General Comfort Questionnaire Research Articles

A study on the related influencing factors of the quality of bowel preparation and the compliance of middle-aged and elderly patients for colonoscopy.

Quality of bowel preparation and patient compliance are among the most important indicators to assess the quality of colonoscopy. To investigate the independent factors associated with the quality of bowel preparation in subjects undergoing colonoscopy and its impact on compliance. A total of 329 patient records were collected and were divided into an adequate bowel preparation group (272 cases) and an inadequate bowel preparation group (57 cases), or a compliant group (260 cases) and a non-compliant group (69 cases), based on bowel preparation quality or compliance. The quality of bowel preparation is evaluated using the Boston Bowel Preparation Scale. The comfort level of subjects during bowel preparation is assessed using the Kolcaba General Comfort Questionnaire (GCQ). Subjects' compliance was assessed according to a self-developed compliance questionnaire. Prediction analyses were conducted to identify factors associated with the quality of bowel preparation and compliance. Age, bowel preparation duration, history of bowel inadequacy, and laxative dosage showed statistical differences between the adequate and inadequate bowel preparation groups (P < 0.05). Age, bowel preparation duration, and laxative dosage were independent influencing factors of bowel preparation quality. Correlation analysis showed that GCQ scores was significantly negatively correlated with age, bowel preparation duration, laxative dose, defecation frequency, and colonoscopy duration (r < 0, P < 0.05), and positively correlated with sleep duration (r > 0, P < 0.05). In addition, age, gender, bowel preparation duration, and laxative dosage showed statistical differences between the compliant and non-compliant groups (P < 0.05). Logistic regression analysis revealed that age, bowel preparation duration, and laxative dosage were independent influencing factors of bowel preparation compliance. Age and bowel preparation duration were independent influencing factors for bowel preparation adequacy and compliance. Age, bowel preparation duration, and laxative dosage are independent influencing factors for bowel preparation adequacy and compliance among patients undergoing colonoscopy at the First Affiliated Hospital, School of Medicine, Zhejiang University. It is recommended that a one-day low-residue diet combined with a 2000 mL laxative dosage be used as the bowel preparation protocol for the general colonoscopy population.

Analysis of Anxiety Status and Corresponding Nursing Measures in Long-term Hemodialysis Patients

Objective: This study was conducted to evaluate the anxiety of patients with long-term hemodialysis and its corresponding nursing measures. Methods: This study employed a prospective observational design. The present study performed an anxiety questionnaire investigation among 150 patients who underwent long-term hemodialysis in our hospital between March 2020 and January 2022. Convenience sampling was used to select the participants. Data were collected using a structured questionnaire consisting of the Self-Rating Anxiety Scale (SAS), General Comfort Questionnaire (GCQ), Pittsburgh sleep quality index (PSQI), and Emotional Behavioral Dimensions section of the Body Quality Management Scale. The collected data were analyzed using SPSS 26.0 statistical software. Descriptive statistics, t-tests, and chi-square tests were employed for data analysis. Statistical significance was indicated by P&lt;0.05. Results: The results of this study revealed that out of 150 patients undergoing long-term hemodialysis, 58 patients (38.66%) exhibited anxiety. The study group, receiving individualized care, showed significantly higher GCQ scores (82.64±5.65) compared to the control group (routine care) with scores of 71.89±5.25 (P&lt;0.05). Furthermore, the study group demonstrated improved sleep quality, as indicated by lower PSQI scores (8.25±1.98) compared to the control group (12.88±2.94) (P&lt;0.05). The study group also exhibited higher scores in emotional processing (11.89±1.39), partnership (15.14±1.94), and mental activity management (20.88±2.17) compared to the control group (9.12±1.21, 11.73±1.58, and 16.98±2.08, respectively) (P&lt;0.05). Notably, the study group displayed lower levels of anxiety and depression, as evidenced by lower SAS scores (39.56±5.14) and SDS scores (31.71±3.89) compared to the control group (42.62±5.98 and 38.56±6.75, respectively) (P&lt;0.05). In conclusion, individualized care interventions were found to enhance the comfort, sleep quality, and emotional management ability of patients undergoing long-term hemodialysis, while reducing anxiety and depression levels. Conclusion: Anxiety is highly prevalent in patients with long-term hemodialysis. Targeted intervention care and the establishment of a positive environment can effectively promote patients’ physical and mental health, enhance their comfort and sleep quality, and effectively strengthen the management of negative emotions, demonstrating a promising potential for clinical promotion.

