Purpose: This study aimed to investigate the effect of a nurse-led multidomain intervention on chemotherapy induced nausea and vomiting (CINV) in patients with head and neck squamous cell carcinomas (HNSCC). Methods: Ninety-two HNSCC patients who received cisplatin-based chemotherapy were divided into intervention group (n = 45) and control group (n = 47). The control group received usual care of CINV, which consisted of administration of antiemetics according to physicians' preference, education about CINV control and dietary recommendations provided by primary nurses. The intervention group received nurse-led, evidence-based multidomain management, including nurse-led CINV risk factors assessment, education on prevention and control of CINV, antiemetics following guidelines, dietary strategies, and relaxation therapy. The number of patients who experienced CINV was collected. The severity of CINV was graded according to the Common Terminology Criteria for Adverse Events v3.0. The influence of CINV on patient's quality of life was assessed by the Functional Living Index-Emesis (FLIE). Results: The incidence and the severity of nausea and vomiting in the intervention group were significantly lower than those in the control group within 5 days after chemotherapy, and the scores of the dimension of nausea and vomiting in the intervention group were significantly higher than those in the control group [63.00 (50.00-63.00) vs 40.00(28.00-63.00), 63.00(63.00-63.00) vs 63.00 (43.00-63.00)], the differences were statistically significant (P < 0.05). Conclusions: Nurse-led multidomain intervention can reduce the incidence and the severity of CINV in patients with HNSCC who were treated with cisplatin-based chemotherapy, and thus reduced the influence of CINV on patients' quality of life.

Background: The incidence of differentiated thyroid cancer in Mainland China has increased rapidly in recent years, yet the number of studies focusing on health-related quality of life (HR-QOL) is still limited. Additionally, some of the quality-of-life (QOL) issues specific to thyroid cancer have not been adequately described. The aims of this study were to assess the generic and disease-specific HR-QOL of differentiated thyroid cancer survivors and to identify the associated factors. Methods: A cross-sectional survey including 373 patients was conducted in Mainland China. Participants completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QOL), and a questionnaire on patient demographics and clinical characteristics. Results: The QLQ-C30 global mean score was 73.12 (standard deviation [SD] = 11.95), while the THYCA-QOL summary mean score was 34.50 (SD = 12.68). The two QLQ-C30 functional subscales with the lowest scores were the social functioning and role functioning subscales. The five symptom subscales of the THYCA-QOL with the highest scores were the subscales regarding less interest in sex, problems with scar, psychological problems, voice problems, and sympathetic problems. Factors associated with worse global QOL on the QLQ-C30 included a shorter time since completing primary treatment (<= 6 months), a history of lateral neck dissection, and a lower current thyrotropin (TSH) level (<= 0.5 mIU/L). Higher cumulative activities of radioiodine (RAI; >100 mCi), gender (women), postoperative hypoparathyroidism, and a history of lateral neck dissection were associated with worse thyroid cancer-specific QOL. In contrast, higher monthly household income (>5000(sic)) and a history of minimally invasive thyroid surgery were associated with better thyroid cancer-specific QOL. Conclusions: Thyroid cancer patients experience multiple health-related problems and disease-specific symptoms after completing primary treatment. Patients with a duration <= 6 months from the completion of primary treatment, those with a history of lateral neck dissection, and a current TSH level <= 0.5 mIU/L may be more likely to have impaired generic QOL. More thyroid cancer-specific symptoms may be associated with higher cumulative activities of RAI, gender (women), postoperative hypoparathyroidism, a history of lateral neck dissection, lower monthly household income, and conventional surgery.

目的 系统评价综合护理干预对衰弱老年人的影响.方法 计算机检索从2010年1月至2020年12月Cochrane Library、Embase、PubMed、Web of Science、CINAHL、CNKI、中国生物医学文献数据库、万方和维普数据库中公开发表的关于综合护理干预对衰弱老年人影响的随机对照试验.结果 共纳入11篇文献,2714例衰弱老年人.Meta分析结果显示,综合护理干预对步速[SMD=0.13,95％CI(0.03,0.22),P=0.007]、Barthel指数[W MD=2.52,95％CI(0.81,4.23),P=0.004]、抑郁[SMD=-0.09,95％CI(-0.18,-0.00),P=0.04]具有积极影响,对衰弱评分[W MD=-0.12,95％CI(-0.43,0.18),P=0.42]、握力[WMD=1.35,95％CI(-0.92,3.61),P=0.24]及生活质量[WMD=-0.42,95％CI(-0.97,0.13),P=0.13]无明显作用.结论 综合护理干预可以提高衰弱老年人步速、Barthel指数,改善其抑郁状态,但对衰弱评分、握力和生活质量无明显影响.目前有关综合护理干预对衰弱老年人影响的研究证据尚不充足,且各研究间差异较大,需进行更多高质量的研究以验证其效果.

