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Luo HL, Luo HL. Analysis of the effect of multi-channel continuous nursing intervention on patients post-radical gastrectomy. World J Gastrointest Surg 2025; 17:100848. [PMID: 40291863 PMCID: PMC12019047 DOI: 10.4240/wjgs.v17.i4.100848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 02/08/2025] [Accepted: 03/10/2025] [Indexed: 03/29/2025] Open
Abstract
BACKGROUND Radical gastrectomy (RGE) for gastric carcinoma (GC) has exerted definite therapeutic efficacy in treating patients with GC. However, a notable risk of postoperative complications (POCs) persists among middle-aged and elderly patients with compromised physiological functions. Hence, developing and implementing reliable nursing interventions to optimize the comprehensive management of these patients is deemed imperative. AIM To analyze the association of multi-channel continuous nursing intervention with POCs, negative emotions (NEs), and quality of life (QoL) of patients undergoing RGE for GC. METHODS This retrospective study selected 99 patients who underwent RGE for GC in our hospital from May 2020 to May 2023. Participants were categorized into the control (n = 49 cases) and research groups (n = 50 cases) receiving routine and multi-channel continuous nursing care, respectively. Comparative analysis involved data on postoperative rehabilitation (time to first anal exhaust, oral feeding and ambulation, and hospital stay), complications (nausea and vomiting, delayed gastric emptying, and abdominal distension), NEs [Self-rating Anxiety (SAS)/Depression Scale (SDS)], treatment compliance, self-efficacy, and QoL [World Health Organization QoL Brief Version (WHOQOL-BREF)]. RESULTS Compared to the control group, the research group demonstrated earlier first postoperative anal exhaust, oral feeding, and ambulation, shorter hospital stay, lower POC rate, and more reduced SAS and SDS scores postintervention, which was significantly lower than the baseline. The treatment compliance scores were significantly higher in the research group than in the control group in terms of medication adherence, daily exercise, reasonable diet, and regular review. Further, the research group demonstrated increased self-efficacy scores in terms of positive attitude, self-stress relief, and self-decision-making, as well as the overall score postintervention, which were higher than the control group. Moreover, the research group reported notably higher WHOQOL-BREF scores in domains such as physiology, psychology, social relations, and environment. CONCLUSION Multi-channel continuous nursing intervention prevents POCs in patients undergoing RGE for GC as well as significantly alleviates patients' NEs and boosts their QoL.
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Affiliation(s)
- Huan-Li Luo
- Department of Nursing, Henan Vocational College of Nursing, Anyang 455000, Henan Province, China
| | - Huan-Ling Luo
- Department of International Education, Henan Vocational College of Nursing, Anyang 455000, Henan Province, China
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Choudhary SK, Bijarniya D, Jat SK, Agrawal M, Vasudeva S. Effect of the enhanced recovery after surgery protocol in patients undergoing elective craniotomies: a systematic review and meta-analysis. Neurosurg Rev 2025; 48:291. [PMID: 40063290 DOI: 10.1007/s10143-025-03446-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2024] [Revised: 02/23/2025] [Accepted: 03/03/2025] [Indexed: 05/13/2025]
Abstract
Enhanced recovery after surgery protocol (ERASP) improves postoperative outcomes. However, its implementation in neurosurgery remains under explored, resulting in the absence of standard evidence-based guidelines. Thus, we compared the outcomes of ERASP and conventional perioperative care (CPC) in patients undergoing elective craniotomy for various intracranial pathologies. This systematic review and meta-analysis involved the search of PubMed, Cochrane Library, and Google Scholar until December 4, 2024. The primary outcomes were total and postoperative length of stay (LOS). Secondary outcomes included hospitalization cost, pain, analgesic use, Karnofsky performance status (KPS) score, postoperative nausea and vomiting (PONV), postoperative complications, 30-days readmission and reoperation, and mortality. A total of 15 studies, including randomized controlled trials (n = 9) as well as prospective and retrospective studies (each n = 3) were included. Compared to CPC, ERASP significantly reduced total LOS (MD -3.32, 95%CI -3.66 to -2.98; P < 0.0001, I2 = 34%), postoperative LOS (MD -2.80, 95%CI -3.82 to -1.79; P < 0.0001, I2 = 90%), hospitalization cost (MD -$1044, 95%CI -$1289 to -$800; P < 0.0001, I2 = 47%), postoperative pain (MD -1.55, 95%CI -1.92 to -1.19; P < 0.0001, I2 = 83%), analgesic use (OR 0.56, 95%CI 0.40 to 0.80; P = 0.001, I2 = 0%), KPS score (MD 6.68, 95%CI 0.15 to 13.21; P = 0.045, I2 = 93%), respiratory complications (OR 0.28, 95%CI 0.13 to 0.58; P = 0.001, I2 = 0%), and PONV (OR 0.39, 95%CI 0.27 to 0.57; P < 0.0001, I2 = 0%). While ERASP and CPC were comparable regarding other outcome measures. Thus, in elective craniotomy, ERASP shortens total and postoperative LOS, decreases hospitalization costs, improves functional recovery, decreases pain and analgesic use, with reduced incidence of PONV and respiratory complications.
