Routine Nursing Research Articles

Clinical application of the concept of enhanced recovery after surgery in perioperative nursing of patients with total hip replacement

Objective To explore the clinical effect of the concept of enhanced recovery after surgery (ERAS) in the perioperative nursing of patients with total hip replacement. Methods A total of 93 patients with hip osteoarthritis admitted from June 2017 to June 2018 were divided into routine nursing group and ERAS nursing group according to the random number table method. Patients in both groups were treated with unilateral total hip arthroplasty. Routine nursing group was treated with routine perioperative nursing, and ERAS nursing group was treated with ERAS concept. The ERAS nursing team was established, including a head nurse and an orthopedic physician, in addition to the regular nursing staff. The treatment, perioperative pain and nursing satisfaction of the two groups were compared. Results The first time of getting out of bed activity [(1.95 ± 0.45) days vs. (5.52 ± 2.52) days], the first time of defecation after operation [(1.34 ± 0.56) days vs. (2.15 ± 0.84) days], the time of hospitalization [(5.73 ± 1.65) days vs. (10.04 ± 2.14) days] in ERAS nursing group were shorter than those in routine nursing group, and the cost of hospitalization [(49 450.50 ± 880.52) yuan vs. (53 053.50 ± 780.50) yuan] was lower than that in routine nursing group, the differences were statistically significant (t=6.639-31.622, P < 0.05). The NRS scores of 24 hours [(3.35 ± 0.85) vs. (4.32 ± 1.05)], 48 hours [(2.65 ± 0.52) vs. (3.48 ± 0.54)] after operation and discharge [(1.74 ± 0.65) vs. (2.36 ± 0.53)] in the ERAS nursing group were lower than those of the routine nursing group, the differences were statistically significant (t=4.526, 4.856 and 4.456, P < 0.05). The nursing satisfaction rate of ERAS nursing group (95.7%, 45/47) was higher than that of routine nursing group (76.60%, 36/47), the difference was statistically significant (P<0.05). Conclusion The idea of ERAS has a good clinical effect in perioperative nursing of patients with total hip replacement. Key words: Enhanced recovery after surgery; Hip osteoarthritis; Hip replacement; Perioperative nursing

Intervention effect of clinical nursing pathway on the contrast induced nephropathy in percutaneous coronary intervention patients

Objective To investigate the effect of clinical nursing pathway in prevention of contrast induced nephropathy in percutaneous coronary intervention patients. Methods A total of 118 cases of coronary heart disease patients who had undergo percutaneous coronary intervention in hospital from May 2018 to May 2019 were randomly divided into the intervention group (n=59) and the control group (n=59). Participants in the control group received routine nursing, while the intervention group carried out clinical nursing pathway nursing method. The renal index such as serum creatinine, blood urea nitrogen, urine β2 microglobulin, N-acetyl-beta-D-glucosidase (NAG) were compared before and after intervention between two groups, the incidence of CIN were also compared. Meanwhile, the psychology status and sleep quality was assessed by self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Pittsburgh sleep quality index (PSQI), respectively. Results The 3rd day after the operation, serum creatinine, serum urea nitrogen, urine β2 microglobulin, NAG in the intervention group and control group were (81.06±15.60) μmol/L, (9.43 ± 2.73) mmol/L, (256.87 ± 18.99) μg/L, (19.56 ± 2.44) U/L and (87.87 ± 19.60) μmol/L, (10.55 ± 2.18) mmol/L, (270.45 ± 40.85) μg/L, (20.60 ± 2.13) U/L, respectively. The levels of serum creatinine, serum urea nitrogen, urine β2 microglobulin, NAG were significantly increased in the intervention group compared to the control group (t=2.087-2.464, P<0.05). The incidence of CIN in the intervention group were 3.4% (2/59) and 13.6% (8/59) in the control group, the differences had statistical significance (χ2=3.933, P<0.05). In addition, the scores of SAS, SDS and sleep quality, sleep time, sleep duration, daytime function and total PSQI score were (44.71 ± 8.20), (41.36 ± 6.52), (0.78 ± 0.11), (1.02 ± 0.15), (1.20 ± 0.19), (0.97 ± 0.27), (6.42 ± 0.54), those index were (48.85 ± 6.52), (46.49 ± 8.29), (1.03 ± 0.21), (1.23 ± 0.28), (1.44 ± 0.30), (1.30 ± 0.28), (7.79 ± 0.69), the differences had statistical significance (t=3.033-12.016, P<0.05). Conclusion Clinical nursing pathway can improve renal function, reduce the incidence of contrast-induced nephropathy, and improve psychological status and sleep quality of percutaneous coronary intervention patients. Key words: Clinical nursing pathway; Interventional cardiovascular therapy; Contrast induced nephropathy; Renal function

