A randomised trial of nursing interventions supporting recovery of the postmastectomy patient

Aims and objectives. This ABC to recovery study evaluated the combined and separate components of preoperative education and the effectiveness of wearing the Papilla Gown. Background. Surgical removal of the breast may lead to activity limitation, self‐image issues, discomfort and later complication of lymphoedema. Design. This study used experimental and longitudinal design. Methods. One hundred and forty‐five women undergoing mastectomies for stages two and three breast cancer were randomised into four groups: education and Papilla Gown, education only, gown only and control. The outcomes of activity (A), body image (B), comfort (C), knowledge and lymphoedema were assessed at baseline and/or 1 week and 6 months using three measures. All 145 participants completed the study questionnaires at first two measures, and forty‐six of these participants completed the questionnaires at 6 months postoperatively. The setting for the study included two clinics and hospitals. To examine statistical significance at each time point after surgery, 2‐way anova s were performed on ABC, knowledge and tape measurement to see whether there were any statistically significant differences between the four groups. All reported p‐values are two sided. All statistical analyses were performed using sas 9.2 for Windows. Results. The mean age of the sample was 55 years. The study revealed that women who received the combined intervention demonstrated greater activity. Women who wore the gown only had a greater comfort level and decreased lymphoedema. Women that received preoperative education experienced increased knowledge. Conclusions. Outcomes suggest that the combined intervention (ABCs to recovery) can improve recovery following mastectomy. Relevance to clinical practice. The results will be used to further modify the intervention and to increase awareness of nurse practitioners and other healthcare professionals of the specific needs of postmastectomy patients.     

医用间隙性气囊气圈设计与应用

为预防卧床病人发生压疮,病人在使用传统橡胶气圈时,气圈的圈部面积都在直接和皮肤接触,为了减少刺激,家属往往在橡胶气圈上包上毛巾或棉布,使病人臀部皮肤避免直接接触气圈橡胶,同时又不能随意调整橡胶气圈高度,且气圈因长时间充气垫在病人臀部,皮肤与气圈接触范围大,易引起接触部位红、痒、不舒服等病症。因此,为了使病人减少或减轻接触部位红、     

护理本科男生学习适应性的调查与分析

学习适应性是指学生根据环境及学习的需要,努力调整自我,以期达成和学习环境平衡的心理与行为过程。有研究表明,顺利渡过从中学到大学的转折期,学习适应性直接影响着学生的学业成就[1,2],同时对未来的社会职业发展也具有重要潜在     

EGFR、Her-2和细胞周期素A在食管鳞癌中的表达

目的：探讨食管鳞癌中EGFR信号传导通路相关分子（EGFR、Her-2）及细胞周期素A的表达情况及三者之间的相互关系。方法：随机选取食管鳞癌根治术后的切除标本76例和21例癌旁正常鳞状上皮组织,应用免疫组化法检测EGFR、Her-2和细胞周期素A的表达。结果：EGFR、细胞周期素A在食管鳞癌的表达明显高于癌旁正常鳞状上皮（63.2%vs 33.3%、61.8%vs 23.8%,P〈0.05）,Her-2在食管鳞癌低表达（3.9%）,正常鳞状上皮不表达;EGFR、Her-2和细胞周期素A均与脉管累犯、淋巴结转移正相关,此外,Her-2和细胞周期素A还与肿瘤浸润深度正相关;EGFR与细胞周期素A的表达成正相关（P〈0.01）,而Her-2与EGFR及细胞周期素A表达未发现相关关系。结论：EGFR和细胞周期素A在食管鳞癌中高表达可能与食管鳞癌的发生发展有关,并有可能成为靶向治疗的靶点,而Her-2在食管鳞癌由于表达很低,有可能不是该肿瘤分子治疗的靶点。     

超声与神经阻滞

高频超声可清晰地显示外周神外,用超声引导行外周神经阻滞能更好地减少操作的盲目性并提高成功率。本文就国外对外周神经的超声影像学研究,超声引导外周神经阻滞技术的临床应用和评价作一综述。