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Affiliation(s)
- Suresh Kumar Choudhary
- Department of Neurosurgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, 302004, India
| | - Dinesh Bijarniya
- Department of Neurosurgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, 302004, India
| | - Shravan Kumar Jat
- Department of Anesthesia, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, 302004, India
| | - Manish Agrawal
- Department of Neurosurgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, 302004, India
| | - Shubham Vasudeva
- Department of Neurosurgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, 302004, India.
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Fu WH, Hu ZL, Liao YJ, Chen RJ, Qiu JB, Que WT, Wang WT, Li WH, Lan WB. Relationship between preoperative psychological stress and short-term prognosis in elderly patients with femoral neck fracture. World J Psychiatry 2024; 14:838-847. [PMID: 38984342 PMCID: PMC11230083 DOI: 10.5498/wjp.v14.i6.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/23/2024] [Accepted: 05/06/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Older adults are at high risk of femoral neck fractures (FNFs). Elderly patients face and adapt to significant psychological burdens, resulting in different degrees of psychological stress response. Total hip replacement is the preferred treatment for FNF in elderly patients; however, some patients have poor postoperative prognoses, and the underlying mechanism is unknown. We speculated that the postoperative prognosis of elderly patients with FNF may be related to preoperative psychological stress. AIM To explore the relationship between preoperative psychological stress and the short-term prognosis of elderly patients with FNF. METHODS In this retrospective analysis, the baseline data, preoperative 90-item Symptom Checklist score, and Harris score within 6 months of surgery of 120 elderly patients with FNF who underwent total hip arthroplasty were collected. We analyzed the indicators of poor short-term postoperative prognosis and the ability of the indicators to predict poor prognosis and compared the correlation between the indicators and the Harris score. RESULTS Anxiety, depression, garden classification of FNF, cause of fracture, FNF reduction quality, and length of hospital stay were independent influencing factors for poor short-term postoperative prognoses in elderly patients with FNF (P < 0.05). The areas under the curve for anxiety, depression, and length of hospital stay were 0.742, 0.854, and 0.749, respectively. The sensitivities of anxiety, depression, garden classification of FNF, and prediction of the cause of fracture were 0.857, 0.786, 0.821, and 0.821, respectively. The specificities of depression, FNF quality reduction, and length of hospital stay were the highest at 0.880, 0.783, and 0.761, respectively. Anxiety, depression, and somatization scores correlated moderately with Harris scores (r = -0.523, -0.625, and -0.554; all P < 0.001). CONCLUSION Preoperative anxiety, depression, and somatization are correlated with poor short-term prognosis in elderly patients with FNF and warrant consideration.