The Relationship Between Cognitive Intrusion of Pain, Fear of Surgery, and Comfort

The aim of this study was to examine the relationship between cognitive intrusion of pain, fear of surgery, and comfort in the perioperative period. This was a descriptive study conducted with 180 patients hospitalized for surgery in a training and research hospital. A sociodemographic questionnaire, Surgical Fear Questionnaire, General Comfort Questionnaire, and Experience of Cognitive Intrusion of Pain Scale were administered to the participants prior to surgery, while General Comfort Questionnaire and Experience of Cognitive Intrusion of Pain Scale were administered after surgery. Of the participants with a mean age of 49.94 ± 17.26 years, 62.2% were male and 31.1% had at least one chronic disease. The mean preoperative and postoperative pain scores were 2.65 and 3.47, respectively. There was a statistically significant negative correlation between perioperative experience of cognitive intrusion of pain and perioperative comfort and a positive correlation between perioperative experience of cognitive intrusion of pain and preoperative fear of surgery (p < .05). Cognitive intrusion of pain does not change in the perioperative period. As the cognitive intrusion of pain increases, patient comfort decreases and surgical fear increases. Our study contributes to the literature since it is the first study evaluating the cognitive intrusion of pain in the perioperative period.

Predictive Care Improves Recovery Status and Complications after Ureteral Calculi Surgery: A Retrospective Study.

Predictive care in patients undergoing ureteroscopic stone surgery has emerged as a promising approach. Thus, this study aims to enhance personalised nursing plans and reduce the risk of complications by conducting predictive analysis of possible risks early in the treatment and nursing process. Clinical data were collected from 108 patients who underwent ureteroscopic stone surgery and were admitted to our hospital between January 2020 and January 2023. Patients were divided into a control group (conventional nursing, n = 53) and an observation group (predictive care, n = 55) based on the nursing method, and various clinical indicators were compared between the two groups of surgical patients. No significant difference in general data was found between the two groups (p > 0.05). Compared with the control group, the first time to exhaust gas (p < 0.05), the first time to get out of bed (p < 0.05), the time to exhaust stone (p < 0.05), the first time to defecate (p < 0.05) and the length of hospital stay (p < 0.05) in the observation group were shorter; 1 day after surgery, no significant differences in all dimensions of the general comfort questionnaire (GCQ) score were found; 2 days after surgery, the GCQ score in all dimensions of the observation group was significantly higher than that of the control group (p < 0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (p < 0.05). Predictive nursing can effectively improve the patients with ureteral calculi, accelerate the process of postoperative recovery and reduce the occurrence of complications; Thus, this process is worthy of widespread clinical promotion.