Emergency effect of the seamless nursing for patients with acute myocardial infarction in emergency

Objective To explore the emergency effect of the seamless nursing for patients with acute myocardial infarction in emergency. Methods A total of 102 patients with AMI received pre-emergency treatment in the emergency department of Hainan West Central Hospital were randomly divided into control group and experimental group, with 51 cases each.The control group was given routine nursing, and the experimental group was given no-gap nursing.The response time, electrocardiogram time, total emergency time and emergency admission time of the two groups were recorded. Meanwhile, the success rate of first aid, the success rate of transport and the emergency diagnosis rate were recorded.Anxiety and depression levels were assessed in both groups, and nursing satisfaction was investigated. Results The difference of response time, electrocardiogram time, total emergency time and emergency admission time between the experimental group and the control group was statistically significant (P<0.05). At the same time, the emergency diagnosis rate, transport success rate and first aid success rate of the experimental group were significantly increased compared with the control group, and the SAS and SDS scores of the experimental group were significantly reduced compared with the control group after nursing, the differences were statistically significant (P<0.05). In addition, the difference of nursing satisfaction between the control group and the experimental group was statistically significant (P<0.05). Conclusions Application of seamless nursing in emergency procedures of AMI could improve the efficiency of visit, improve the success rate of patient rescue, relieve the anxiety and depression of patients, and improve the satisfaction of patients. Key words: Seamless nursing; Acute myocardium infarction; Emergency

Effects of extended nursing combined with traditional Chinese medicine nursing on gastrointestinal function and adverse reactions in patients with tumor chemotherapy

Objective To explore the effect of extended nursing combined with traditional Chinese medicine nursing on gastrointestinal function and adverse reactions in patients with tumor chemotherapy. Methods A total of 100 tumor patients who received chemotherapy in the hospital from February 2016 to May 2018 were selected. According to the random number table method, they were divided into the study group and the control group, 50 patients in each group.The control group received routine nursing, and the research group received extended nursing combined with TCM nursing model.Gastrointestinal function and adverse reaction symptoms were compared between the two groups. Results The improvement of gastrointestinal function in the study group was better than that in the control group(P<0.05), and the incidence of gastrointestinal adverse reactions was lower than that in the control group(P<0.05). Conclusions Extended nursing combined with traditional Chinese medicine nursing model can effectively improve gastrointestinal function and reduce the incidence of gastrointestinal adverse reactions in tumor patients undergoing chemotherapy. Key words: Extended nursing; Traditional Chinese medicine nursing; Cancer patients undergoing chemotherapy; Gastrointestinal function; Adverse symptoms

Effects of web-based self-management model on preventing renal vein thrombosis in patients with nephrotic syndrome