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Affiliation(s)
- Wen-Hui Fu
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Zhi-Long Hu
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Yuan-Jun Liao
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Ri-Jiang Chen
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Jian-Bin Qiu
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Wu-Tang Que
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Wan-Tao Wang
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Wei-Hua Li
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Wei-Bin Lan
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
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Chang HC, Lu HY, Guo YC, Lin CY, Chen SJ, Gau SY. Depression risk in chronic tonsillitis patients underwent tonsillectomy: a global federated health network analysis. Int J Med Sci 2024; 21:949-957. [PMID: 38616998 PMCID: PMC11008477 DOI: 10.7150/ijms.93977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/21/2024] [Indexed: 04/16/2024] Open
Abstract
Background: Tonsillectomy is a common surgery in the US, with possible postoperative complications. While small studies indicate postoperative depressive symptoms may occur, large-scale evidence is lacking on the tonsillectomy-depression link. Methods: We conducted a retrospective cohort study using the TriNetX US collaborative network, offering de-identified electronic health data from 59 collaborative healthcare organizations (HCOs) in the United States. In this study, people being diagnosed of chronic tonsillitis between January 2005 and December 2017 were enrolled. Patients deceased, with previous record of cancers or psychiatric events before index date were excluded. 14,874 chronic tonsillitis patients undergoing tonsillectomy were propensity score matched 1:1 to controls for age, sex, and race. New-onset depression risks were evaluated over 5 years post-tonsillectomy and stratified by age and sex. Confounders were adjusted for including demographics, medications, comorbidities and socioeconomic statuses. Results: After matching, the difference of key baseline characteristics including age, sex, comedications status and obesity status was insignificant between tonsillectomy and non-tonsillectomy groups. Tonsillectomy had a 1.29 times higher 5-year depression risk versus matched controls (95% CI, 1.19-1.40), with elevated risks seen at 1 year (HR=1.51; 95% CI, 1.28-1.79) and 3 years (HR=1.30; 95% CI, 1.18-1.43). By stratifications, risks were increased for both males (HR=1.30; 95% CI, 1.08-1.57) and females (HR=1.30; 95% CI, 1.18-1.42), and significantly higher in ages 18-64 years (HR=1.37; 1.26-1.49), but no significance observed for those 65 years and older. After performing sensitivity analyses and applying washout periods of 6, 12, and 36 months, the outcome remained consistent with unadjusted results. Conclusion: This real-world analysis found tonsillectomy was associated with a 30% higher 5-year depression risk versus matched non-tonsillectomy patients with chronic tonsillitis. Further mechanistic research is needed to clarify the pathophysiologic association between depression and tonsillectomy. Depression is not commonly mentioned in the current post-tonsillectomy care realm; however, the outcome of our study emphasized the possibility of these suffering condition after operation. Attention to psychological impacts following tonsillectomy is warranted to support patient well-being, leading to better management of post-tonsillectomy individuals.
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Affiliation(s)
- Hui-Chin Chang
- Evidence-based Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan
- Library, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hsin-Yo Lu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Chen Guo
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chen-Yu Lin
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shiu-Jau Chen
- Department of Neurosurgery, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Shuo-Yan Gau
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Orthopedics Department, Chi-Mei Medical Center, Tainan, Taiwan
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Buus AAØ, Udsen FW, Laugesen B, El-Galaly A, Laursen M, Hejlesen OK. Patient-Reported Outcomes for Function and Pain in Total Knee Arthroplasty Patients. Nurs Res 2022; 71:E39-E47. [PMID: 35552336 DOI: 10.1097/nnr.0000000000000602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Some patients undergoing total knee arthroplasty successfully manage their condition postoperatively, while others encounter challenges in regaining function and controlling pain during recovery at home. OBJECTIVE To use traditional statistics and machine learning to develop prediction models that identify patients likely to have increased care needs related to managing function and pain following total knee arthroplasty. METHODS This study included 201 patients. Outcomes were changes between baseline and follow-up in the functional and pain subcomponents of the Oxford Knee Score. Both classification and regression modeling were applied. Twenty-one predictors were included. Tenfold cross-validation was used, and the regression models were evaluated based on root mean square error, mean absolute error, and coefficient of determination. Classification models were evaluated based on the area under the receiver operating curve, sensitivity, and specificity. RESULTS In classification modeling, random forest and stochastic gradient boosting provided the best overall metrics for model performance. A support vector machine and a stochastic gradient boosting machine in regression modeling provided the best predictive performance. The models performed better in predicting challenges related to function compared to challenges related to pain. DISCUSSION There is valuable predictive information in the data routinely collected for patients undergoing total knee arthroplasty. The developed models may predict patients who are likely to have enhanced care needs regarding function and pain management. Improvements are needed before the models can be implemented in routine clinical practice.