Percepción del confort en el paciente crítico desde el modelo teórico de Kolcaba

BackgroundThe stay in a critical care unit (CCU) has a serious impact on physical condition causing numerous discomfort factors such as pain or difficulty in communicating. All of these are associated with possible sequelae following discharge from the Intensive Care Unit (ICU) named post-ICU syndrome. The Kolcaba Comfort Theory allows, from a holistic approach, to identify care needs from the patient's perspective using instruments such as the General Comfort Questionnaire (GCQ). ObjectivesTo determine the comfort level of patients admitted to the CCU using the GCQ of Kolcaba and to identify the discomfort factors. MethodsCross-sectional descriptive observational prospective study. Population: 580 patients admitted to adult CCU of two high complexity hospitals from June 2015 to March 2020 with stay ≥24h were interviewed. Descriptive analysis, Student's t-test and ANOVA and multivariate analysis were performed using SPSS v26 and STATA v16. ResultsThe mean age was 52.62 (16.21), 357 (61.6%) were male and 434 (74.8%) were believers. The type of admission was planned in 322 (55.5%) and the most prevalent reason for admission was surgical 486 (83.8%). The median pain score (NRS) was 3.00 [0-4] and severity score (APACHE II) was 13.26 (5.89), the median length of stay was 4.00 [2-7] days. The mean comfort level was 3.02 (0.31) showing the highest value for the Reanimation Unit 3.02 (0.30) and the lowest fort the Emergency and Trauma Unit 2.95 (0.38). Statistically significant differences were found between the units in the comfort level of patients >65 years of age (P=.029). The Relief comfort type obtained the lowest mean 2.81 (0.33) and the physical context 2.75 (0.41) in the three units. In the multivariate analysis, statistically significant differences were found between the comfort level and the pain level: no pain (P=.000) OR: 4.361; IC: 2.184-8.707, mild pain (P=.000) OR: 4.007; IC: 2.068-7.763, moderate pain (P=.007) OR: 2.803; IC: 1.328-5.913, and the APACHE II score equal to or greater than 10 (P=.000) OR: 0.472; IC: 0.316-0.705. ConclusionsThe comfort level showed high scores in all three units. The physical and environmental contexts and the relief comfort type negatively affected the perception of comfort. The variables that explained comfort were pain and severity of illness. The evaluation of comfort from the patient's perspective through the GCQ could be considered an indicator of quality of nursing interventions.

Preoperative Temporary Fixation for Fractures around the Ankle Using a Simple Extensible External Fixator Significantly Improves Patient Comfort

BackgroundThe authors developed a simple extensible external fixator, which has the advantages of easy application and inexpensiveness. The present study aimed to make a comparison between this external fixator and calcaneal traction in preoperative temporary fixation for malaligned ankle fractures and pilon fractures. MethodsFrom May 2020 to February 2022, patients with malaligned ankle fractures or Rüedi-Allgöwer type 2 or 3 pilon fractures with obvious soft tissue swelling were retrospectively reviewed and divided into the calcaneal traction group and the external fixation group. The two groups of patients were matched 1:1 before making comparisons. ResultsA total of 38 patients were included. Higher General Comfort Questionnaire score and lower visual analog scale score were noticed in the external fixation group during hospitalization (p<0.05), while the operation latency time, total cost, patient satisfaction, and functional outcomes one year after surgery were not significantly different between the two groups. No wound complications were observed. ConclusionPreoperative temporary fixation for fractures around the ankle using this simple extensible external fixator significantly improves patient comfort when compared to calcaneal traction. Level of EvidenceIII, retrospective comparative study.

Penehyclidine for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Gynecological Laparoscopic Surgery Under Combined Intravenous and Inhalation Anesthesia: A Randomized, Double-Blind, Placebo-Controlled Trial.

We designed this study to investigate the effect of intravenous use of penehyclidine on postoperative nausea and vomiting (PONV) after gynecological laparoscopic surgery. Ninety-two Women Patients (Aged ≥ 18) Scheduled for Elective Gynecologic Laparoscopy Were Enrolled in the Current Study. Patients Were Equally Randomized Assigned Into Penehyclidine group (PHC group: received a bolus of penehyclidine 10 μg/kg during the induction of anesthesia, then followed by a continuous infusion of 10 μg/kg penehyclidine at a fixed rate of 2.0 mL/h in postoperative intravenous analgesia pump over 48h, 0.5 mg upper limit respectively) or Control group (received 0.9% saline in replace of penehyclidine at the same time points). The primary outcome measure was the incidence of postoperative nausea and vomiting in the postanesthesia care unit and ward area. Quality of Recovery-15 (QoR-15) scores and general comfort questionnaire (GCQ) scores were assessed on postoperative day (POD) 1, 2. Patients between two groups had comparable baseline characteristics. Compared with the Control group, the incidence and severity of PONV, postoperative nausea (PON), and postoperative vomiting (POV) were significantly lower in the PHC group at 2h (PONV: P = 0.002, P = 0.004, respectively; PON: P = 0.018, P = 0.038, respectively; POV: P = 0.011, P = 0.072, respectively), 24h (PONV: P = 0.003, P = 0.001, respectively; PON: P = 0.010, P = 0.032, respectively; POV: P = 0.006, P = 0.044, respectively), and 48h (PONV: P = 0.003, P = 0.002, respectively; PON: P = 0.007, P = 0.019, respectively; POV: P = 0.002, P = 0.013, respectively) after surgery. The QoR-15 and GCQ scores of the PHC group were significantly higher than those of the Control group at POD 1, 2 (P < 0.001; P < 0.001, respectively). Our findings suggest that perioperative intravenous application of penehyclidine can effectively prevent postoperative nausea and vomiting in gynecological laparoscopic surgery patients and improve postoperative recovery.

