Preoperative Health Education Research Articles

An Empirical Study of Feedforward Control in Unplanned Extubation of Nasogastric Tube.

To explore the effect of feedforward control on reducing the incidence of unplanned extubation and improving the quality of catheter nursing. A total of 186 patients with nasogastric tube after gastrointestinal surgery in the eastern region of our hospital from September 2020 to September 2021 were selected as the control group; 186 patients with nasogastric tube after gastrointestinal surgery in the western region of our hospital at the same period were selected as the experimental group. The influencing factors of unplanned extubation in patients with long-term postoperative nasogastric tube were analyzed, and effective preoperative and postoperative health education was conducted. The ratio of unplanned extubation of nasogastric tube and nursing satisfaction of patients in the two groups were compared. Patient constraint, perceived pressure score, anxiety score, nasal gastrointestinal canal health education feedback score and indwell tube comfort score were independent risk factors for unplanned extubation. The restraint rate and the incidence of unplanned extubation in the experimental group were lower than those in the control group after intervention, with statistical significance (P < 0.05). The nursing satisfaction of the experimental group was significantly higher than that of the control group after feedforward cognitive intervention. After intervention, serum albumin and gastric PH in the experimental group were significantly higher than those in the control group (P < 0.05). The safe nursing management method of feed forward control can effectively reduce the incidence of unplanned extubation in inpatients, which is worth further promoting in nursing work.

Predicting surgical outcome and sagittal alignment change in patients with cervical spondylosis and degenerative kyphosis after anterior cervical discectomy and fusion

The aim of this study was to forecast the risk factors of poor outcomes and postoperative loss of lordosis or recurrence of kyphosis. In this retrospective study, 101 patients with cervical spondylosis and preoperative kyphosis who underwent anterior cervical discectomy and fusion (ACDF) were enrolled, between June 2015 and June 2019. Patients were grouped according to the recovery rate of Japanese Orthopaedic Association (JOA) score whether more than 50%, and the change of postoperative cervical Cobb angle. There were 22 cases with less than 50% of recovery rate and 35 cases with the worsening of postoperative sagittal alignment (WPSA). Multivariate linear-regression analysis was conducted with the data. Advanced age (p = 0.019), longer duration of symptoms (p = 0.003) and loss of local Cobb angle (LCA) after surgery (p = 0.031) was significantly associated with a poor clinical outcome. A whole kyphosis (p = 0.009), aggravated neck pain after surgery (p = 0.012), preoperative lower thoracic 1 (T1) (p < 0.001), bigger change of C2-7 sagittal vertical axis (SVA) (p = 0.008) and adjacent segment degeneration (ASD) (p = 0.024) was significantly associated with the WPSA. Preoperative health education, nutritional support and early postoperative rehabilitation intervention, in perioperative period, were recommended for patients with advance age, longer duration of symptoms, whole cervical kyphosis and lower T1. Postoperative sagittal malalignment was related to neck pain and ASD after surgery.

The Effect of Psychological Intervention on the Visual Quality of Patients with a Diffractive Multifocal Intraocular Lens Implant.

This study aimed to investigate the effect of psychological intervention on the visual quality of patients with a diffractive multifocal intraocular lens implant and its possible mechanism. Eighty-nine patients undergoing age-related cataract surgery were enrolled in the study at the Affiliated Hospital of Southwest Medical University between December 2015 and July 2017. They were randomly divided into two groups: multiple focus M1 group (n = 45) and multiple focus M2 group (n = 40). The M1 group was only given routine preoperative health education, treatment, and evaluation, while the M2 group also received psychological intervention. After treatment, there was no statistical difference in the uncorrected distance and near visual acuity, corrected distance and near visual acuity, or the vision and near removal rate in either of the two groups (p > 0.05). However, postoperative glare was lower in the M2 group (p < 0.05), and patient satisfaction was higher in the M2 group (p < 0.05). The M2 group had a more obvious improvement in the Symptom Checklist-90 score (p < 0.05), the serum interleukin-6 (IL-6) was lower, and the serum brain-derived neurotrophic factor (BDNF) was higher in the M2 group (p < 0.05). In addition, serum IL-6 had a negative correlation with the depression score, and serum BDNF also showed a negative correlation with the anxiety score (p < 0.05). Psychological intervention improved the stress state of patients with age-related cataracts and diffractive multifocal intraocular lens implants, reduced the level of inflammatory factors in the body, improved the level of BDNF, reduced postoperative visual interference, and improved postoperative satisfaction.

