Effect of progressive muscle relaxation on postoperative pain,fatigue, and vital signs in patients with head and neck cancers: A randomized controlled trial

ObjectiveSurgery for head and neck cancers are associated with significant preoperative stress. We investigated the effects of progressive muscle relaxation (PMR) on postoperative pain, fatigue, and vital signs in patients with head and neck cancers.MethodsAll patients were hospitalized and randomly assigned to intervention or usual care groups. A generalized estimating equation was used to evaluate the PMR effects on pain and symptoms across the preoperative day to postoperative day 10.ResultsThe PMR group displayed significantly lower overall pain and muscle tightness than control group along with the timeline of multiple measurements (p < 0.01). PMR significantly reduces sleep disturbances and levels of fatigue, anxiety, and depression compared with the control group with time trend (p < 0.01). PMR also lowered the respiratory rates and diastolic blood pressure (p < 0.01).ConclusionsPMR can reduce sleep disturbances and levels of pain, fatigue, muscle tightness, anxiety, and depression in patients with head and neck cancer undergoing major surgeries. Future study should focus on improving the effectiveness of the exercise and standardization of the application.Practical implicationsprogressive muscle relaxation help relieve discomforts in patients with head and neck cancers with minimal costs and efforts.     

循证护理在患者行腹腔镜胆囊切除术后并发症中的应用研究

目的:探讨循证护理在预防患者行腹腔镜胆囊切除术后并发症中作用。方法:将80例行腹腔镜胆囊切除术的患者随机分成观察组(40例)和对照组(40例),观察组采用循证护理,对照组采用传统的护理方法,比较二者的护理效果。结果:观察组护理效果明显好于对照组,差异有统计学意义(P<0.05),如恶心和呕吐的发生率。结论:循证护理可以减少患者行腹腔镜胆囊切除术后并发症的发生,值得临床推广。     

Benefits of hand massage on anxiety in preoperative outpatient: A quasi-experimental study with pre- and post-tests

ContextSurgical patients experience procedure-related anxiety preoperatively. With delays and long waiting periods, surgical patients can experience increased anxiety and decreased satisfaction with their hospital visit.Main ObjectivesTo evaluate whether a 15-minute non-therapeutic hand massage provided by the Caring Hands massage volunteers would reduce anxiety levels, increase satisfaction, and decrease physiological parameters among preoperative surgical patients.DesignThis research study has a quasi-experimental design, with control and intervention groups, and pre and post-tests.Setting: This research study was conducted at Same Day Surgical Stations 53 and 63 at the Mayo Clinic Hospital, Methodist Campus, in Rochester Minnesota.PatientsOne hundred and thirty-eight surgical outpatients were recruited preoperatively, with 31 participants in the control group and 107 in the intervention group.InterventionsPatients in the control group were asked to rest for 15 min. Patients in the intervention group received a 15-minute non-therapeutic hand massage administered by the Caring Hands massage volunteers from the Mayo Clinic Volunteer Program.Main Outcome MeasuresPatient anxiety level and physiological parameters were measured and recorded before and after a resting session (control group) or a 15-minute non-therapeutic hand massage session (intervention group). Patients in the intervention group were also surveyed for satisfaction. The feasibility of incorporating a 15-minute non-therapeutic hand massage into the preoperative routine was also analyzed.ResultsAfter receiving a 15-minute non-therapeutic hand massage, patients experienced reduced anxiety levels and increased satisfaction. It was also found that it is feasible to add a 15-minute non-therapeutic hand massage to the routine of a same-day surgical station.     

Shared decision-making and patient engagement program during acute exacerbation of COPD hospitalization: A randomized control trial

ObjectiveTo evaluate the effectiveness of a shared decision-making and patient engagement (SDM-PE) program concerning in-hospital stay during acute exacerbation of COPD and determine its impact on patients’ perceived health status.MethodsPatients were randomly allocated to a control group that received standard treatment or an intervention group that received an individualized SDM-PE program in addition to standard treatment. The SDM-PE program included personalized health care focused on information about the disease, healthcare management, and reinforcement of behaviors regarding nutrition and exercise taking into account patients’ preferences.ResultsA comparative analysis between groups showed a significant improvement in perceived health status at discharge in patients included in the experimental group compared to those in the control group (60.28 ± 21.65 vs. 54.13 ± 22.69, p = 0.036). In addition, perceived health status, COPD knowledge, adherence to pharmacological treatment, general functionality, and healthy lifestyle measures were significantly better at 3-month follow-up in the intervention group.ConclusionAn SDM-PE program significantly enhanced all the clinical measures assessed during hospitalization at 3-month follow-up.Practice implicationsCOPD patients and professionals need to work together to select the best care and treatment model for patients, taking into account individual values and preferences.     