Local injection of a freshly manufactured 35 kDa hyaluronan fragment reduces neuropathic and inflammatory pain: A clinical study

To investigate the ability of the 35 kDa low-molecular-weight hyaluronan fragment (HA35) to relieve neuropathic and inflammatory pain, including postherpetic neuralgia and shoulder, neck, back and temporomandibular pain. Ten patients with postherpetic neuralgia and 26 patients with shoulder, neck, back or temporomandibular pain were studied and assessed. The 35 kDa hyaluronan fragment (HA35) was prepared by mixing hyaluronidase and 100 mg of high-molecular-weight HA at room temperature for 20 mins. This mixture was locally injected once at the pain point or where the nerve trunk innervated the pain point. Patients scored their pain and comfort on the numerical pain rating scale (NPRS) and the General Comfort Questionnaire (GCQ). After treatment, the NPRS scores and GCQ scores improved. Patients with postherpetic neuralgia and shoulder, neck, back or temporomandibular pain had significantly lower NPRS scores at 30 min to 180 min after injection, especially at 180 min ( p &lt; .001). The GCQ scores after treatment for 24 h was significantly greater than that before treatment ( p &lt; .01). No adverse reactions occurred. The 35 kDa hyaluronan fragment (HA35) effectively relieved postherpetic neuralgia-induced neuropathic pain and shoulder, neck, back and temporomandibular inflammatory pain. Clinical Trial Registration: NCT05809700 at https://www.clinicaltrials.gov .

The effect of murottal auditory therapy on anxiety and comfort levels in patients with cardiovascular disease

Patients with cardiovascular disease often experience anxiety and discomfort, which can negatively affect their outcomes. The purpose of this study was to examine the effect of murottal auditory therapy on anxiety and comfort levels in hospitalized patients with cardiovascular disease. This quasi-experimental study included 45 patients in both the intervention and control groups, selected through purposive sampling. Participants met criteria such as consciousness, effective communication skills, Muslim faith, and no hearing impairments. Anxiety was assessed using the Zung Self-Rating Anxiety Scale, while comfort was evaluated with the General Comfort Questionnaire. The Mc Nemar test was employed to determine the effect of the intervention. The findings indicate that a substantial number of patients in the intervention group reported mild anxiety (91.1%) and increased comfort (95.6%) following murottal therapy. Significant differences in anxiety and comfort levels were observed between the control and intervention groups, with p-values of 0.004 and 0.000, respectively. In conclusion, murottal auditory therapy, specifically Surah Ar-Rahman, effectively reduces anxiety and enhances comfort among patients with cardiovascular disease. These results underscore the potential of murottal auditory therapy as a complementary approach to expedite patients' recovery during treatment.

Application of arterial infusion ports in hepatic arterial infusion chemotherapy and embolization for advanced hepatocellular carcinoma.

To investigate the safety and feasibility of subcutaneous implantable infusion ports in repeated hepatic arterial infusion chemotherapy (HAIC) for advanced hepatocellular carcinoma (HCC) in China. A total of 237 patients who were clinically diagnosed with advanced HCC (CNLC III a/III b) in our hospitals from December 2020 to October 2022 were retrospectively analyzed. The approaches of HAIC were divided into 2 groups: arterial infusion port implantation (group A) and one-time femoral artery catheterization (group B) based on the physicians' suggestion and the patients' intention. The comfort level (evaluated with the General Comfort Questionnaire), complications and average inpatient expenditure were compared between the 2 groups. 116 patients were finally enrolled in the study (group A: 69; group B: 47) and completed HAIC (FOLFOX-4 regimen) according to the dosing schedules (mean: 6±1 cycles). The comfort level of group A was greater than that of group B (p<0.05). The average inpatient expenditure of group A was lower than that of group B (5.4±2.4 vs 10.4±1.9 thousand yuan RMB/cycle, p<0.05). No patients developed port incision infection, hematoma or catheter-related thrombosis in group A, whereas four patients had groin hematomas, one had femoral artery dissection and four had deep vein thrombosis in group B. Hepatic arterial infusion chemotherapy via arterial infusion ports for advanced HCC decreased complications and medical expenditures and improved patient comfort levels compared with indwelling catheters.