Poster 210: Effects of a Comprehensive Behavioral Health Program on Functional Outcomes after Osteochondral Allograft Transplantation in the Knee

Objectives:To use prospectively collected registry data to evaluate an evidence-based shift in practice for implementation of a comprehensive behavioral health program, including preoperative screening and education in conjunction with postoperative counseling for their effects on patient-reported mental health scores and functional outcomes after osteochondral allograft (OCA) transplantation in the knee. We hypothesized that patient-reported preoperative mental health issues would be associated with inferior outcomes and that the comprehensive behavioral health program led by a health behavior psychologist would be associated with superior outcomes for these patients.Methods:With IRB approval and informed consent, patients undergoing transplantation in the knee were enrolled in a lifelong registry designed to collect comprehensive outcomes data. Patients that had large (>4cm2) shell-graft OCA transplants and complete one-year data for patient-reported IKDC subjective knee evaluation, VAS Pain, SANE, PROMIS Physical Function, and PROMIS Mental Health measures for pre-operative and 1-year time points were included in analyses. One-year improvement (D) scores for each variable were calculated as the difference between each score compared to the respective pre-operative score. Patients who required OCA revision surgery or total knee arthroplasty within the study period were defined as graft failures. Patients treated after the shift in practice were assigned to the Psych cohort. Patients who self-reported a history of mental health issues (Anxiety, Depression, Bipolar, ADHD, Schizophrenia) were assigned to the Mental Health Issue (MHI) cohort. Patients whose mental health history could not be obtained were not included in the respective analyses. Two-tailed t-Tests were used to analyze the survey scores between cohorts. Chi-square tests were used to compare proportions of successful versus failed outcomes between cohorts. A p value < 0.05 was used to indicate statistical significance for all tests.Results:A total of 269 patients met criteria for inclusion in the Psych analysis and 189 patients met criteria for inclusion in the MHI analysis. One-year SANE raw scores (p=0.03), one-year Physical Function D scores (p<0.0001), one-year IKDC D scores (p<0.0001), and one-year Pain D scores (p=0.01) were significantly better for patients in the comprehensive behavioral health program cohort. One-year PROMIS Mental Health D scores (p<0.0001), one-year Physical Function raw scores (p=0.03), and one-year Physical Function D scores (p<0.0001) were significantly better for patients who did not have a history of mental health issues, while one-year SANE D scores (p<0.0001) were significantly better in the MHI cohort. A significantly higher proportion of patients in the comprehensive behavioral health program cohort had successful 1-year outcomes (87.5 versus 64%, p=0.037). No statistically significant difference in proportions of successful versus failed grafts was noted between patient cohorts with self-reported preoperative mental health issues compared to those without self-reported preoperative mental health issues (p=0.23).Conclusions:The results of this study highlight the potential impacts of mental and behavioral health on outcomes after osteochondral allograft transplantation surgeries in the knee. Improvements in pain, knee function, and overall physical function were significantly better in patients enrolled in a comprehensive behavioral health program prior to surgery, while patients with self-reported preoperative mental health issues including anxiety, depression, bipolar disorder, ADHD, or schizophrenia had significantly worse outcomes with respect to mental health, physical function, and knee function. In addition, graft failure rate as defined by the need for OCA revision or TKA was significantly lower (12.5%) for patients undergoing comprehensive preoperative behavioral health screening and education. Taken together, these data suggest that mental and behavioral health can have significant influences on clinical outcomes after OCA transplantation in the knee and that preoperative assessment and education in conjunction with postoperative counseling and support may result in more successful outcomes for patients. However, based on the multifactorial nature of outcomes in these complex cases, longer term outcome studies in a larger population of patients are required before conclusions regarding the direct impact of this shift in practice can be made.