Objective To explore the effects of web-based self-management model on preventing renal vein thrombosis (RVT) in patients with nephrotic syndrome (NS) . Methods Totally 126 NS patients hospitalized in the First Affiliated Hospital of Zhengzhou University from June 2017 to June 2018 were selected by convenient sampling and divided into conventional management group (n=64) and web-based self-management group (n=62) by random draw. Patients in the conventional management group received routine discharge guidance, while patients in the web-based self-management group received comprehensive web-based self-management based on routine nursing, including education webpage, WeChat group, and SMS and phone alerts based on the telecommunications network. The incidence of RVT in the two groups was collected in the outpatient clinic 6 months after discharge. The Self-Efficacy Scale and Health Promoting Lifestyle Profile (HPLP-II) were used to evaluate the self-management efficacy and health behavior of the two groups on the day of discharge and 6 months after discharge. Results One cases of RVT occurred in the web-based self-management group (1 case was lost to follow-up) , and 8 cases of RVT occurred in the conventional management group (4 cases were lost to follow-up) . The incidence of RVT in the web-based self-management group was 1.64%, lower than 13.33% in the conventional management group, and the differences were statistically significant (χ2=6.008; P=0.014) . The scores of two dimensions as well as the total self-efficacy scores increased in both groups 6 months after discharge, and those of the web-based self-management group were higher than those of the conventional management group, and the differences were statistically significant (P< 0.01) . Compared with the day of discharge, the scores in different HPLP-II dimensions increased in both groups 6 months post discharge, and the differences were statistically significant (P< 0.01) . The scores of the web-based self-management group were higher than those of the conventional management group, and the differences were statistically significant (P< 0.01) . Conclusions The web-based self-management model can reduce the incidence of RVT in NS patients, and improve their self-efficacy, health behavior and self-management out of hospital. Key words: Nephrotic syndrome; Renal vein thrombosis; Self-management; Health behavior; Prevention; Web

Intervention effect of three-line relaxation method on the fear of childbirth and pregnancy outcome in primipara

Objective To investigate the effect of three-line relaxation method on the fear of childbirth and pregnancy outcome in primipara, to explore the useful method to prevent childbirth fear of primipara. Methods A total of 94 cases of primipara who had regular prenatal care at Rizhao Maternal and Child Health Care Hospital from June 2017 to June 2018 were divided into study group and control group with 47 cases each by random number table method. Participants in the control group received routine nursing, while the study group carried out Lamaze respiratory delivery-based three-line relaxation method. The fear of childbirth was investigated by Wijma Delivery Expectancy Questionnaire (W-DEQ-A) before intervention, 4 weeks of intervention and before delivery, the anxiety was assessed by Pregnancy-Related Anxiety Questionnaire (PAQ). Meanwhile, the pregnancy and neonatal outcome was also compared between two groups. Results After 4 weeks of intervention and before delivery, the W-DEQ-A scores were (74.73±7.48) and (80.32±9.25) points in the study group, lower than in the control group (83.11±12.19) and (87.11±10.22) pionts; the PAQ scores were (20.79±4.04) and (18.68±4.09) points, also lower than in the control group (24.74±4.69) and (23.22±4.11) points, the difference was statistically significant (t value was 3.301-5.246, P<0.01). The duration of labor and the rate of caesarean section were (11.66±3.71) h, 6.82% (3/44) and (15.39±4.27) h, 21.74% (10/46) in the study group and control group, respectively, the difference was statistically significant (t value was 4.417, χ2 value was 4.051, P<0.01 or 0.05). Conclusions Lamaze respiratory delivery-based three-line relaxation method can reduce anxiety and childbirth fear and improve pregnancy outcome of primipara, which is worthy of popularization and application. Key words: Three-line relaxation method; Lamaze respiratory care; Fear of childbirth; Pregnancy outcome; Primipara

Intelligent Surgery Nursing Work for Elderly Patients with Acute Appendicitis

Objective: To explore the nursing effect of clinical, surgical nursing on patients with acute appendicitis. Methods: A total of 80 patients with acute appendicitis admitted to our hospital from May2016 to July 2018 were randomly divided into two groups. The patients in the control group received routine nursing. Those in the observation group received clinical, surgical nursing based on that in the control group. After nursing for a period, the nursing effectiveness, incidence of complications. Results: The incidence of postoperative complications in the observation group was 6.67% (4/60), and that in the control group was 21.67 (13/60). The effective nursing rate was 91.67% in the observation group, and that in the control group was 80.00%. Conclusions: The implementation of personalized surgical nursing intervention in the treatment of elderly patients with acute appendicitis can effectively alleviate the adverse emotions of the patients, shorten the time required for anesthesia recovery, reduce the occurrence of various adverse symptoms, with relatively high safety.

