Objective:To evaluate the rehabilitation efficacy of early mobilization based on collaboration care model for patients with laparoscopic colorectal surgery.Methods:Cluster sampling method was used in the department to recruit colorectal cancer patients with laparoscopic surgery. The control group (49 cases) received routine perioperative care and exercise, and the intervention group (47 cases) received the coordinated early mobilization combined with routine perioperative care and exercise, from January to March 2019. Primary outcome were health status and the proportion of patients returning to preoperative functional walking capacity (6-min walk test) at 4 weeks after surgery. The in-hospital mobilization (time out-of-bed), time to achieve discharge criteria, time to recover gastrointestinal function and complication rate were explored.Results:In intervention group,89.4%(42/47) of patients achieved mobilization target on 4 days after surgery compared with 42.6%(20/47) on the day of surgery. Time out of bed were greater in the intervention group compared with the control group, and there were differences between the two groups( Z values were -8.437--7.381, P<0.01). Time to recover gastrointestinal function and the recovery of energy on 3 days after surgery were (58.74±17.41) h, (59.02±9.46) points in the observation group, and (71.82±21.53) h, (62.61±7.68) points in the control group, and there were significant differences between the two groups ( t values were -3.263, -2.046, P<0.05). But other outcome measures were not different between the two groups ( P>0.05). Conclusions:For colorectal laparoscopic surgery patients, the coordinated early mobilization improved the adherence to ambulation, in-hospital mobilization, time to recover gastrointestinal function and recovery of energy to promote rehabilitation.
Objective To construct the index system of the core competence of nursing emergency personnel in the case of infectious disease outbreak, and to provide reference basis for the assessment and training of the core competence of nursing emergency personnel. Methods Based on the core competence indicators of nurses defined by the International Nurses' Association and the action framework of WHO's outbreak of infectious diseases as the theoretical framework, the item pool was summarized through semi- structured interviews and research group meetings, the Delphi expert letter consultation method was used to construct the indicator system, and the analytic hierarchy process and the average distribution method were used to determine the weight of indicators at all levels. Results Two rounds of Delphi expert letter consultation, 36 questionnaires were issued in each round, and the effective recovery rate was 86% (31) and 92% (33), respectively.Finally, it was determined that the core competence index system of nursing emergency personnel for infectious disease emergencies included 5 first-level indicators, 13 second- level indicators and 53 third- level indicators. The coefficient of variation ranged from 0 to 0.173, the weight ranged from 0.074 to 0.525, and the balanced combination weight ranged from 0.165 to 0.266. Conclusion The index system of the core competence of nursing emergency personnel in infectious disease emergencies is comprehensive and scientific, which can provide theoretical basis for evaluating and training the core competence of nursing emergency personnel in infectious disease emergencies. © 2021 Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.
Objective To explore the protective cognition of the first batch of nurses against novel coronavirus pneumonia on apparatus-related stress injury, so as to provide reference for formulating and implementing relevant training and improving management measures. Methods Using the phenomenological method of qualitative research, from January 20, 2020 to February 17, 2020, a half structured in-depth interview was conducted among the echelon nurses who completed the first batch of nurses against novel coronavirus pneumonia on apparatus-related stress injury. A total of 13 nurses in isolation wards were interviewed for the study. Results Using the method of Colaizzi phenomenology to analyze the interview data, the related knowledge cognition was low, the identification of risk factors was limited, the risk assessment was not carried out, the treatment measures were not timely, the awareness of protection was lacking, the management training was not perfect, and the medical protection materials were not enough. Conclusion The first batch of nurses to fight against novel coronavirus pneumonia had a low awareness of the prevention of medical device- related stress injury. Hospital managers should strengthen the training of related knowledge, improve management strategies, enhance the awareness of protection, and identify risk factors early, take preventive measures to ensure the safety and health of front-line medical staff in a timely manner. © 2021 Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.
Objective:To explore the effect of therapeutic communication on infusion safety, disease uncertainty, coping styles, anxiety and depression in patients with emergency infusion.Methods:A total of 126 patients treated with infusion patients in emergency department in Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University from July 2019 to December 2019 were selected and divided into two groups by random digits table method with 63 cases in each group. Patients in the control group received routine nursing, and patients in the intervention group received therapeutic communication nursing intervention on this basis. The incidence of adverse events of infusion during the intervention of the two groups of patients was observed. The disease uncertainty, coping styles, anxiety and depression were evaluated by Mishel's Uncertainty in Illness Scale (MUIS), Medical Coping Mode Questionnaire (MCMQ), Self-rating Anxiety Scale (SAS) and Self-rating Depressive Scale (SDS) before and after intervention.Results:The final collection of 109 patients with complete questionnaire, the recovery rate was 86.51% (109/126), including 55 cases in the intervention group, 54 cases in the control group. The incidence of adverse events of infusion was 16.36%(9/55) in the intervention group and 29.63%(16/54) in the control group, and there was significant difference( χ2 value was 5.057, P<0.05). There was no significant difference in the score of MUIS, MCMQ, SAS, SDS before the intervention between the two groups ( P>0.05). After the intervention, the uncertainty, unpredictability, lack of information and complexity dimension of the intervention group patients' MUIS scores were respectively (17.76 ± 2.49), (12.03 ± 2.51), (11.82 ± 2.12), (11.74 ± 2.24), which were lower than those in the control group (24.72 ± 2.94), (16.31 ± 2.27), (16.13 ± 2.51), (15.39 ± 2.31), the differences were significant( t values were -13.346- -8.375, P<0.05). The confront score of the intervention group patients' MCMQ was (19.13 ± 2.62) higher than that in the control group(13.79 ± 1.96), the avoidance and yield scores were respectively (8.71 ± 1.34), (9.81 ± 1.17), which were lower than those in the control group (14.57 ± 1.93), (15.12 ± 1.86), the differences were significant( t values were 12.031, -18.441, -17.875, P<0.05). The scores of SAS and SDS in the intervention group were (29.43 ± 3.62), (27.67 ± 3.11) respectively, which were lower than those in the control group (37.44 ± 5.31), (40.12 ± 4.92), the differences were significant( t values were -9.216, -15.821, P<0.05). Conclusions:Therapeutic communication can reduce the risk of emergency infusion, reduce the uncertainty of patients to the disease, improve patients' countermeasures to the disease, relieve patients' anxiety and depression, and improve the nursing quality of emergency infusion patients.
Objective:To develop a quality assessment scale of ICU transitional care based on patient-reported outcomes and test its performance.Methods:According to the guidelines of patient-reported outcomes development process, the item pool was established combining with analysis of relevant literatures and patients′ experience and needs in ICU transitional period based on the grounded theory about ICU transitional care. Cognitive test of patients and Delphi expert correspondence were utilized to amend the initial scale before pretest. One hundred and seventy-seven patients who had been transferred from ICU to general ward from March to August 2019 in Tianjin Third Central Hospital were recruited by convenience sampling method for project analysis.Results:The active coefficient and authority degree of expert were above 0.90 and 0.785 respectively for the two rounds of expert enquiry. The final scale consisted of 28 items, from which 4 principal factors, which were preparation for self-care, communication and coordination, psychological support and health belief, respectively, were extracted by exploratory factor analysis, explaining 78.307% of total variance. The content validity index of each item was 0.769-1.000, and the scale-level content validity was 0.896. The Cronbach α coefficients of the 4 factors and the scale were 0.844, 0.793, 0.897, 0.681 and 0.807, respectively.Conclusions:The patient-reported outcomes scale measuring ICU transitional care quality has good reliability and validity and can be used as an auxiliary tool measuring ICU transitional care quality in clinic.