Application of Quality Control Circle in Improving the Awareness Rate of Preoperative Gastrointestinal Preparation Health Education in Esophageal Cancer Patients

Application of Quality Control Circle in Improving the Awareness Rate of Preoperative Gastrointestinal Preparation Health Education in Esophageal Cancer Patients

The Effect of Preoperative Health Education, Delivered as Animation Videos, on Postoperative Anxiety and Pain in Femoral Fractures

ObjectiveThis article explores the effect of preoperative health education, in the form of animation videos, on postoperative self-reported pain levels and anxiety in femoral fractures.MethodsNinety cases of femoral fracture were divided at random into the oral instruction group, the recorded video group, and the animation video group, with 30 cases in each group. Sociodemographic data were collected the day before surgery. Health education was then offered in one of three ways: orally, using a recorded video, or using an animation video. On days 2, 4, and 7 after surgery, the state-trait anxiety inventory (STAI) and the visual analog scale (VAS) were used to assess postoperative anxiety and pain levels, respectively, in the participants.ResultsAt different time points during the evaluation, total anxiety scores in the animation and recorded video groups were significantly lower than in the oral instruction group (P < 0.01), and the pairwise comparisons indicated statistically significant differences (F = 11.04, 10.06, 10.37, P < 0.01). However, the levels of postoperative pain in the animation and recorded video groups were not significantly different (P > 0.05). STAI scores in the three groups were found to have significant interactions with the measurement time (F = 6.74, P < 0.01). However, there were no apparent interactions between the VAS score and the measurement time (F = 1.31, P > 0.05) in the three groups.ConclusionPreoperative health education with the aid of multimedia is more effective than oral instruction in lowering patients’ postoperative anxiety and pain levels. In addition, animation videos are superior to recorded videos in mitigating postoperative anxiety. Whether the two approaches differ in reducing postoperative pain in bone fractures remains to be further tested.

Embedding evidence of early postoperative off-bed activities and rehabilitation in a real clinical setting in China: an interrupted time-series study

BackgroundPatients should be encouraged to mobilize with 24 h of caesarean section. However, the time of the first off-bed activity after surgery is usually 24 ~ 48 h in China. Due to the lack of knowledge of early off-bed activities, lack of attention to medical pain, and the absence of systematic evidence for the clinical transformation process. the aim of this study was showed that the application of evidence needs to be embedding in the real setting to construct the localization plan and achieve the effective result.MethodsTo establish evidence of the benefits of early postoperative off-bed activities on patients’ well-being based on a literature review. An interrupted time series analysis was used to evaluate the effectiveness of the intervention. The first and third periods were both five months (from February 1st, 2019 to January 31st, 2020), with a two-month interrupted time (from July 1st, 2019 to August 31st, 2019).ResultsEight clinical practices were retrieved from the literature and incorporated into the intervention. A total of 465 patients were included: 226 patients before and 239 patients after implementing the intervention. The average onset time of postoperative off-bed activities was significantly earlier after the intervention than before the intervention (20.01 vs. 31.89 h after the operation, P < 0.001). The 24-h off-bed rate increased from 30.94% before to 91.21% after the intervention (P < 0.001). The average pain score of patients decreased from 5.23 points before to 3.82 points after the intervention (P = 0.032). The average postoperative hospital stay was shortened from 5.06 days before to 3.51 days after the intervention (P < 0.001). In addition, the incidence rates of postoperative ileus (POI) and infection decreased from 5.38% and 2.65% before to 1.67% and 0.84% after the intervention, respectively (P < 0.001).ConclusionsWe established an evidence-based nursing intervention. Evaluation of the effect of evidence-based practices should be considered in the clinical setting and include preoperative health education, effective analgesia management, and safety management.