The application effect of comfort nursing in the treatment of aged patients with permanent cardiac pacemaker

Objective To investigate the effect of comfort care on the complication rate of permanent cardiac pacemaker in elderly patients. Methods A total of 66 elderly patients undergoing permanent pacemaker implantation from August 2017 to August 2018 were selected as the study subjects.The patients who met the requirements of the study were numbered and randomly grouped by random sampling according to the order of admission, 33 patients with single number were enrolled in the control group and 33 patients with double number were enrolled in the study group.Patients in the control group received routine nursing, while patients in the study group received comfortable nursing.Anxiety and depression, quality of life and complications were compared between the two groups before and after nursing intervention. Results The complication rate of the study group was significantly lower than that of the control group(P<0.05). After cardiac pacemaker implantation and nursing intervention, the psychological state of patients in both groups was significantly improved, and the improvement in the study group was significantly better than that in the control group (P<0.05). The scores of PF, RP, BP, GH and VT in the study group were higher than those of the control group(P<0.05). Conclusions Comfort nursing is effective in the treatment of elderly patients with permanent cardiac pacemaker, which can effectively reduce the complication rate and promote the improvement of patients' psychological state and quality of life. Key words: Elderly patients; Pacemaker; Comfortable nursing; Complication

Evaluation of the effect of continuous nursing in patients with chronic heart failure

Objective To explore the effect of continuous nursing in patients with chronic heart failure. Methods A total of 80 patients with chronic heart failure (NYHA Ⅱ-Ⅲ) in Department of Cardiology were randomly divided into experimental group (40 cases) and control group (40 cases). The patients in the experimental group were given continuous nursing for 6 months on the basis of routine treatment and nursing. The patients in the control group were treated with routine treatment and nursing. The self-management ability of heart failure patients was evaluated by self-management scale at discharge and 6 months after discharge, cardiac function was evaluated by 6-minute walking test, and quality of life was evaluated by Minnesota Living with Heart Failure Questionnaire (MLHFQ). Results All 80 patients completed the study. The score of self-management ability in the experimental group was 69.51 ±4.89 after intervention, and that in the control group was 52.42 ±10.48. There was significant difference between the two groups (t value was -9.346, P< 0.05). The 6-minute walking test distance was (468.56 ±32.53) m in the experimental group and (372.95 ± 32.37) m after the intervention in the control group. There was significant difference between the two groups (t value was -13.177, P < 0.05). The MLHFQ score of the patients in the experimental group was 15.74 ± 4.66 after intervention, and that in the control group was 36.29 ± 11.67. There was significant difference between the two groups (t value was 10.343, P<0.05). Conclusion Continuous nursing intervention can significantly improve the self-management ability, cardiac function and quality of life of patients with chronic heart failure. Key words: Continuous nursing; Chronic heart failure; Self-management ability; Cardiac function; Quality of life

Effects of clinical nursing path model on depression and anxiety among rectal cancer patients with permanent intestinal stoma

Objective To explore the effects of clinical nursing path model on depression and anxiety among rectal cancer patients with stoma. Methods From January 2017 to December 2018, this study selected 100 rectal cancer patients with stoma in the First Affiliated Hospital of Nanjing Medical University. All of patients were randomly divided into control group and intervention group with the method of random number table, 50 cases in each group. Patients of two groups all received routine nursing. On the basis of routine nursing, observation group carried out the intervention based on the clinical nursing path model. Depression and anxiety before and after intervention was assessed with the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) . Results Before intervention, there was no statistical difference in the scores of PHQ-9 of patients between two groups (t=0.116, P=0.908) . After intervention, the score of PHQ-9 of intervention group was lower than that of control group with a statistical difference (t=6.083, P<0.01) , and lower than that before intervention also with a statistical difference (t=7.676, P<0.01) . Before intervention, there was no statistical difference in the scores of GAD-7 patients between two groups (t=0.227, P=0.821) . After intervention, the score of GAD-7 of intervention group was lower than that of control group with a statistical difference (t=9.249, P<0.01) ; scores of GAD-7 of two groups were lower than that before intervention also with statistical differences (P<0.01) . Conclusions Application of clinical nursing path model can effectively improve depression and anxiety of rectal cancer patients with stoma. Key words: Rectal neoplasm; Intestinal stoma; Depression; Anxiety; Clinical nursing path

Effects of holistic nursing management model in aerosol inhalation for children with mycoplasma pneumonia

