ObjectiveTo explore the effect of comprehensive nursing service in patients with autoimmune encephalitis (AE).Methods32 patients with AE were selected and treated in our hospital from January 2017 to January 2019. There are 16 patients in the observation group and the control group respectively. The observation group received comprehensive nursing service and the control group received routine nursing intervention. Total satisfaction of clinical nursing was compared between the two groups.ResultsCompared with 10 cases (62.50%) in the control group, 15 cases (93.75%) in the observation group had better overall nursing satisfaction, and the difference between the two groups was significant (P<0.05).ConclusionsFor patients with AE, comprehensive nursing service can significantly improve the quality of life of patients, which has clinical application value.
ObjectiveTo investigate the job satisfaction, emotional state and related factors of medical staff participating in online consultation of West China Internet Hospital during the COVID-19 epidemic.MethodsThrough literature review and expert consultation (Delphi method), the questionnaire was developed, and the online consulting medical staff of West China Hospital of Sichuan University were invited to conduct the questionnaire survey from 26 January to 19 June 2020, and finally the statistical analysis was summarized.ResultsA total of 132 valid questionnaires were retrieved. Of the 132 subjects, 127 people (96.2%) expressed satisfaction or special satisfaction with the online consulting office format; 103 respondents (78.0%) said that online consulting did not affect or completely did not affect the work and life; 81 people (61.4%) consulted online more than 5 days a week, and 108 people (81.8%) worked within 2 hours a day; the vast majority (97.7%) of the research subjects were satisfied with the content of the training materials and the related support work of the coordination group. Only 29 (22.0%) of the study participants believed that the epidemic caused negative emotions, mainly due to the severity of the epidemic.ConclusionThe online consulting medical staff are satisfied with the office form, training materials and coordination work group of the COVID-19 epidemic, and think that it does not affect their work and life. 22.0% of medical staff have negative emotions, and the severity of the epidemic is the main reason.
ObjectiveTo investigate the effect of continuous occupational therapy (OT) on the life satisfaction of patients with spinal cord injury (SCI). MethodsFifty-two SCI patients treated in Department of Rehabilitation at People’s Hospital of Mianzhu City between 2008 and 2010 were randomly assigned into two groups with 26 patients in each. Patients in the trial group received OT and rehabilitation nursing both in hospital and after being discharged from hospital, whereas patients in the control group only received treatment in hospital. Life satisfaction was assessed when patients were discharged from hospital and 21 months later. ResultsThe patients were treated for an average of 12 weeks in hospital before being discharged. Twenty-six questionnaires were given out to the patients when they were discharged from hospital, and another 26 were given 21 months later. All the questionnaires were retrieved, with a retrieval rate of 100%. The life satisfaction scores between the trial and control groups were not different from each other when the patients were discharged from hospital (P>0.05). The trial group was more satisfied with their life 21 months after being discharged from hospital (P<0.05). The life satisfaction scores of the control group were not changed (P>0.05). The trial group had higher life satisfaction than the control group 21 months after being discharged (P<0.05). ConclusionContinuous OT instruction on patients can increase their life satisfaction, and the rehabilitation effect of patients is better than rehabilitation intervention at a certain stage.
Objective To survey the relations between the rural residents’ occupational satisfaction, the health policies and demographic factors in Henan province and then to confirm the health policy order and its key target populations. Methods The questionnaires were distributed to 1 117 rural residents in 156 villages among 44 townships in 19 counties (cities, districts). The frequency analysis, multivariate linear regression analysis and multiple comparisons were conducted. Results The average value of rural residents’ occupational satisfaction scored 68.23, among which the complete dissatisfaction scored 0 accounting for 1.9%, the complete satisfaction scored 100 accounting for 9.0%, the one scoring no more than 50 accounted for 20.9%, and the one scoreing equal 80 or more than 80 accounted for 37.5%. By regarding the occupational satisfaction as the dependent variable, the independent variables stayed in the model were as follows in order according to their influence from heavy to little on the dependent variable: new rural cooperative medical system (NRCMS), occupation, village general practitioner’s work, family formation, age, disease prevention and control efforts. The occupational satisfaction was much higher when there were the following conditions: the higher satisfaction with the NRCMS, the more financial burden relieved by the NRCMS, and the higher satisfaction with village general practitioners’ work. The occupational satisfaction was the highest when villagers lived with their spouses, while it was the lowest when villagers lived with their spouses and children, as well as they lived with their parents, spouses and children. The peasants’ occupational satisfaction was the lowest. The occupational satisfaction had significantly negative correlation with cultural level, and had positive correlation with age. Conclusion The occupational satisfaction is an important indicator for assessing the level of social harmony, and is the basis for policy decision-making, implementation, and evaluation. The overall occupational satisfaction of the rural residents in Henan is lower, so the social harmoniy and stability should be alerted. The priority order of the existing rural health policy should be the NRCMS policy, village general practitioner work policy, and village disease prevention and control policy. When we are formulating and implementing the rural health policy, the key target populations should be considered among the people whose families comprise two or three generations, whose occupations are farmers, whose cultural level is lower, and whose ages are younger.