The Influence Of Pre-Operative Health Education To The Self-Concept Improvement On Femoral Fracture Patientsat Haji Medan Hospital Of North SumateraGovernment In 2021

Femoral fracture is continuity disconnected of the femoral shaft occurring due to direct trauma (traffic accidents, falls from the height), and it is usually experienced by the adult males. Fractures of this area affects heavy bleeding and impacts the shock. This study aimed to find out whether there is the influence of pre-operative health education to the self-concept improvement on femoral fracture patients At Haji Medan Hospital of North Sumatera Government in 2021The research type used was Quasi Experiment design. This study used one group pre-test and post-test design. The research location was at Haji Medan Hospital of North Sumatera Government in 2021. The population were all femoral fracture patients having treatment at Haji Medan Hospital of North Sumatera Government. Based on RSU Haji Medical record data, there were 30 patients in July- December 2020. The sampling technique was purposive sampling. The total sample were 20 femoral patients.The outputs described that there is a significant correlation between pre operative health education and self-concept improvement on femoral fracture patients At Haji Medan Hospital of North Sumatera Government in 2021. The value is p &lt; α as 0.000 &lt; 0.05. It is proved that pre operative health education to be effective in improving self-concept on femoral fracture patients At Haji Medan Hospital of North Sumatera Government in 2021.The suggestion of the study is required to be applied by medical practitioner in the hospital, particularly the nurses providing the nursing care to the femoral fracture patients and support the patients in overcoming the anxiety of the disease by maximizing the existing social supports.

WeChat-assisted pre-operative health education improves the quality of life of parents of children with ventricular septal defects: A prospective randomised controlled study.

This study aimed to explore the effect of implementing pre-operative WeChat-assisted health education for parents of children with restrictive ventricular septal defects to improve their quality of life. A prospective randomised controlled study was conducted in a provincial hospital in China. Participants were randomly divided into the intervention group (WeChat group, n= 35) and the control group (leaflet group, n= 35). The quality of life of parents of children with restricted ventricular septal defects was studied. Compared with the leaflet group, the WeChat group had a significantly lower score for the pre-operative Self-Rating Anxiety Scale (SAS) (P< 0.05). The pre-operative SAS score in the WeChat group was significantly lower than that at the first visit (P< 0.05). However, the SAS score in the leaflet group was similar at the time of preoperation and the first visit (P> 0.05). The pre-operative scores of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale in the physiological, psychological, social, and environmental fields and the total life quality score in the WeChat group were significantly higher than those of the leaflet group (P< 0.05). Implementing pre-operative WeChat-assisted health education for parents of children with restrictive ventricular septal defects can effectively relieve their anxiety and improve their quality of life.

WeChat-Assisted Preoperative Health Education Reduces Burden of Care on Parents of Children with Simple Congenital Heart Disease: a Prospective Randomized Controlled Study.

ObjectiveThe purpose of this study was to explore the clinical effect of preoperative health education based on the WeChat platform for parents of children with simple congenital heart disease.MethodsIn this study, participants were randomly divided into an intervention group (WeChat group, n=40) and a control group (leaflet group, n=40) in our center. All parents were required to complete the Family Caregiver Task Inventory (FCTI) on the first visit and the Zarit Burden Interview (ZBI) and FCTI before the operation. Clinical, family and relevant data from children and parents were collected and subsequently analyzed.ResultsBefore the operation, the FCTI score and the ZBI score in the WeChat group were significantly lower than those in the control group (P=0.010, P=0.027, respectively). Compared to the FCTI score on the first visit, the preoperative status score was significantly lower in the WeChat group (P=0.008). The rate of loss to follow-up and complications in the WeChat group was also significantly lower than in the control group (P=0.003).ConclusionPreoperative health education assisted by the WeChat platform for parents of children with simple congenital heart disease can effectively improve the parents' care ability and reduce the burden of care, preoperative complications and the rate of loss to follow-up.

Research Progress of Rapid Rehabilitation Surgery in Anesthesia

Rapid rehabilitation surgery, also known as accelerated rehabilitation surgery, is a series of perioperative optimal management measures based on evidence-based medicine, in order to minimize the perioperative stress reaction of patients and reduce the risk of various complications, so as to achieve the goal of improving prognosis and promoting rapid recovery of patients. The concept of rapid rehabilitation surgery plays an important role in clinical anesthesia. It runs through the whole anesthetic work, such as preoperative anesthetic health education, preoperative fasting, selection of anesthetic scheme, intraoperative fluid therapy, intraoperative body temperature monitoring, postoperative analgesia and perioperative anesthetic management. The following article will review the application progress of rapid rehabilitation surgery in clinical anesthesia in recent years.