Objective To explore the effects of holistic nursing management model in aerosol inhalation for children with mycoplasma pneumonia. Methods From June 2018 to April 2019, this study selected 150 mycoplasma pneumonia children with aerosol inhalation in the Affiliated Hospital of Jining Medical University as subjects by convenience sampling. All of children were divided into observation group and control group with the method of random number table, 75 cases in each group. Control group carried out routine nursing, while observation group implemented nursing care with the holistic nursing management model. This study compared the compliance of aerosol inhalation among children between two groups. Perceived society support of children parents and quality of life of children between two groups were evaluated with the Perceived Social Support Scale (PSSS) and the Pediatric Quality of Life Inventory Measurement Models (PedsQL 4.0) respectively before and after intervention. Results The compliance rates of aerosol inhalation among children were 94.67% (71/75) in observation group and 82.67% (62/75) in control group with a statistical difference (P<0.05) . A total of 5 days after intervention, the scores of PSSS of children parents in observation group and control group were (73.25±10.08) and (66.36±9.96) respectively with a statistical difference (P<0.05) . There were also statistical differences in the scores of PedsQL 4.0 between observation group (74.14±10.77) and control group (65.64±9.55) 5 days after intervention (P<0.05) . Conclusions The holistic nursing management model is conducive to improving the aerosol inhalation compliance and quality of life among children with pneumonia as well as social support among children parents which has high application effects. Key words: Mycoplasma pneumohia; Child pneumonia; Aerosol inhalation; Holistic nursing management model

Effects of psychological nursing in anterior tooth injury young patients with fiber splint fixing

Objective To explore the effects of psychological nursing on treatment in anterior tooth injury young patients with fiber splint fixing. Methods From September 2016 to September 2019, this study selected 110 anterior tooth injury young patients with fiber splint fixing in Emergency Comprehensive Treatment Center at Beijing Stomatological Hospital as subjects by convenience sampling. All of patients were randomly divided into routine nursing group (n=58) and psychological nursing group (n=52) . Routine nursing group carried out the routine nursing. On the basis of that in routine nursing group, psychological nursing group implemented psychological nursing. Patients of two groups were investigated with the Self-Rating Anxiety Scale (SAS) to explore the anxiety of patients with different nursing interventions; and the postoperative satisfaction and compliance of patients were compared between two groups. Results The scores of SAS in psychological nursing group were lower than those in routine nursing group 2 and 4 weeks after surgery with statistical differences (P 0.05) . The postoperative satisfaction of patients in psychological nursing group was higher than that in routine nursing group with a statistical difference (P 0.05) . The compliance of brushing their teeth as required and without biting hard object among patients in psychological nursing group were higher than those in routine nursing group with statistical differences (P<0.05) . Conclusions Psychological nursing can reduce anxiety in anterior tooth injury young patients with fiber splint fixing, which also improve patients satisfaction and postoperative compliance, and has a positive role in treatment. Key words: Young adult; Psychological nursing; Teeth injury; Fiber splint fixing

Effects of dual-track continuous health education based on universalization and individualization in patients post operation for endometrial cancer

Objective To explore the effects of dual-track continuous health education based on universalization and individualization in patients post operation for endometrial cancer (EC) . Methods From June 2017 to June 2018, this prospective study selected 194 EC patients with surgery of Zhongnan Hospital of Wuhan University to carry out. All of patients were divided into observation group and control group with the method of random number table, 97 cases in each group. Observation group carried out the dual-track continuous health education based on universalization and individualization, while control group implemented the routine continuous nursing. This study compared the scores the Chinese Edition of Exercise of Self-Care Agency Rating Scale (ESCA) , Medical Coping Modes Questionnaire (MCMQ) , Zung Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) , Functional Assessment of Cancer Therapy-general (FACT-G) between two groups three after intervention. Results After intervention, the scores of health knowledge, self-conception, self-care responsibility, self-care agency and the total score of ESCA between two groups were higher than those before intervention, and those scores of observation group were higher than those of control group with statistical differences (P<0.05) . After intervention, the score of confrontation in MCMQ of two groups was higher than that before intervention, and scores of avoidance and submission were lower than those before intervention; the score of confrontation in MCMQ of observation group was higher than that of control group, and the scores of avoidance and submission of observation group were lower than those of control group with statistical differences (P<0.05) . The scores of SAS and SDS of two groups after intervention were higher than those before intervention, and the scores of SAS and SDS of observation group after intervention were higher than those of control group with statistical differences (P<0.05) . After intervention, the scores of family/society, physiology, emotion and function of FACT-G between two groups were higher than those before intervention, and those dimension scores of observation group were higher than those of control group with statistical differences (P<0.05) . Conclusions Dual-track continuous health education based on universalization and individualization for EC post operation can effectively lift patient's self-care ability and promote the positive coping style which helps patients improve their mental state, CRF and quality of life. Key words: Endometrial neoplasms; Continuing nursing; Dual-track health education; Universalization; Individualization