ObjectiveTo explore the therapeutic effect of gasless endoscopic thyroidectomy via axillary posterior approach for unilateral papillary thyroid microcarcinoma. MethodsThe clinicopathologic data of patients with unilateral papillary thyroid microcarcinoma who were treated by gasless endoscopic thyroidectomy via axillary posterior approach (observation group) or breast approach (control group) in the Xuzhou Central Hospital from January 2020 to February 2022 were collected. The operation time, accidental intraoperative bleeding, exposure time of recurrent laryngeal nerve, number of lymph node dissection, total hospital stay, and postoperative complications such as superior laryngeal nerve injury, cough due to drinking, temporary hoarseness, transient hypocalcemia, tunnel hematoma, and neck discomfort were compared between the two groups. Meanwhile, the cosmetic effects of the two groups were evaluated. ResultsA total of 87 patients who met the study conditions were enrolled in this study, including 47 cases in the observation group and 40 cases in the control group. There were no statistical differences in the baseline data such as gende, age, maximum tumor diameter, location of tumor, etc. between the two groups (P>0.05). Compared with the control group, the exposure time of recurrent laryngeal nerve was shorter (P<0.001) and the number of lymph node dissection was more (P=0.034), but the accidental intraoperative bleeding during operation was more (P=0.015) in the observation group. There were no statistical differences in the operation time and total hospital stay between the two groups (P>0.05). There were no superior laryngeal nerve injury and cough due to drinking in the two groups after operation, and there were no statistical differences between the two groups in the terms of postoperative temporary hoarseness, transient hypocalcemia, and tunnel hematoma (P>0.05), but it was found that the incidence of postoperative neck discomfort in the observation group was lower than that in the control group (P=0.043), and the postoperative cosmetic satisfaction score was also higher than that in the control group (P<0.001). ConclusionsFrom the results of this study, gasless endoscopic thyroidectomy via axillary posterior approach for unilateral papillary thyroid microcarcinoma is safe and feasible. It can quickly expose the recurrent laryngeal nerve and greatly improve the efficiency of lymph node dissection, as well as the cosmetic effect is better.
Objective To evaluate if performing thyroidectomy through small incision has any notable aesthetic impact on patients compared with larger incision. Methods Thirty consecutive patients underwent thyroidectomy were enrolled from March 2008 to June 2008 in this prospective randomized pilot study. The incision length was 6 cm in the small incision group and 9 cm in the larger incision group. After 3 years follow-up，the scar aesthetics were evaluated by patients and surgeons using the Patient and Observer Scar Assessment Scale （POSAS），Vancouver Scar Scale （VSS），respectively. Digital photographs about scars were taken and assessed by non-research related viewers. Results There were 13 cases who received scar aesthetic assessment in both groups. The demographic characteristics of both groups were comparative. The overall patients’ satisfactions for the small incision group and the larger incision group were （2.5±1.9） scores and （2.2±1.5）scores， respectively （P=0.55）. There were no significant differences in scar assessment scale score as for other scar assessment scales （including VSS score，PSAS score，and OSAS score） between the two groups. The evaluation of digital photographs about scars by non-research related viewers was no significant difference （P＞0.05）. Conclusion Larger cervical scar in thyroidectomy does not decrease patients’ satisfaction with their scar results.