Effect of the Use of WeChat to Disseminate Preoperative Health Education to Parents of Children with Restrictive Ventricular Septal Defects: A Prospective Randomized Controlled Study

This study explored the clinical effect of implementing WeChat-based preoperative health education for parents of children with restrictive ventricular septal defect. A prospective randomized controlled study was conducted in a provincial hospital on the southeast coast of China. Participants were randomly divided into an intervention (WeChat) group (n = 35) and a control group (leaflet) group (n = 35). The study explored the parents' knowledge of preoperative care, the follow-up rate, and complications of children with restrictive ventricular septal defect. The score of preoperative care knowledge of the WeChat group (66.9 ± 3.5) was significantly higher than that of the leaflet group (47.3 ± 6.3) (P = .006). Compared with the score of care knowledge at the first visit, the score of the WeChat group at the preoperation was significantly higher (P < .05), whereas the increase in the score of the leaflet group was not significant. The rate of lost follow-up in the WeChat group (0%) was significantly lower than in the leaflet group (16.7%) (P = .02). The complications in the leaflet group were significantly higher than in the WeChat group. Using WeChat to provide preoperative health education to parents of children with restrictive ventricular septal defect can effectively enhance the parents' knowledge of preoperative care and reduce the occurrence of complications and loss to follow-up.

Application of Plan-Do-Check-Action cycle and fishbone diagram analysis in optimizing surgical procedures to improve satisfaction degree of doctor-nurse-patient

Background: To study the application of management tools such as Plan-Do-Check-Action (PDCA) cycle and fishbone diagram in optimizing surgical procedures to improve the satisfaction of doctor-nurse-patient. Methods: The fundus surgery nursing team of our hospital began to implement the PDCA cycle management mode to optimize the surgical procedure from July 2017, set up a project activity improvement team, unified the surgical labeling processing plan, and made the fundus surgery procedure, and established the preoperative health education for surgical patients, and standardized the training content of post-rotating doctors and interns. Results: The satisfaction degree to surgical procedure after implementation of doctors and nurses was higher than that before implementation. Conclusions: Using PDCA cycle and fishbone diagram analysis tools to manage the surgical procedure optimization can better integrate doctor-nurse medical care, improve the efficiency and accuracy of the surgical procedure delivery and operation, and optimize the satisfaction of the three parties of doctor-nursepatient.

THE IMPORTANCE OF HEALTH EDUCATION REDUCE STRESS LEVEL IN CATARACS OPERATION CLIENTS IN MANADO EYE HOSPITAL UPTD

Introduction: Cataracts occur as a result of the opacification of the lens of the eye which decreases vision ability until blindness. The risk of blindness caused by cataracts can be cured through surgical removal of cataracts. Cataract surgery is a stressor for patients with cataracts. One of the measures to reduce stress levels before surgery is to prepare the patient's mentality. Mental preparation of patients can be done through Health Education. Health education in preoperative patients is provided with the aim of providing information relating to preoperative preparation. Purpose: The purpose of this study is to determine whether there is an influence of health education on stress levels in pre-cataract surgery clients at UPTD Manado Eye Hospital. Method: The design of this study used a quasi-one-group pre-post-test test and accidental sampling technique of 30 respondents and data analysis using the Wilcoxon Signed Rank Test. Results : The results of the study showed that there was a significant influence on health education on stress levels in pre-cataract surgery clients with a p-value of 0,000, meaning that the P-value α ≤ 0.05. Discussion: According to researchers, health education plays an important role in reducing stress levels in someone who will undergo cataract surgery. By providing preoperative health education the client will obtain clear information about the illness and the operating experience that will be faced so as to reduce the level of stress on the preoperative client. Referring to the opinion of Induniasih and Ratih (2017), that health education is all efforts to educate, provide information, knowledge, skills to improve the quality of health, both at the individual, group, and community level. Conclusion: The conclusion of this study is that health education can reduce the level of stress a person faces in cataract surgery. Suggestions for further researchers can do research with different methods or types of research or conduct research on the same topic with different samples that can represent the population, so they can compare the results of research.