Establishment and Clinical Application of the General Comfort Scale for Postoperative Lung Cancer Patients.

Background and purpose The concept of enhanced recovery after surgery (ERAS) not only reflects rapid perioperative recovery but also focuses on the comfort experience of inpatients. This study intends to establish a clinically applicable general comfort questionnaire (GCQ) for patients with lung cancer after surgery and verify its clinical application effect. Methods The comfort index items for postoperative lung cancer were formed by combining previous research and literature, clinically applied comfort scales, and expert interviews. The Delphi method was used to conduct two rounds of expert consultations to determine the final index and establish a postoperative comfort scale for lung cancer patients. This scale was used to conduct a questionnaire survey on 200 patients to test the reliability and validity of the scale. Results The comfort scale contains 3 dimensions and 10 items and is easy to operate and evaluate in clinical applications. The Cronbach's α coefficient of the comfort scale is 0.801, and the scale content validity index (SCVI/ave) is 0.97. The common factor 1 and 2 characteristic roots of scale structural validity evaluation are 3.257 and 1.352 respectively, both greater than 1, with cumulative variance contribution rates of 32.57% and 13.52%. Pain and getting out of bed are the main factors influencing patient comfort. Conclusion The postoperative comfort scale for lung cancer patients has high clinical application reliability and validity. This study identified pain and mobility (early ambulation or getting out of bed) as the primary factors influencing the postoperative comfort of lung cancer patients.

The effect of back massage with frankincense and myrrh oil before the cardiac electrophysiological procedure on back pain intensity and comfort: A single-blind randomized controlled trial

ContextBack pain is one of the most common problems experienced by patients after the cardiac electrophysiological study procedure. In addition, limitation of movement after the procedure negatively affects the comfort and satisfaction of patients. ObjectivesThe aim of this study was to determine the effect of back massage with frankincense and myrrh oil on back pain severity and comfort in patients who were to undergo cardiac electrophysiological study. MethodsThis is a randomized controlled study with a pretest–posttest design. This study was conducted from October 2020 to March 2021, at the angio unit of a heart hospital at a university in Turkey. The study was completed with 30 patients in each group, a total of 90 people. Data were collected using a patient information form, a Visual Analogue Scale (VAS) and the General Comfort Questionnaire (GCQ). The intervention group and the placebo group received back massage with frankincense and myrrh essential oil and with jojoba fixed oil respectively. No intervention was applied to the control group. ResultsThere was no statistically significant difference between the post-procedure VAS values according to the groups. Except for sociocultural comfort, there were significant differences between the groups in terms of GCQ total scores and subscales at the first and last follow-up. ConclusionsBack massage with frankincense and myrrh oil increased overall comfort, physical comfort, the psychospiritual comfort. Additional research with a rigorous design is needed to determine its effect on pain.

The Role of Cluster Nursing Methods Following Laparoscopic Partial Nephrectomy

Objective: Laparoscopic partial nephrectomy has become an important treatment method for patients with limited renal tumors; however, its most common complication is postoperative bleeding and, until now, little has been known about the use of enhanced recovery after surgery following the use of laparoscopic partial nephrectomy for kidney tumors in China. In the present study, we assessed the efficacy of cluster nursing methods in the recovery of patients after laparoscopic partial nephrectomy. Methods: We included 96 patients were in the study and separated them into an observation group and a control group. The control group received traditional oral and written education as well as routine care; the observation group received the cluster nursing methods of a dissociate hemorrhage risk classification and position plan, performed by doctors and nurses, respectively. We used the Kolcaba General Comfort Questionnaire (GCQ), Digital Pain Scoring, and Hamilton Anxiety Scale to evaluate the patients′ conditions. Results: We compared the durations of absolute bedrest, Kolcaba GCQ scores, flank pain scores, psychological anxiety scores and hospitalization indicators between the 2 groups; the differences were statistically significant (p&lt;.05). No bleeding or lower extremity venous thrombosis occurred in either of the 2 groups. Conclusions: Position management and diversified health education may enhance post-surgery recovery, shorten the hospitalization time, and improve inpatient comfort.