Application of six-step cancer notification model in lung cancer nursing

Objective To study the application value of six-step cancer notification model (setting, patient's perception, invitation, knowledge, exploring/empathy, strategy/summary, SPIKES) in lung cancer nursing. Methods The convenience sampling method was used. Forty-two lung cancer patients admitted to the First Affiliated Hospital of Zhengzhou University from June 2017 to June 2018 were selected as control group, and 42 lung cancer patients admitted from July 2018 to July 2019 were selected as observation group. The control group underwent routine nursing, and the observation group underwent SPIKES on the basis of the control group. Hamilton Anxiety Scale (HAMA) , Hamilton Depression Scale (HAMD) , Herth Hope Index (HHI) and Quality of Life Questionnaire-Core30 (QLQ-C30) were used to compare the intervention effect between the two groups. Results At discharge, the scores of HAMA (13.84±3.04) and HAMD (15.87±2.11) in the observation group were lower than those in the control group, and the differences were statistically significant (t=5.079, 7.232; P<0.05) . At discharge, the total HHI score of the observation group (34.53±9.25) and the QLQ-C30 score (7.24±2.61) were higher than those in the control group, and the differences were statistically significant (t=5.550, 3.641; P<0.05) . Conclusions Carrying out SPIKES for lung cancer patients can alleviate the negative emotions of patients, improve the hope index and quality of life, which has high clinical application value. Key words: Lung neoplasms; Six-step cancer notification model; Negative emotion; Quality of life

Effects of mindfulness therapy on self-burden, hope and sleep in patients undergoing perfusion chemotherapy for bladder cancer

Objective To explore the effect of mindfulness therapy on self burden, hope and sleep of middle-aged bladder cancer patients undergoing bladder sparing chemotherapy. Methods Sixty patients with bladder cancer treated by intravesical instillation chemotherapy with bladder preservation from January 2018 to December 2019 were selected as the study subjects. They were divided into control group and intervention group according to the sequence of chemotherapy time, with 30 cases in each group. Both groups received routine nursing and rehabilitation training in urology, and mindfulness therapy was added to the intervention group for 6 weeks. Before and 6 weeks after the intervention, the sleeping and mental status of the two groups were compared by the Self-Burden Feeling Scale (SPBS), Herth Hope Scale (HHI) and Insomnia Severity Index Scale (lSI). Results There was no significant difference in SPBS, HHI and ISI scores between the two groups before intervention (P > 0.05). After 6 weeks of intervention, SPBS score of patients in the intervention group was 47.00±1.41, and that of the control group was 49.50±0.62.After 6 weeks of intervention, the total score of HHI was 32.61±1.94 in the intervention group and 27.22±2.67 in the control group.After 6 weeks of intervention, ISI score of patients in the intervention group was 19.17± 1.72, and that of the control group was 20.67±2.24. The difference between the two groups was statistically significant (t values were 6.454, -7.042, 2.097, P < 0.01 or 0.05). Conclusions Mindfulness therapy can effectively improve insomnia and cancer emotional problems in patients with bladder cancer who underwent bladder preservation and perfusion. Key words: Mindfulness therapy; Bladder cancer; Perfusion chemotherapy; Self perceived burden; Survival hope; Sleep status

Effect of multidisciplinary team-based precise nursing on fatigue-pain-sleeping disorder symptom cluster of lung cancer patients undergoing hemotherapy