目的:比较衰弱表型(Frailty Phenotype,FP)、衰弱量表(Frail scale,FS)、埃德蒙特衰弱量表(The Edmonton Frail Scale,EFS)3种衰弱评估工具对老年腹部手术患者术后并发症的预测效能,以期为衰弱评估工具的选择提供参考.方法:便利选取某三级甲等医院年龄≥60岁的老年腹部手术患者184例,采用FP、FS、EFS评估患者的衰弱状态,收集患者的一般资料、手术类型、手术方式以及术后并发症的资料.应用X2检验,通过受试者工作特征(receiver operating characteristic,ROC)曲线分析FP、FS和EFS对老年腹部手术患者术后并发症的预测作用.结果:184例老年腹部手术患者FP、FS、EFS衰弱的检出率分别为22.3％、16.8％、22.2％,3种评估工具的衰弱检出率比较差异无统计学意义(P＞0.05).FP预测老年腹部手术患者术后并发症发生的ROC面积为0.798,高于FS、EFS的0.681和0.670(P＜0.05)o结论:3种衰弱评估工具对老年腹部手术患者的衰弱检出率具有一致性.与FS、EFS相比较,FP更能够有效预测老年腹部手术患者术后并发症的发生.

ObjectiveTo explore the intervention effect of the nurse⁃led frailty full⁃process management model on elderly patients undergoing abdominal surgery.MethodsA total of 60 elderly frail patients who underwent elective abdominal surgery in a tertiary grade A general hospital，were randomly divided into an observation group and a control group，30 cases in each.The control group received routine nursing care，and the observation group adopted the nurse⁃led fraility full⁃process management model.The grip strength，pace，weakness，length of postoperative hospital stay，and complications occurance between two groups were compared.The patients' quality of life at 1 month，3 months，and 6 months after discharge was followed up.ResultsAt the time of discharge，the scores of grip strength，pace，and weakness of the patients in the observation group were 23.98±6.45 kg，0.55±0.13 m/s，and 2.83±0.79，respectively，while those of the control group were 20.49±6.54 kg，0.48±0.10 m/s，3.40±1.13，respectively.The differences between the two groups were statistically significant （P<0.05）.The observation group's length of postoperative hospital stay and complication rate were shorter and lower than those of the control group （P<0.05）.With the extension of follow⁃up time，the physical health status （PCS） and role⁃emotional （RE） scores of the observation group gradually increased.ConclusionsThe nurse⁃led frailty whole⁃process management model could help delay the patient's decline degree of grip strength，pace，and frailty.It could also shorten the length of postoperative hospital stay，reduce postoperative complications，and improve the quality of life of the elderly patients with frailty after abdominal surgery.

目的 了解2型糖尿病住院患者积极度和心理弹性的现状,探讨两者之间的相关性,为糖尿病患者护理干预提供理论依据.方法 于2019年10月至2020年1月,采取便利抽样的方法选取天津市2所三级甲等医院内分泌科住院治疗的413例2型糖尿病患者作为研究对象.采用一般资料调查表、患者积极度量表(PAM)、心理弹性量表(CD-RISC)对患者进行调查.采用SPSS 24.0统计软件进行方差分析、x2检验、Brown-Forsythe检验,采用多元有序logistic回归分析患者积极度和心理弹性的相关性.结果 413例2型糖尿病住院患者PAM的中位数为53.2 分(P25～P75:48.9～60.6分),处于第2水平;患者心理弹性平均分为(63.41±11.03)分,为中等水平.多元有序logistic回归分析结果显示,病程(OR=0.437,95％CI:0.259～0.738)、文化程度(OR=0.314,95％CI:0.141～0.703)、坚韧(OR=1.080,95％CI:1.025～1.138)、力量(OR=1.103,95％CI:1.019～1.193)及乐观(OR=1.200,95％CI:1.050～1.373)与患者积极度呈正相关;体质指数(OR=0.930,95％CI:0.879～0.983)、收缩压(OR=0.985,95％CI:0.971～0.998)、糖化血红蛋白(OR=0.881,95％CI:0.785～0.988)与患者积极度呈负相关,均有统计学意义(P＜0.05).结论 医护人员应注重患者积极情绪的调动与培养,并针对性地对患者进行疾病管理,提高患者积极度及疾病的自我管理能力.