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Affiliation(s)
- Amanda A Ø Buus
- Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Flemming W Udsen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Anders El-Galaly
- Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Mogens Laursen
- Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Ole K Hejlesen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Li Q, Wang Y, Shen X. Improvement of Negative Psychological Stress Response in Elderly Patients With Femoral Neck Fracture by Integrated High-Quality Nursing Model of Medical Care. Front Surg 2022; 9:859269. [PMID: 35402483 PMCID: PMC8987229 DOI: 10.3389/fsurg.2022.859269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/16/2022] [Indexed: 11/15/2022] Open
Abstract
Objective The objective of this study was to explore the nursing effect and negative psychological stress response of elderly patients with femoral neck fracture by applying the high-quality nursing mode of medical care. Methods A total of 130 elderly patients with femoral neck fractures hospitalized in our hospital from January 2020 to June 2021 were randomly divided into the control group and observation group, with 65 patients in each group. The control group adopted the conventional nursing mode, while the observation group adopted the high-quality nursing mode of medical care. The observation indexes selected in this study are nursing satisfaction, hip flexion activity on the 1, 15, and 30 days after the operation, the time when the affected limb was lifted off the bed actively, and the anxiety and depression of patients. Results On the 1, 15, and 30 days after the operation, there were statistically significant differences between the two groups in hip flexion activity and the time when the affected limb was lifted off the bed (P < 0.05). The nursing satisfaction of the observation group was 95.38%, which was statistically significant compared with the 80.00% of the control group (P < 0.05). After treatment, the self rating depression scale (SDS) and self rating anxiety scale (SAS) scores in the observation group were lower than those in the control group (P < 0.05). Conclusion The high-quality nursing model of medical care can effectively promote the rehabilitation of elderly patients with femoral neck fracture, reduce the negative psychological stress reaction of patients, and improve nursing satisfaction, which has important application value and guiding significance for the nursing of patients with femoral neck fracture.
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Wang P, Chen H, Ji Q. Application of Operating Room Nursing Intervention to Incision Infection of Patients Undergoing Gastrointestinal Surgery Can Reduce Complications and Improve Gastrointestinal Function. Front Surg 2022; 9:842309. [PMID: 35242807 PMCID: PMC8885529 DOI: 10.3389/fsurg.2022.842309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/12/2022] [Indexed: 01/17/2023] Open
Abstract
Objective To observe the influence of nursing intervention in operation rooms on incision infection of patients undergoing gastrointestinal surgery and the improvement of gastrointestinal function. Methods A total of 340 patients who underwent gastrointestinal surgery in our hospital from June 2020 to August 2021 were included. According to the random number table, they were divided into the conventional nursing group (n = 170) and the operating room nursing group (n = 170). The conventional nursing group was treated with routine nursing intervention, while the operating room nursing group was treated with operating room nursing intervention. The incision infection, healing, gastrointestinal function recovery, and complications in the two groups were compared, and the patient care satisfaction was recorded. Results The incidence of incision swelling, pain, and incision secretion in the operating room nursing group was significantly lower than that in the conventional nursing group (p < 0.05). The patients in the operating room nursing group had higher grade A healing than in the conventional nursing group, and lower grade B and grade C healing than in the conventional nursing group (p < 0.05). The time of anal exhaust, first defecation, and the time of gastric tube removal in the operating room nursing group were lower than those in the conventional nursing group (p < 0.05). The incidence of postoperative complications, such as incision infection, incision dehiscence, early inflammatory bowel adhesion, and abdominal abscess, in the operating room nursing group was lower than that in the conventional nursing group (p < 0.05). The total satisfaction degree in the operating room nursing group was significantly higher than that in the conventional nursing group (p < 0.05). Conclusion Nursing intervention in operation room can reduce complications and improve gastrointestinal function when applied to patients undergoing gastrointestinal surgery due to incision infection.