Coronal tibiofemoral subluxation is a risk factor for postoperative overcorrection in high tibial osteotomy

BackgroundSevere tibiofemoral (TF) subluxation > 10 mm is a contraindication for high tibial osteotomy (HTO). However, the relationship between the degree of preoperative TF subluxation at < 10 mm and postoperative radiographic/clinical outcomes remains unclear.MethodsSixty-seven patients who underwent open wedge HTO with a planned postoperative mechanical femorotibial angle (mFTA) of three degrees valgus were retrospectively studied. The minimal subluxation (MIN) group included 39 patients with TF subluxation < 5 mm, while the moderate subluxation (MOD) group included 28 patients with TF subluxation of five to 10 mm. The preoperative and one-year postoperative mFTA, TF subluxation, medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), preoperative Kellgren-Lawrence (K–L) grade and varus-valgus laxity were evaluated. Clinical scores and pain visual analogue scale (VAS) were also analyzed.ResultsThe mean preoperative TF values in the MIN and MOD groups were 3.1±1.0 mm and 6.7±1.6 mm (mean±standard deviation, p < 0.001), respectively, with no significant difference in K–L grades. The MIN group demonstrated a significantly smaller varus preoperative mFTA (p < 0.001), larger MPTA (p = 0.011), smaller JLCA (p = 0.004), and less varus laxity (p = 0.023). Postoperative TF subluxation, MPTAs, and JLCAs did not differ significantly between the two groups, while the postoperative mFTA was significantly different (p = 0.001), with unintended overcorrection in the MOD group. No significant difference in clinical scores and VAS were observed.ConclusionsAfter HTO, compared to patients with TF subluxation < 5 mm, patients with TF subluxation of five to 10 mm were more likely to demonstrate unintended valgus overcorrection on one-year postoperative radiography.     

The effect of preoperative education on anxiety of open cardiac surgery patients

The purpose of this experimental study was to evaluate the effect of preoperative teaching method on anxiety levels of the patients. This study consisted of 100 patients having open cardiac surgery. Of 100 patients 50 were placed in the intervention group while the remaining 50 were in the control group. The patients in the intervention group were given a planned teaching according to the patient education booklet. Patients in the control group were informed about pre- and postoperative routines by a nurse by the purpose of comparing anxiety levels of the patients in the intervention and control groups. The anxiety level of the patients in control and intervention groups was measured on the 3rd day after the operation by using the Self-Evaluation Questionnaire for State and Trait Anxiety Inventory. The mean postoperative state and trait anxiety score in the control group was slightly higher than the mean of the patients in the intervention group. There was no statistically significant difference in the state and trait anxiety scores between the groups, and the patients in the intervention group had lower scores than the patients in the control group. In addition, all patients in the intervention group stated that they were satisfied with the preoperative teaching given by the researcher.     

Preoperative administration of intramuscular dezocine reduces postoperative pain for laparoscopic cholecystectomy

Postoperative pain is the most common complaint after laparoscopic cholecystectomy.This study was carried out to evaluate whether preoperative administration of intramuscular dezocine can provide postoperative analgesia and reduce postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy.Patients (ASA Ⅰ or Ⅱ) scheduled for laparoscopic cholecystectomy were randomly assigned into intramuscular dezocine group (group 1) or intramuscular normal saline group (group 2).Dezocine and equal volume normal saline were administered intramuscularly 10 min before the induction of anesthesia.After operation,the severity of postoperative pain,postoperative fentanyl requirement,incidence and severity of side-effects were assessed.Postoperative pain and postoperative patient-controlled fentanyl consumption were reduced significantly in group 1 compared with group 2.The incidence and severity of side effects were similar between the two groups.Preoperative single-dose administration of intramuscular dezocine 0.1 mg/kg was effective in reducing postoperative pain and postoperative patient-controlled fentanyl requirement in patients undergoing laparoscopic cholecystectomy.     