Application of the healthcare failure mode and effects analysis system to reduce the incidence of posture syndrome of thyroid surgery.

This study aimed to investigate the application of the healthcare failure mode and effect analysis (HFMEA) to reduce the incidence of posture syndrome of thyroid surgery (PSTS).Subjects before (n = 78, July 2017–December 2017) and after (n = 114, January 2018–June 2018) HFMEA implementation (The Second Hospital of Nanjing, Nanjing University of Chinese Medicine) were selected. The training for PSTS was optimized using HFMEA.The occurrence of PSTS was reduced from 59% to 18% after HFMEA (P < .001). Symptoms of pain and nausea and vomiting were also decreased after HFMEA (all P < .001). The critical thinking ability of 34 medical personnel to evaluate the reduction of thyroid postoperative posture syndrome increased from 246 ± 19 to 301 ± 14 (P < .001) after HFMEA.HFMEA was used to create preoperative posture training procedures for PSTS, bedside cards for training, innovative preoperative posture training equipment, and a diversified preoperative posture training health education model.

Effect of systematic health education on anxiety in corneal refractive surgery patients

Objective To explore the effect of systematic health education on anxiety in corneal refractive surgery patients. Methods From May to December 2018, we selected 200 corneal refractive surgery patients of Outpatient Operating Room at Peking Union Medical College Hospital as subjects by convenience sampling. All patients were randomly divided into observation group (n=100, 200 eyes) and control group (n=100, 200 eyes) . Patients of observation group adopted systematic perioperativehealth education, while patients of control group were treated with necessary preoperative health education. The intervention effect was compared with the self-rating anxiety scale (SAS) . Results After intervention, the score of SAS of observation group was (38.55±6.49) higher than that (34.45±6.32) of control group with a statistical difference (t=4.526, P<0.001) . Conclusions Systematic health education can improve patients' anxiety. Moderate anxiety can improve patients' compliance and promote doctor-patient coordination to ensure the operation performed successfully. Key words: Corneal refractive surgery; Anxiety; Health education

Application of multimedia health education in patients with endoscopic retrograde cholangio-pancreatography minimally invasive treatment

Objective To evaluate the effect of mobile nursing workstation multimedia module applied to preoperative health education of patients with minimally invasive endoscopic retrograde cholangiopancreatography (ERCP) . Methods By convenience sampling, 100 patients who met the inclusion criteria in-hospitalized in Department of Digestive Medicine, Beijing Chao-Yang Hospital, Capital Medical University from January to June of 2018 were selected and divided into the observation group (n=44) and control group (n=44) according to the random number table. Conventional education approach of oral teaching and distribution of teaching materials was adopted in the control group, besides of that the observation group received the intensive teaching approach through mobile nursing platform multimedia and open communication. The knowledge mastering status, satisfactory degree and anxiety scores were compared between the two groups after health education. Results In the observation group, the score of knowledge mastering status was (33.00±9.41) , satisfactory degree was (23.45±1.18) , both higher than the control group [ (28.82±7.48) , (17.61±1.95) ] with statistical difference (P<0.05) ; the observation group achieved lower score in anxiety than the control group with statistical difference (P<0.01) . Conclusion The use of mobile nursing platform multimedia teaching method can improve the quality of health education for patients with minimally invasive ERCP treatment and patient satisfaction, alleviate the anxiety of patients. Key words: Health education; Endoscopic retrograde cholangiopancreatography; Minimally invasive treatment; Multimedia

Role of Gynaecology Oncology Specialist Nurses in Improving Patient Follow-Up and Integration With the Health Care Team