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The Clinical Value of High-Quality Nursing in Concurrent Radiotherapy and Chemotherapy after Glioma Surgery and Its Influence on the Stress Indicators Cor, ACTH, and CRP. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:8335400. [PMID: 35126950 PMCID: PMC8808127 DOI: 10.1155/2022/8335400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/31/2021] [Indexed: 12/30/2022]
Abstract
Objective The purpose of this study is to explore the clinical value of high-quality nursing in concurrent radiotherapy and chemotherapy after glioma surgery and its influence on the stress indicators such as cortisol (Cor), adrenocorticotrophic hormone (ACTH), and C-reactive protein (CRP). Methods A total of 94 glioma patients diagnosed and treated in our hospital were randomly divided into a research group and a control group, with 47 cases in each group. Both groups of patients were given concurrent radiotherapy and chemotherapy. On this basis, patients in the control group were given basic care, while patients in the research group were given a combination of basic care and high-quality care. The nursing satisfaction and adverse reactions of the two groups were compared. The pain degree and the levels of stress indicators Cor, ACTH, and CRP at different time points were compared between the two groups. The sleep quality, bad mood, and quality of life before and after nursing were compared between the two groups. Results After nursing, the nursing satisfaction of the research group (95.74%) was higher than that of the control group (80.85%), and the difference between the two groups was statistically significant (X2 = 11.678, P < 0.05). There was no significant difference between patients in the Visual Analogue Scale (VAS) score and the levels of stress indicators Cor, ACTH, and CRP at the T1 time point between the two groups (P > 0.05). With the passage of time, the levels of Cor and ACTH of the two groups showed an upward trend. At T4, the increased levels of Cor and ACTH in the research group were less than those in the control group, and the difference was statistically significant (P < 0.05). The VAS scores and CRP levels of the two groups showed an upward trend at T1 and T2 and a downward trend at T3 and T4. And, at T4, the decrease in CRP level of the research group was greater than that in the control group, and the difference was statistically significant (P < 0.05). Before nursing, there was no statistically significant difference between two groups of patients in the time to fall asleep, sleep time, number of awakenings, SAS score, self-rating depression scale (SDS) score, quality of life index scores, and total scores (P > 0.05). After nursing, the time to fall asleep and the number of awakenings in the two groups of patients showed an upward trend, and the increase in the control group was higher (P < 0.05). The sleep time of the two groups showed a downward trend, and the degree of decline in the control group was higher (P < 0.05). After nursing, the SAS score and SDS score of the two groups of patients decreased (∗P < 0.05), and the decrease in the research group was more obvious (#P < 0.05). After nursing, the scores of all indicators of the quality of life and the total score of the two groups increased and the score of the research group increased more significantly (P < 0.05). After nursing, the control group had 5 cases of gastrointestinal reactions, 7 cases of bone marrow suppression, 6 cases of leukopenia, 6 cases of thrombocytopenia, and 10 cases of dizziness and nausea. In the research group, there were 1 case of gastrointestinal reaction, 2 cases of bone marrow suppression, 1 case of leukopenia, 1 case of thrombocytopenia, and 2 cases of dizziness and nausea. The difference between the two groups was statistically significant (P < 0.05). Conclusion Glioma patients are given high-quality care during the course of concurrent radiotherapy and chemotherapy, which can reduce the pain and bad mood of the patient, reduce the stress response of the patient, and improve the quality of sleep and the quality of life of the patient, thereby improving nursing satisfaction and patients compliance, reducing adverse reactions, and having a good prognosis.
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