Effect of Music on Anxiety of Women Awaiting Breast Biopsy

Abstract

The authors investigated the effect of music on the state anxiety of a sample of 20 patients awaiting breast biopsy at a suburban medical facility. The patients were assigned alternately to either the control or experimental group. The individuals in the experimental group were given a 20-minute music-based intervention in a preoperative holding area, whereas the patients in the control group received the customary preoperative care. Clinicians measured blood pressure, heart rate, and respiration in both groups of patients, and the participants completed the State portion of the self-administered State-Trait Anxiety Inventory (STAI). After the patients completed the 20 minutes of music or of preoperative care without music, clinicians again measured the participants' vital signs and the patients completed the STAI. The authors' findings indicated that the posttest state anxiety and respiratory rates of the patients in the experimental group were significantly lower than those of the patients in the control group.     

Effect of inhaler drug education on fatigue,dyspnea severity,and respiratory function tests in patients with COPD

ObjectiveThis study was conducted to examine the effect of inhaler drug education on fatigue, dyspnea severity, and respiratory function tests in patients with chronic obstructive pulmonary disease (COPD).MethodsThis randomized controlled study was conducted with a total of 85 patients treated at the chest diseases clinic and outpatient clinic of a state hospital. The data were collected using questionnaires, respiratory function tests, and the COPD and Asthma Fatigue Scale (CAFS) and Visual Analogue Scale (VAS-for dyspnea severity).ResultsIt was determined that after 4 weeks of inhaler drug education, the CAFS mean score decreased to 35.32 ± 14.36, the dyspnea severity mean score decreased to 4.76 ± 2.50, and the respiratory function tests mean scores increased to forced expiratory volume in 1 s (FEV₁) = 58.83 ± 25.48, forced vital capacity (FVC) = 59.04 ± 19.19, and FEV₁/FVC = 88.39 ± 21.59 in the intervention group (p < 0.05). No change was observed in the patients in the control group except for FEV₁ and FVC mean scores (p > 0.05).ConclusionThese results demonstrate that inhaler drug education can improve fatigue, dyspnea severity, and respiratory function tests of patients with COPD.Practice implicationsThe training by nurses of every patient hospitalized in the clinic regarding inhaler drug therapy, and the regular checking of patients’ way of using the inhaled drugs, will contribute to COPD management.     

Results of a self-management program added to standard physical therapy in chronic neck pain

ObjectiveTo evaluate the effectiveness of a self-management treatment added to a physical therapy program compared to a physical therapy program in patients with chronic neck pain.MethodsFifty-three patients with chronic neck pain were randomly allocated to a physical therapy intervention (control group) or an individualized self-management combined with physical therapy intervention (experimental group). Both interventions were developed over a four-week period. Outcome measures included were Disability, Fear-Avoidance Beliefs, Health-Related Quality of Life, Pain, and Anxiety and Depression. All outcomes were measured before and after the treatment and at three-month follow-up.ResultsThere were not significant differences between groups at baseline. After the intervention both groups obtained better results in the Neck Disability Index but there were not significant differences between them (p > 0.05). At follow-up, the self-management group obtained significant better results compared to the control group (95 % CI: -5.20(-6.8 to -1.5), p = 0.032).ConclusionsAn individualized self-management program added to a physical therapy program led to a greater improvement in disability at 3 months follow up compared to a physical therapy program alone. Catastrophizing, pain, and health-related quality of life improved significantly after the intervention and at follow-up compared to the standard care alone.Practical implicationsThis study indicates that physical therapy for patients with chronic neck pain preferably should include self-management education.     

