivery. These findings indicate that endoscopy departments face ethical challenges, including inadequate informed consent, routine sedation and restraints, time constraints, and a physician-centered hierarchy. Addressing these issues requires enhancing ethical sensitivity and competence, fostering interdepartmental and interprofessional collaboration, developing systems for patient-centered care, and setting ethical practice goals.
Inflammatory bowel disease (IBD) presents ongoing physical, psychological, and social challenges that can significantly affect quality of life. Despite this, little is known about how individuals with IBD seek help from healthcare professionals. This study used a qualitative descriptive design and latent pattern content analysis of semi-structured interviews (n = 8) to explore how individuals living with IBD seek help from healthcare professionals to manage challenges associated with their condition. The study adheres to the COREQ guidelines. Many participants delayed seeking help until symptoms interfered with daily activities, raised concern about severity, or others encouraged them to seek care. Reasons for delaying help-seeking included not seeing the symptoms as emergent, competing demands and priorities, or uncertainty about whether symptoms were IBD-related. Decisions around who to seek help from were shaped by prior experiences and perceived effectiveness of previous healthcare encounters. Physical symptoms often had a negative effect on participants' psychological wellbeing. While some participants accessed online support, another emphasized the need for integrated psychological care within IBD services. Findings highlight that patients with IBD frequently navigate physical, psychological, and social challenges but predominantly seek help for physical symptoms. This study strengthens the need for routine inclusion of psychological support within specialist IBD care.
As obesity becomes more prevalent in the United States, the incidence of undiagnosed or untreated obstructive sleep apnea (OSA) and the associated comorbidities present challenges when providing sedation to office-based gastroenterology patients. This study examined changes between pre-post procedural oxygen saturations among patients with moderate to high OSA risk. Patients (N = 316) in the preprocedural area were screened using the STOP-BANG questionnaire prior to receiving anesthesia. The patients' STOP-BANG score (SBS) and pre-post procedural oxygen saturations were obtained and documented. Of the patients screened, 59.8% were identified as having a moderate to high risk of OSA (SBS ≥ 3). Patients with STOP BANG scores ≥3 had significantly lower mean post-procedural oxygen saturations (M = 94.23, SD = 3.53) compared to those with STOP BANG scores < 3 (M = 95.76, SD = 3, F(1, 314) = 13.70, p < .001). Patients screened as moderate-to-high risk for OSA showed significant decreases in oxygen saturations after administration of anesthesia, emphasizing the importance of routine preprocedural OSA screening. Prescreening outpatient endoscopy patients for OSA is imperative to identify patients that are at increased risk to improve patient outcomes by decreasing the incidence of intraprocedural and postprocedural complications.
Enterobius vermicularis is a common intestinal parasite affecting a large proportion of the global population. It typically inhabits the terminal ileum and cecum without causing significant damage to the intestinal mucosa. However, several studies and case reports have documented instances of mucosal invasion. The pathogenesis of such invasion remains a matter of debate. It is not yet clear whether pre-existing mucosal injury is a prerequisite for invasion or whether mucosal damage can occur primarily as a direct consequence of E. vermicularis infection. Here, we present a case of terminal ileitis caused by E. vermicularis that was successfully treated with antiparasitic therapy.
Self-efficacy in coping with cancer surgery is a key concept for planning and organizing nursing care. However, there is no validated measurement tool that can be used to assess self-efficacy in patients with colorectal cancer surgery. This cross-sectional study, with a multi-phase design, was conducted with 170 patients to describe the development and validation of the Self-Efficacy Scale for Patients with Colorectal Cancer Surgery (SES-CRCS). Phase 1 addressed the development procedures of the scale. In Phase 2, a 3-step validation process was conducted: (a) assessing the content validity, (b) evaluating construct validity with exploratory and confirmatory factor analysis, and (c) assessing internal consistency reliability with Cronbach's α coefficient, test-retest, and item-total correlation methods. Exploratory factor analysis suggested a 16-item single-factor structure. The factor loadings of the 16 items were above .40, and various indices used to examine the consistency of the scale indicated a good model fit. The Cronbach's α value was .838, the item-total correlations for all items were positive, and there was a strong correlation between the test-retest measurements (r = .933; p < .05). As a result, the SES-CRCS was found to be a valid and reliable measurement tool in assessing self-efficacy among patients with colorectal cancer surgery.