Impact of Natural Chinese Medicine Acupoint Application on Anxiety in Long-Term Hemodialysis Patients and Analysis of the Corresponding Nursing Measures

This study aimed to determine the effects of natural herbal acupoint application on anxiety in long-term hemodialysis patients and analyze the corresponding nursing measures. Between March 2020 and January 2022, 150 long-term hemodialysis patients admitted to our hospital were surveyed for this study. A questionnaire survey was conducted to determine the anxiety status of the patients. Patients with anxiety were registered and randomly divided into a research group and a control group. The control group received traditional routine nursing care, while the research group received personalized interventional nursing care combined with natural herbal acupoint application. The comfort level, sleep quality, emotional management ability, and negative emotional status before and after the intervention were compared between the two groups. The 58 (38.66%) patients who experienced anxiety were divided into control and research groups, with 29 patients per group. No significant differences in baseline characteristics were detected between the two groups (P &gt;0.05). The research group had significantly higher General Comfort Questionnaire (GCQ) scores and significantly lower Pittsburgh Sleep Quality Index (PSQI) scores compared with the scores in the control group (P &lt;0.05 for both). The research group had higher scores in emotional processing, interpersonal relationships, and psychological activity management than the control group, indicating better emotional management ability (P &lt;0.05). Moreover, the research group had significantly lower scores on the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) than the control group (P &lt;0.05). In this study, targeted interventions combining individualized nursing care and traditional Chinese medicine acupoint patching were administered to patients, which effectively promoted their physical and mental well-being, enhanced patient comfort, improved sleep quality, and effectively managed patient anxiety, as well as alleviated negative emotions. Therefore, natural herbal patches are worthy of promotion and application in clinical settings.

The effect of regular nursing rounds on patients' comfort and satisfaction, and violence against nurses in surgical ward

BackgroundPatients' satisfaction and comfort are known as the quality indicators of nursing care. Nowadays, violence against nurses has an increasing trend. Regular nursing rounds are one of the caring programs that help improve these indicators. This study aimed to examine the effect of regular nursing rounds on patients' comfort, satisfaction, and violence against nurses. Materials and methodsThis quasi-experimental study was conducted in two groups consisting of 100 patients and 35 nurses in a surgery ward in the northwest of Iran. The satisfaction with nursing care quality questionnaire, Kolcaba's general comfort questionnaire, and work environment violence were used for data collection. In the present study, the control and intervention groups were selected using a simple sampling method. The control group received routine care only; however, the intervention group received a regular nursing round program every 2 h from the second day of their admission for three days. The satisfaction questionnaire and comfort scale were completed on the second and fifth days of admission, and the evaluation of violence against nurses was performed from the second to the fourth day. The results were analyzed using chi-square, Fisher, independent t, and paired t tests. ResultsBefore the intervention, no statistically significant difference was observed between the two groups in terms of demographic and dependent variables (p > 0/05). After the intervention, statistically significant differences were observed among the mean scores of satisfaction with nursing care (p < 0/001), comfort (p < 0.001), and violence against nurses (p = 0.041) between the two study groups, so that in the intervention group, the patients’ satisfaction and comfort increased and violence against nurses reduced during the intervention period. ConclusionsThe use of regular nursing rounds had a positive effect on the study results. Therefore, it is recommended that nurse managers design, implement, encourage, and evaluate regular nursing rounds to improve nursing care.

Patient comfort in percutaneous coronary interventions.