Objective To investigate the effect of multidisciplinary team-based precise nursing on fatigue-pain-sleeping disorder symptom cluster of lung cancer patients received chemotherapy. Methods A total of 110 lung cancer patients who received chemotherapy were randomly divided into study group (55 cases) and control group (55 cases) . The control group received routine nursing, while the study group carried out multidisciplinary team-based precise nursing. The degree of fatigue, pain and sleeping disorder was assessed by Multidimensional Fatigue Inventory-20 (MFI-20), Brief Pain Inventory-Chinese version (BPI-C) and Pittsburgh Sleep Quality Index (PSQI), respectively. Results Before intervention, the scores of fatigue, pain and sleep quality showed no significant difference (P>0.05). After intervention, the scores of physical fatigue, psychological fatigue, mental fatigue and total fatigue in MFI-20 were 17.78±3.96, 8.02±1.58, 10.19±2.01, 35.98±4.96 in the study group; the scores of pain right now, pain at least in the 24 hours, pain at worst in the 24 hours and pain on the average in BPI-C were 3.76±0.53, 2.15±0.39, 4.11±0.77, (2.72±0.43) in the study group; the scores of the habitual sleep efficiency, sleep latency, subjective sleep quality, sleep duration, sleep disturbances, daytime dysfunction, use of sleeping medication scores and total scores in PSQI were 0.96±0.20, 1.66±0.27, 1.74±0.36, 1.58±0.22, 1.12±0.21, 1.70±0.30, 1.45±0.28, 10.20±0.61 in the study group. However, those scores were 18.84±2.99, 9.15±1.95, 11.06±3.71, 39.05±5.28 and 5.42±1.18, 3.58±0.59, 6.18±1.44, 3.85±0.78 and 1.12±0.19, 1.74±0.27, 1.91±0.25, 1.66±0.46, 1.33±0.32, 1.75±0.29, 1.33±0.42, 10.85±0.70 in the control group. The scores of psychological fatigue, total fatigue, pain right now, pain at least in the 24 hours, pain at worst in the 24 hours, pain on the average and habitual sleep efficiency, subjective sleep quality, sleep disturbances and total PSQI scores were all significantly decreased in the study group compared to the control group (t values were 2.815-14.873, P<0.01). Conclusion Multidisciplinary team-based precise nursing can alleviate fatigue-pain-sleeping disorder symptom cluster of lung cancer patients during received chemotherapy. Key words: Multidisciplinary team; Precise nursing; Lung cancer; Chemotherapy; Symptom cluster

Effect of quality nursing care on stress response and VAS score of emergency surgical debridement and suture patients

Objective To explore the effect of quality nursing care on stress response and visual analogue pain score (VAS) in patients undergoing surgical debridement and suture in emergency department. Methods A total of 116 patients receiving debridement suture from the emergency surgery department of this hospital from March 2017 to February 2018 were selected and divided into control group (March to August 2017) and observation group (September 2017 to February 2018) according to the order of admission, with 58 patients in each group.The control group was given routine nursing, and the observation group was given high-quality nursing service on the basis of routine nursing.Changes in stress response indicators such as adrenaline, TNF-α, Interleukin-6, Cortisol, VAS score, heart rate, systolic blood pressure, operation time and nursing satisfaction were compared between the two groups. Results The levels of epinephrine, TNF-α, Interleukin-6, Cortisol and other stress response indicators in the observation group were lower than those in the control group, and the VAS score 3 hours after the elimination of postoperative anesthesia was lower than that in the control group, with statistically significant differences(P<0.05). The intraoperative systolic blood pressure, heart rate and operation time of the observation group were lower than that of the control group, and the nursing satisfaction rate was higher than that of the control group, and the differences were statistically significant(P<0.05). Conclusions The application of high-quality nursing care in debridement and suture of emergency surgery can effectively alleviate the stress response of patients, maintain the operation center rate and blood pressure to be stable, shorten the operation time, reduce the VAS score, and improve the nursing satisfaction of patients. Key words: Emergency surgery; Debridement suture; High quality care; Stress response; Pain

Application of time-based nursing mode in patients with newly diagnosed type 2 diabetes mellitus