Background: All advanced gynecologic cancers treated initially with a curative intent should also be referred to palliative care at the outset for symptom management. Specialist nurses can play an integral role in this process as patients feel more comfortable to relay their symptoms to nurses rather than busy clinicians. The concept of specialist nurses has been introduced in June 2016 in the Gynecologic Oncology Department in Tata Medical Center. We aim evaluate our services through this prospective audit. Aim: i: To assess whether pre and posttreatment counseling and follow-up by gynecologic oncology specialist nurses lead to better patient care in the following areas. Increased patient participation in self-reporting of PROM (patient reported outcome monitoring) and uptake of follow-up methods via e-mail, telephone etc. ii: Coordinate administration of intraperitoneal chemotherapy and follow-up. iii: Detection of posttreatment complications and symptoms by telephonic follow up and coordination with the treating team including quality of life data collection. iv: Communicating MDT decisions to patients and arrange appropriate follow-up. v: Reduction of patient follow-up appointments and distress by coordinating with other departments i.e., palliative care team and gynae/medical oncology at same visit. vi: Develop patient information leaflets and providing preoperative education Methods: Prospective audit for service evaluation. Patients follow-up was done by face to face, telephone, e-mail in the pre and postoperative period, during chemotherapy and follow-up visits by 4 specialist nurses. Results: Between June 2016 and December 2017, specialist nurses conducted follow-up of 225 patients both in preoperative and postoperative period and collected 30 day morbidity data. Preoperative health education was given to all. 36 patients were coordinated with palliative care team on same day with gynecologic visit to reduce harassment/repeat appointments. Postchemotherapy follow-up was done for 80 patients after each cycle of chemotherapy. Coordination for 19 intraperitoneal chemotherapy was done by nurses during a 9 month period. As a result of regular follow-up visits, women were more comfortable in self-reporting of symptoms to the nurse including sensitive issues like body image and sexuality even by nonface to face methods including telephone calls/e-mails and postal mails. This has led to early detection of recurrences in 4 women, participation in multicentric national/international quality of life studies (SOCQER2/ SOCQER IND) and successful organization of survivorship programs in gynecologic oncology. Conclusion: Counseling, education and building up of interpersonal relationship with specialist nurses can improve patient participation. The role of CNS is vital to the advancement of nursing practice.

The application of chain management in preoperative health education for pregnant women with second scar uterus incision pregnancy

Objective To explore the application effect of chain management on preoperative health education for pregnant women with second scar uterus incision. Methods A total of 120 patients with scarred uterus incision pregnancy of surgerily treatment admitted to the department of obstetrics of this hospital and were selected as the research objects and were divided into the observation group and the control group according to the random number table method, 60 cases of each group.The patients of the control group received routine preoperative health education, the patients of the observation group received the chain management mode preoperative health education.The disease knowledge, anxiety, depression and preoperative sleep quality of the two groups were measured and compared. Results The awareness rate of disease in the observation group was significantly higher than that of the control group, and the difference was statistically significant(P<0.05). The rate of awareness of patients in the observation group was significantly higher than that of the control group.The difference was statistically significant(P<0.01). The scores of anxiety and depression of the observation group were significantly lower than those of the control group, and the differences were statistically significant(P<0.05). The total score of PSQL in the observation group was significantly higher than that of the control group, and the difference was statistically siginificant(P<0.05). Conclusions The health education in the chain management model can make the health education more systematic, continuous and flexible.It can effectively relieve preoperative anxiety and improve sleep quality of pregnant patients with second pregnancy scar uterine incision. Key words: Chain management; Second scar uterine incision pregnancy patients; Preoperative health education

Nurse’s Health Education in Families of Pediatric Surgical Clients

Health education is one important component in caring for children with surgical cases. Health education is done to clients and families as an intervention of various nursing problems that appear both pre and post surgery. This study aims to find out how the implementation of health education provided by nurses to families of child surgical clients. This research method is descriptive qualitative phenomenology by using in-depth interview. The number of participants was 5 nurses. The amount is determined after the researchers assume that the research data saturated. The research produced five themes: preoperative health education, postoperative health education, postoperative nutrition, surgical wound care and post operative post pain. The health education provided by the majority nurses is physical. Psychosocial should also be a topic in health education provided by nurses to clients of children and their families.