To identify patients' general comfort levels in percutaneous coronary intervention. This descriptive research included 2 hundred cardiac patients, whom were in the Medipol Mega University Hospital, Istanbul, during the period between May 2018 and May 2019. The data were obtained by General Comfort Questionnaire and evaluated using mean, standard deviation, percentage and t-test. In this study reports that patients had the mean total comfort score as 3.03±0.3. They acquired the maximum score from the psychospiritual comfort subdimension and the minimum score from the physical comfort subdimension. Patients who experienced transradial percutaneous coronaryintervention had statistically higher general, physical, psycospiritual and environmental comfort levels than those who had transfemoral intervention (p<0.05). According to both access methods, relief and ease levels were significantly different. Patients who experienced percutaneous coronary intervention have above medium general comfort levels. Their physical comfort scored lowest within the comfort dimensions investigated in this study. The comfort level of the patients to whom the transradial method was applied was found to be higher in comparison with the transfemoral method.

Ultrasound-Guided Thoracic Paravertebral Block Using Paraventricular Oblique Sagittal (POS) Approach for the Treatment of Acute Herpes Zoster: A Two-Blind Randomized Controlled Trial.

The aim of this work is to examine the efficacy and benefits of ultrasound (US)-guided thoracic paravertebral block (TPVB) using paraventricular oblique sagittal (POS) approach for the treatment of herpes zoster related acute pain (ZAP) and its preventive effects on post-herpetic neuralgia (PHN). A total of 136 patients suffering from ZAP within 2weeks of rash onset were randomly allocated to transverse short axial approach (TSA) and paraventricular oblique sagittal (POS) group in 1:1 ratio. All patients received a standard antiviral treatment and rescue analgesics besides TPVB. Primary outcome was HZ illness burden (HZ-BOI) measured by a severity-by-duration composite pain assessment during 30days. The non-inferiority margin (NIM) was set at - 10. Secondary outcomes included visual analog pain scores (VAS) and Kolcaba's General Comfort Questionnaire discomfortable scores (GCQ) during block needle insertion, quality of life (QoL), and PHN incidence during follow-up. Adverse events were also recorded. VAS pain scores (30 (IQR: 20, 40) vs. 65 (IQR: 45, 90), p < 0.001) and GCQ discomfortable scores (p < 0.001) were significantly lower in the POS group during needle insertion. The POS approach was not inferior to the proved TSA method in terms of BOI-30AUC when the lower limit of 95% confidence interval (CI) of two mean differences (13.54 (95% CI - 3.55, 30.63)) lay within the NIM. There were no differences between the two groups in BOI-30-90AUC, and BOI-90-180AUC (p = 0.260 and 0.182). Greater QoL improvement and lower PHN incidence were comparable between the two groups. No serious adverse events occurred. US-guided TPVB using less-invasive POS technique was as an optimal early intervention to reduce ZAP and a possible preventive strategy for PHN. The study was retrospectively registered in the Chinese Clinical Trial Registry on November 15, 2022 (ChiCTR2200065783).

Psychometric validation of the Kolcaba General Comfort Questionnaire in critically ill patients

BackgroundThere is a lack of validated tools to measure comfort in critically ill patients. ObjectiveThe objective of this study was to evaluate the psychometric properties of the General Comfort Questionnaire (GCQ) in patients admitted to intensive care units (ICUs). MethodologyA total of 580 patients were recruited, randomising the sample into two homogeneous subgroups of 290 patients for exploratory factor analysis and confirmatory factor analysis, respectively. The GCQ was used to assess patient comfort. Reliability, structural validity, and criterion validity were analysed. ResultsThe final version included 28 of the 48 items from the original version of the GCQ. This tool was named the Comfort Questionnaire (CQ)-ICU, maintaining all types and contexts of the Kolcaba theory. The resulting factorial structure included seven factors: psychological context, need for information, physical context, sociocultural context, emotional support, spirituality, and environmental context. A Kaiser–Meyer–Olkin value of 0.785 was obtained, with Bartlett's sphericity test (0.000) being significant, and the total variance explained was 49.750%. The Cronbach's alpha was 0.807, with subscale values ranging from 0.788 to 0.418. Regarding convergent validity, high positive correlations were obtained between the factors and the GCQ score, the CQ-ICU score, and the criterion item GCQ31: “I am content”. In terms of divergent validity, correlations were low with the APACHE II scale and with the NRS-O except for physical context (−0.267). ConclusionThe Spanish version of the CQ-ICU is a valid and reliable tool to assess comfort in an ICU population 24 h after admission. Although the resulting multidimensional structure does not replicate the Kolcaba Comfort Model, all types and contexts of the Kolcaba theory are included. Therefore, this tool enables an individualised and holistic evaluation of comfort needs.