Objective To explore the effects of time-based nursing mode on acceptance and action, healthy empowerment cognition in patients with newly diagnosed type 2 diabetes mellitus (T2DM) . Methods Using convenience sampling method, a total of 129 patients with newly diagnosed T2DM who were diagnosed and hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Xinjiang Medical University were selected from January to December 2018. According to the admission time of patients, the 62 cases who were admitted in odd month were included in the routine nursing group, and the 67 cases who were admitted in even month were included in the time-based nursing group. Patients in the routine nursing group received routine nursing for patients with diabetes, while based on the routine nursing and the principle of do the right thing at the right time, patients in the time-based nursing group received health education, exercise management and retrospective guidance in three time areas from 9∶00 to 11∶00, 16∶00 to 17∶00 and 19∶00 to 21∶00. The degree of acceptance and action, healthy empowerment cognition was investigated and compared between two groups on admission and discharge by Chinese version of Acceptance and Action Diabetes Questionnaire (AADQ) and Health Empowerment Scale. Results There was no significant difference in Chinese version of AADQ score on admission between the two groups (P>0.05) ; on discharge, the Chinese version of AADQ score in two groups were reduced than those on admission, and the AADQ score in the time-based nursing group was lower than that in the routine nursing group, and the differences were statistical (P 0.05) ; compared with that at admission, the score of the time-based nursing group increased, and the difference was statistically significant (P<0.01) ; at discharge, the scores of each dimension of Health Empowerment Scale in the time-based nursing group were higher than those in the routine nursing group, the differences were statistical (P<0.01) . Conclusions Time-based nursing mode can improve the levels of acceptance and action, healthy empowerment cognition in patients with newly diagnosed T2DM, and improve the acceptance degree of the disease and self-consciousness. Key words: Diabetes mellitus, type 2; Time-based nursing; Acceptance and action; Healthy empowerment cognition

Effects of parent synchronous health education-based continuing nursing in Nuss procedure among funnel chest children

Objective To explore the effects of parent synchronous health education-based continuing nursing among funnel chest children after Nuss procedure. Methods From June 2017 to December 2018, this study selected 80 funnel chest children with Nuss procedure and their parents in the First Affiliated Hospital of Zhengzhou University as subjects. All of subjects were divided into control group and observation group with the method of random table, 40 children and 40 parents in each group. Control group carried out routine nursing, while observation group implemented parent synchronous health education-based continuing nursing. The study compared the disease knowledge, care ability, mental status of parents and thoracic correction effects of children of two groups after observation group. Results A total of six months after intervention, the disease knowledge and care ability of parents in observation group were higher than those in control group with statistical differences (P<0.05) . The scores of anxiety and depression of parents in observation group were lower than those in control group with statistical differences (P<0.05) . A total of six months after surgery, the excellent rates of thoracic correction effects of children in observation group were higher than those in control group with a statistical difference (P<0.05) . Conclusions Parent synchronous health education-based continuing nursing can effectively improve disease cognition, care ability, mental status of parents and thoracic correction effects of children. Key words: Children; Funnel chest; Parents; Health education; Nuss procedure; Transitional care

Application of acceptance and commitment therapy in young and middle-aged patients with maintenancehemodialysis

Objective To explore the effect of acceptance and commitment therapy on self-efficacy and post-traumatic growth among young and middle-aged patients with maintenance hemodialysis. Methods From February 2018 to February 2019, we selected patients with maintenance hemodialysis at the Second People's Hospital of Lianyungang as subjects by convenience sampling. All of patients were randomly divided into experimental group and control group with the method of random number table, 42 cases in each group. Control group carried out routine nursing. On the basis of that, experimental group implemented acceptance and commitment therapy. The effects were compared with the General Self-Efficacy Scale (GSES) and Posttraumatic Growth Inventory (PTGI) between two groups. Results There were 41 cases finishing the research in experimental group and 42 cases in control group, except for one case of the experimental group withdrawing from the research. Six weeks after intervention, the scores of GSES and PTGI of patients in experimental group were (30.85±3.12) and (67.89±8.43) respectively higher than those in control group with statistical differences (t=12.254, 10.002; P<0.05) . Conclusions Acceptance and commitment therapy can improve post-traumatic growth as well as self-efficacy among young and middle-aged patients with maintenance hemodialysis. Key words: Dialysis; Maintenance hemodialysis; Acceptance and commitment therapy; Posttraumatic growth; Self-efficacy