Massage and heat application on labor pain and comfort: A quasi-randomized controlled experimental study

AimThe aim of this study was to determine the effects of sacral massage and heat application on the perceptions of labor pain and comfort level in pregnant women.MethodsThis was a quasi-randomized controlled experimental study. The data were collected under three groups in 2016: the heat application group (HAG), the massage group (MG), and the control group (CG). Each group included 30 primiparous pregnant women (range of age: 17–35) whose cervix was dilated to 4–5 cm. At 4–5 cm, 6–7 cm, and 8–9 cm cervical dilation, sacral massage was applied to MG, and sacral heat application was applied to HAG. Each group received standard midwifery care during labor. The data were collected using the Childbirth Comfort Questionnaire (CCQ) and the Numerical Rating Scale (NRS). The data were analyzed by using the Chi-square test, the Friedman test, Paired sample t-test, ANOVA, the Kruskal-Wallis test, and Wilcoxon signed-ranks testResultsThe mean pain score in HAG (4.56±0.67) during 4–5 cm of cervical dilation was significantly lower than those in MG (5.03±1.06) or CG (5.23±0.72) (p < 0.05). The mean pain scores in HAG (6.80±0.7) and MG (7.30±0.8) during 6–7 cm of cervical dilation were significantly lower than that in CG (7.70±0.5) (p < 0.001). Moreover, a statistically significant difference was found between the mean CCQ total scores (HAG: 31.06±3.46, CG: 27.66±3.85, p < 0.05), mean CCQ physical comfort scores (HAG: 13.16±1.89, CG: 11.03±1.80, p < 0.001), mean CCQ relief comfort level score (HAG: 11.23±1.43, CG: 10.00±2.01, p < 0.05) and mean CCQ transcendence comfort level scores (HAG: 19.83±2.37, CG: 17.66±2.15, p < 0.05) and both HAG and CG during 8–9 cm of cervical dilation.ConclusionsHeat application and massage can be used as a safe and effective midwifery intervention to reduce the perception of pain in pregnant women and provide comfort during labor.     

临床观摩式护理干预与下颌阻生牙拔除患者的焦虑状况

目的:下颌阻生牙拔除患者通常存在围手术期的焦虑症状,本研究探讨临床观摩式的护理干预对门诊拔除阻生牙患者焦虑情况的影响。方法:238例患者随机分为实验组和对照组,两组患者均接受常规的健康宣教和临床资料收集。实验组采用临床观摩式护理干预,患者观摩临床阻生牙拔除的全过程。两组于手术前、后行HAMA量表检测患者的焦虑状况。结果:实验组和对照组术后的HAMA值有显著性差异(P<0.05),而术前无统计学意义。结论:临床观摩式的护理干预有助于下颌阻生牙拔除患者降低患者的焦虑状况。     

富血小板血浆复合自体松质骨移植的生物重建治疗陈旧性腕舟状骨骨不连的临床效果分析

目的 观察富血小板血浆（platelet-rich plasma, PRP）复合自体松质骨移植治疗腕舟状骨骨不连的近期临床效果。方法 收集中国人民解放军联勤保障部队第989医院自2019年6月至2021年6月期间收治的30例陈旧性腕舟状骨骨不连的患者作为研究对象,按照随机数表分为观察组和对照组。观察组（15例）采用PRP复合自体松质骨移植的生物重建方法,对照组（15例）采用只采用自体松质骨移植并内固定的手术方式。对比两组的手术时间、住院时间、骨折愈合情况、骨痂等级评分、腕关节功能评估及术后并发症。结果 术后30例患者均得到随访,随访周期为12个月。观察组骨折愈合率为93.3%,对照组骨折愈合率为66.7%,两组比较差异具有统计学意义（P＜0.05）。观察组的手术时间为（1.83±0.23）h,对照组的手术时间为（1.73±0.30）h,两组比较差异无统计学意义（P＞0.05）;观察组骨折愈合时间［（16.54±0.74）周］少于对照组［（20.70±4.73）周］,术后住院时间［（14.27±2.43） d］少于对照组［（19.53±6.29） d］,两组比较差异具有统计学意义（P＜0.05）。观察组术后4、8、12周骨痂等级评分比较优于对照组,两组比较差异具有统计学意义（P＜0.05）;观察组术后16周骨痂等级评分比较优于对照组,两组比较差异无统计学意义（P＞0.05）。数据显示术后6个月,观察组的Mayo评分高于对照组,VAS评分低于对照组,两组比较差异具有统计学意义（P＜0.05）;术后12个月,两组间Mayo评分及VAS评分比较,差异无统计学意义（P＞0.05）。观察组术后并发症共2例,对照组术后并发症共6例,两组比较差异具有统计学意义（P＜0.05）。结论 富血小板血浆（PRP）复合自体松质骨移植治疗腕舟状骨骨不连可促进腕舟状骨骨折愈合,减少手术相关并发症,利于腕关节功能恢复,近期临床效果较好。     