Objective To manage the preoperative, intraoperative and postoperative pain of percutaneous kyphoplasty (PKP) under the concept of enhanced recovery after surgery (ERAS) and explore the role of pain management under the ERAS concept in enhancing postoperative rehabilitation of PKP. Methods From January to December 2016, 136 patients with osteoporotic compression fractures treated with PKP of local anesthesia were selected, among which 71 patients in the ERAS group were treated between July and December 2016, who were treated with celecoxib capsule for analgesia before the operation and such local anesthetics as lidocaine and ropivacaine combined with intravenous injection of dexmedetomidine hydrochloride for multi-mode analgesia during the operation; after the operation, celecoxib capsules and tizanidine hydrochloride tablets were orally administered by the routine for analgesia; if the pain was increased, 40 mg parecoxib would be added for analgesia by intramuscular injection. While 65 patients in the conventional group were treated between January and June 2016, who were given intraoperative local anesthesia with lidocaine; if the patients suffered from severe pain after the operation, they would be given 40 mg parecoxib by intramuscular injection. The Visual Analogue Scale (VAS), mean arterial pressure (MAP), the complications after surgery, postoperative infections, bed rest time, length of hospital stay and patient satisfaction were compared between the two groups. Results There was no statistical difference in age, gender or fracture vertebral number between the two groups (P>0.05). The preoperative, intraoperative and postoperative VAS scores (4.0±1.5, 4.8±1.8, 1.6±1.1), MAP change [(22.0±4.7) mm Hg (1 mm Hg=0.133 kPa)], bed rest time [(1.5±0.7) days], and length of hospital stay [(3.8±0.8) days] in the ERAS group were significantly less than those in the conventional group [4.7±1.7, 5.7±1.5, 2.4±1.1, (31.3±6.1) mm Hg, (2.1±0.8) days, and (5.0±1.6) days, respectively] (P<0.05). The incidence of intraoperative complication of bone cement leakage (4.2%, 3/71) in the ERAS group was lower than that in the conventional group (13.8%, 9/65) (P<0.05); there was no statistical difference in postoperative pulmonary infection between the two groups (P>0.05). Patients’ satisfaction was significantly improved from 86.2% (the conventional group) to 95.8% (the ERAS group) (P<0.05). There was no incision infection, urinary tract infection or venous thrombosis in the two groups. Conclusion With the concept of ERAS, taking a management of pain can effectively alleviate the dis-comfortable pain feeling, improve the patients’ satisfaction, and enhance the recovery for the patients after PKP surgery.
Objective To optimize the environment of outpatient clinics in large hospitals, facilitate the patients’ visits and improve the comprehensive management level. Methods From September to November 2015, 2 hospitals in each part of a provincial city (middle, east, west, north and south), a total of 10 hospitals were chosed by convenient sampling method. The forms, types and distribution of outpatient navigation service system were investigated and analyzed by using a self-designed questionnaire. Results There were a total of 14 forms of counseling-guide services in the 10 hospitals. Just 1 hospital provided all the 14 forms of counseling-guide services, and 2 hospitals provided 13 forms of counseling-guide services, which were relatively complete. While the other 7 large hospitals provided only 4 to 6 forms of counseling-guide services, which were relatively simple. Conclusion Qualified outpatient navigation service system can help patients to receive more effective treatment, optimize the environment, highlighting the modern hospital humanistic service and the concept of intelligent service and scientific management.
Objective To understand the effect and influencing factors of humanistic care on improving the experience of inpatients. Methods Patients were collected from a third grade class A women’s and children’s hospital in June 2015 and June 2016, and their satisfaction was investigated by a third party. The service items of Inpatients Satisfaction Item Score Table in 2015 were analyzed. Appropriate intervention measures were taken to low-score items, such as humanistic knowledge training to all medical staff, improvement health guidelines, implementation of recycling process, carrying out high quality nursing interventions, and so on. The patients satisfaction survey results in 2016 were compared with those of 2015. Results In 2016, the total satisfaction rate (89.94%), and the average score of items ranked the top three (94.64±0.14), including the level of medical technology, medical ethics and the overall evaluation of doctor’s professional ehtics, medical communication and service attitude, were higher than those of 2015 (85.25, 90.86±1.53). The average score of items ranked the last three (89.25±9.21), including hospital ward, hospital environment (clean, quiet and safe), hospital meals and room service, and hospital food quality, was higher than that of 2015 (78.64±2.40). However, compared with the same period in the last year, the rank of hospital environment fell by two places. Conclusions Hardware conditions like physical environment have an important impact on the experience of hospital patients. However, humanistic care is the key factor to improve the patients’ inpatient experience and satisfaction.
ObjectiveTo understand the current research status of conservative mastectomy with breast reconstruction for breast cancer, so as to provide a reference for surgeons and patients with breast cancer to choose surgical method. MethodThe recently domestic and foreign literature on the research of conservative mastectomy with breast reconstruction for breast cancer was reviewed and summarized. ResultsAt present, conservative mastectomy mainly included nipple sparing mastectomy, skin sparing mastectomy, and skin reduction mastectomy. All three surgical methods were safe and effective in the treatment of breast cancer, and the complications could be controlled. When combined with breast reconstruction, the better cosmetic effect could be obtained, and the postoperative satisfaction and quality of life of patients were markedly improved. ConclusionsAfter comprehensively preoperative evaluation for patients with breast cancer, conservative mastectomy provides a treatment choice for them. After conservative mastectomy, individualized reconstruction scheme is formulated according to size and sagging degree of breast, as well as individual expectations of patients, which can obtain a higher quality of life while treating diseases for patients with breast cancer.