Effect of menthol lozenges after extubation on thirst, nausea, physiological parameters, and comfort in cardiovascular surgery patients: A randomized controlled trial

ObjectivesTo determine the effect of post-extubation oral menthol lozenges on thirst, nausea, physiological parameters, and comfort level in patients undergoing cardiovascular surgery. Research methodology/designThe study was a single-centre, randomized controlled trial. SettingThis study included 119 patients undergoing coronary artery bypass graft surgery in a training and research hospital. Patients in the intervention group (n = 59) received menthol lozenges at 30, 60, and 90 min after extubation. Patients in the control group (n = 60) received standard care and treatment. Main outcome measuresThe primary outcome of the study was the change in post-extubation thirst assessed by Visual Analogue Scale after using menthol lozenges compared to baseline. Secondary outcomes were changes in post-extubation physiological parameters and nausea severity assessed by Visual Analogue Scale compared to baseline, and comfort level assessed with Shortened General Comfort Questionnaire. ResultsBetween-group comparisons showed that the intervention group had significantly lower thirst scores at all time points and nausea at the first assessment (p < 0.05) and significantly higher comfort scores (p < 0.05) than the control group. There were no significant differences between the groups in physiological parameters at baseline or any of the postoperative assessments (p > 0.05). ConclusionIn patients undergoing coronary artery bypass graft surgery, the use of menthol lozenges effectively increased comfort level by reducing post-extubation thirst and nausea, but had no effect on physiological parameters. Implications for clinical practiceNurses should be vigilant for complaints such as thirst, nausea, and discomfort in patients after extubation. Nurses’ administration of menthol lozenges to patients may help reduce post-extubation thirst, nausea, and discomfort.

The effect of Reiki on fatigue and comfort in hemodialysis patients

ObjectiveThis prospective, single-blind, randomized parallel controlled study was conducted to determine the effects of distant Reiki on the fatigue and comfort levels of patients undergoing hemodialysis (HD) treatment. MethodsThe study was conducted in a private dialysis center located in one of the metropolises of Turkey between October 2020 and September 2021. Sixty-two patients receiving HD treatment were randomly allocated to intervention (n = 31) and control (n = 31) groups. Distant Reiki was administered to the patients in the intervention group three times a week for four weeks. Distant Reiki sessions were held the night before the patient's hemodialysis day and lasted approximately 36–40 min. The patients in the control group were administered routine treatment under the institutional policy without any further intervention. Data were collected using the Fatigue Severity Scale (FSS) and General Comfort Questionnaire (GCQ). Measurements were performed before Reiki was applied, after Reiki was applied (the first day after the 12th session), and four weeks after the last measurement in order to assess whether Reiki has a long-term effect. The data obtained were assessed using Shapiro Wilk, Repeated Measures, Student's t, Pearson chi-square, Likelihood Ratio chi-square, and Fisher Exact chi-square tests. ResultsThe patients in the intervention and control groups were statistically similar in terms of their descriptive characteristics (p>0.05). The intervention group's fatigue score decreased from 5.42 (SD=1.20) to 3.44 (SD=1.00) immediately after the intervention and 3.21 (SD=0.86) four weeks after the intervention. In the control group, these values were 4.50 (SD=1.29), 4.70 (SD=1.22), and 4.65 (SD=1.02), respectively (p<0.05).The general comfort total score of the intervention group increased from 2.86 (SD=0.30) to 3.03 (SD=0.20) immediately after the intervention and 2.98 (SD=0.22) four weeks after the intervention. In the control group, these values were 2.71 (SD=0.33), 2.63 (SD=0.23), and 2.59 (SD=0.30), respectively (p<0.05). ConclusionThis research has shown that distant Reiki, as one of the non-pharmacological methods, positively affects the fatigue severity and comfort level of patients receiving HD treatment.