食管癌患者术后营养不良状况与认知行为依从干预分析

目的:调查食管癌患者术后营养不良状况,探讨认知行为依从干预对营养不良状况的影响.方法:2013年5月至2016年7月在我院诊治的食管癌术后患者120例作为研究对象,根据随机抽签原则分为观察组与对照组各60例,对照组在术后给予常规饮食干预,观察组在对照组护理的基础上给予基于认知行为依从干预的个性化饮食干预方案,护理观察时间为14d.结果:护理前观察组与对照组的营养不良发生率分别为56.7％和58.3％,护理后分别为6.7％和23.3％,观察组护理后的营养不良发生率明显少于对照组(P＜0.05).护理期间观察组的均衡饮食评分为2.48±0.42,明显高于对照组的1.75±0.44(t=9.296,P＜0.05).护理后观察组与对照组的认知功能评分分别为7.43±2.14和5.89±1.34,都明显高于护理前的3.56±1.33和3.48±1.28(P＜0.05);在认知功能评分方面,护理后观察组显著高于对照组(P＜0.05).护理后观察组与对照组的血清白蛋白与前白蛋白水平都明显高于护理前(P＜0.05),同时护理后观察组的血清白蛋白与前白蛋白水平明显高于对照组(P＜0.05).结论:食管癌术后患者营养不良状况比较常见,认知行为依从干预能缓解营养不良状况,提高饮食依从性,从而改善认知行为能力,促进机体营养状况.     

Effectiveness of mandala coloring in reducing anxiety in women with early-stage breast cancer receiving chemotherapy for the first time

ContextMany people with cancer experience fear or anxiety when starting chemotherapy for the first time. Mandala coloring is an art therapy approach commonly used for anti-stress therapy.ObjectiveTo assess whether mandala coloring reduces the anxiety experienced by women with early-stage breast cancer during their first chemotherapy session.DesignA quasi-experimental controlled study with pretest/posttest design.SettingThe study was conducted in the outpatient chemotherapy unit of the Istanbul University Institute of Oncology between March 2017 and May 2018.ParticipantsEight-four women with early-stage breast cancer who presented for their first session of chemotherapy were included, 41 in the intervention group and 43 in the control group.InterventionPatients in the intervention group were asked to color a mandala for 30 min while receiving premedication prior to chemotherapy. No intervention was applied to the control group.Main outcome measuresLevels of distress and anxiety were assessed before and after premedication using the distress thermometer and State–Trait Anxiety Inventory.ResultsThe sample group consisted primarily of women who had primary school education, were married, and were homemakers. Average distress levels were low in both the intervention and control group before premedication, and state anxiety scores did not differ statistically between the groups before or after premedication. However, patients in the intervention group who had high distress levels before premedication showed a significant decrease in state anxiety score after premedication, while patients in the control group showed no decrease.     

微创手术治疗胆囊结石合并胆总管结石的临床疗效分析

目的 分析腹腔镜胆囊切除（LC）+胆总管探查取石术（LCBDE）与腹腔镜胆囊切除（LC）+十二指肠镜Oddi括约肌切开术（EST）/逆行性胰胆管造影（ERCP）的临床疗效。方法 回顾性分析2016年2月~2017年2月收治的胆囊结石合并胆总管结石患者120例,按照不同治疗方式分为两组,对照组60例行LC+EST/ERCP,观察组60例行LC+LCBDE,观察两组患者的手术成功率、术中出血量、术后住院时间、住院费用、术后并发症发生率安全性和可行性。结果 两组患者手术成功率、并发症发生率、出血量差异均无统计学意义（P＞0.05）。观察组住院时间、住院费用均低于对照组,差异有统计学意义（P＜0.05）。结论 LC+LCBDE与LC+EST/ERCP均是安全有效治疗胆囊合并胆管结石的手术方式,在术中出血量、术后住院时间、住院费用方面LC+LCBDE占优势,临床根据患者情况行个体化治疗,灵活选取手术方式。     

The effect of preoperative Reiki application on patient anxiety levels

PurposeThe purpose of the study was to investigate changes in the anxiety levels of patients receiving preoperative Reiki.Material and methodsThis study used a quasi-experimental model with a pretest-posttest control group. Methods: Subjects (n = 210) were recruited from a hospital in Turkey, from June 2013 to July 2014. Subjects were then assigned to experimental (n = 105) and control (n = 105) groups.ResultsThe level of anxiety of experimental group patients did not change according to their state anxiety scores (p > 0.10); however, the anxiety level of control group patients increased (p < 0.001).ConclusionThe results of this study imply that the administration of Reiki is effective in controlling preoperative anxiety levels and in preventing them from increasing.     

个体化干预对糖尿病合并慢性伤口患者的焦虑情绪及疼痛的影响

目的探讨个体化干预对糖尿病合并慢性伤口患者的焦虑情绪及疼痛的影响。 方法选取2016年10月至2017年11月在开滦总医院和唐山工人医院两所三级甲等医院的88例糖尿病合并慢性伤口患者,遵循压疮愈合计分表评分分层随机分为干预组和对照组各44例,2组患者伤口均采用湿性愈合方法治疗,干预组结合综合性评估结果给予连续性个体化干预措施,对照组实施常规护理措施,通过焦虑自评量表(SAS)和疼痛数字评价量表(NRS),比较2组患者焦虑情绪及疼痛程度的改变。数据比较采用t检验和χ²检验。 结果经过个体化干预后,干预组患者SAS评分为(48.86±7.08)分,低于对照组(56.42±5.38)分,差异有统计学意义(t＝－5.639,P<0.05);干预组患者NRS评分为(3.93±1.82)分,明显低于对照组(4.73±1.93)分,差异有统计学意义(t＝2.296,P＝0.042)。干预组患者愈合时间小于中位数占比65.9%与对照组(36.4%)比较,差异有统计学意义(χ²＝6.545,P＝0.011)。 结论通过对糖尿病合并慢性伤口患者实施个体化干预可显著改善患者焦虑情绪,并降低疼痛程度。     

Effect of nurse-led program on the exercise behavior of coronary artery patients: Pender’s Health Promotion Model

ObjectiveTo determine the effect of nurse-led program based on Pender’s Health Promotion Model on the exercise behaviors of coronary artery patients.MethodsThe two-arm parallel, single-blind, randomized controlled trial was conducted with a total of 62 patients, intervention (n = 32) and control group (n = 30). Intervention group received a nurse-led program based on Pender’s Health Promotion Model and routine follow-ups of control group continued. The health perception, perceived exercise self efficacy, perceived exercise benefits/barriers, exercise-related effect, exercise frequency and time were assessed at baseline, 4th, 8th and 12th weeks. The data were evaluated by frequency, percentage, median, mean and standard deviation, chi-square, Friedman and Mann Whitney U tests.ResultsHealth perception (62.6 ± 9.5; median:67.0; p < 0.001), perceived exercise benefit (105.8 ± 7.4; median:107.0; p < 0.001), perceived exercise self efficacy (71.2 ± 5.4; median: 71.5; p < 0.05), exercise-related effect (31.6 ± 6.0; median:34.0; p < 0.05), exercise frequency (4.8 ± 2.2; median:6.0 days/week; p < 0.05) and time (105.9 ± 53.6; median:130.0 min/week; p < 0.05) were higher and perceived barriers (43.1 ± 3.9; median: 42.0; p < 0.001) were lower in the intervention group at 12th week.ConclusionsThe nurse-led program has been shown to increase the exercise behavior in the intervention group.Practice ImplicationsSince it enables patients to gain and maintain exercise, it is highlighted the model to be integrated into clinical practice.