The Effect of Capacity Assessment Combined with Staged Target Nursing Intervention on Swallowing Functional Disturbance and Pulmonary Infection in Elderly Stroke Patients

2021 ◽  
Vol 7 (5) ◽  
pp. 2492-2500
Author(s):  
Li Huang ◽  
Chenchen Zhang ◽  
Li Li ◽  
Min Pang ◽  
Li Liu

To investigate the effect of capacity assessment combined with staged target nursing intervention on swallowing functional disturbance (SFD) and pulmonary infection in elderly stroke patients. 82 elderly stroke patients treated in the neurological department of our hospital (June 2019-February 2021) were chosen as the study subjects and randomly split into study group (n=41) and control group (n=41). Both groups received basic treatment for cerebrovascular diseases. After that, control group received routine clinical nursing, while study group underwent capacity assessment combined with staged target nursing intervention. The scores of the Burke Lateropulsion scale in both groups after 3-month nursing intervention were obviously lower (P < 0.001), and after 3-month nursing intervention the scores of the Burke Lateropulsion scale in study group were obviously lower compared with control group (P < 0.001). The NIHSS scores in both groups after 3-month nursing intervention were obviously lower (P < 0.001), and the NIHSS scores in study group after 3-month nursing intervention were obviously lower compared with control group (P < 0.001). The total clinical efficacy rate in study group was obviously higher compared with control group (P < 0.05). The SWAL-QOL scores in both groups after 3-month nursing intervention were obviously higher (P < 0.001), and the SWAL-QOL scores in study group after 3-month nursing intervention were obviously higher compared with control group (P < 0.001). The levels of FVC, FEV1 and PEF in both groups after 3-month nursing intervention were obviously higher (P < 0.001), and those after 3-month nursing intervention in study group were obviously higher compared with control group (P < 0.001). Plus, the total incidence of complications in study group was obviously lower compared with control group (P < 0.05). The capacity assessment combined with staged target nursing intervention can effectively improve patients’ swallowing function, neurological function, pulmonary function and life quality, with obvious therapeutic effect, deserving promotion and popularization.

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xiange Zeng ◽  
Ling Li ◽  
Wenjing Wang ◽  
Lihui Zhu

Objective. To seek the improvement of rehabilitation nursing intervention on dysphagia and quality of life of patients with esophageal cancer undergoing radiotherapy. Methods. A total of 109 patients with esophageal cancer undergoing radiotherapy were selected as research objects. According to the random number table, they were separated into the control group (CG) and intervention group (IG), with 45 cases in CG and 64 cases in IG. In CG, patients were given routine nursing intervention, while those in IG were given rehabilitation nursing intervention. After intervention, the degree of acute radiation injury and the improvement of swallowing function were observed to compare the self-nursing ability, quality of life, and incidence of complications between the two groups. Results. The degree of injury in CG was heavier than that in IG. The improvement of swallowing function in IG was better than that in CG. The scores of self-nursing ability and life quality in IG were higher than those in CG, with statistically significant differences ( p < 0.05 ). The incidence of complications in IG was obviously lower than that in CG ( p < 0.05 ). Conclusion. Rehabilitation nursing intervention can ameliorate dysphagia, improve the quality of life, and reduce the incidence of complications for patients with esophageal cancer undergoing radiotherapy. It is worthy of clinical application.


2020 ◽  
Author(s):  
Yuan Gao ◽  
Xiaojie Fu ◽  
Mingxing Lei ◽  
Pengbin Yin ◽  
Qingmei Wang ◽  
...  

BACKGROUND Mobile apps are becoming increasingly relevant to health care. Apps have been used to improve symptoms, quality of life, and adherence for oral drugs in patients with cancers, pregnancy, or chronic diseases, and the results were satisfying . OBJECTIVE This study aims to develop an information platform with the help of a mobile app and then evaluate whether information platform-based nursing can improve patient’s drug compliance and reduce the incidence of VTE in patients with hip fractures. METHODS We retrospectively analyzed hip fracture patients performed with traditional prevention and intervention of VTE (control group) between January 2008 and November 2012, and prospectively analyzed hip fracture patients conducted with nursing intervention based on the information platform (study group) between January 2016 and September 2017. The information platform can be divided into medical and nursing care end and the patient’s end. Based on the information platform, we could implement risk assessments, monitoring management and early warnings, preventions and treatments, health educations, follow-up and other aspects of nursing interventions for patients. We compared basic characteristics, outcomes including drug compliance, VTE occurrence, and mean length of hospitalization between the two groups. Besides, a subgroup analysis was performed in the study group according to different drug compliances. RESULTS Regarding baseline data, patients in the study group had more morbidities than those in the control group (P<0.05). The difference of drug compliance between the two groups was statistically significant (P<0.001): 64.7% of the patients in the control group had poor drug compliance and only 6.1% patients had poor drug compliance in the study group. In terms of VTE, 126 patients (10.7%) in the control group had VTE, while only 35 patients (7.1%) in the study group had VTE, and the difference was statistically significant (P=0.024). Moreover, the average length of hospitalization in the study group was also significantly lower than that in the control group (10.4 d vs. 13.7 d, P=0.000). Subgroup analysis of the study group showed that the incidence of VTE in patients with non-compliance, partial compliance, and good compliance was 56.7%, 5.8% and 2.8%, respectively (P=0.000). CONCLUSIONS Poor drug compliance leads to higher VTE occurrence. The information platform-based nursing can effectively improve the compliance of patients with hip fracture and thus significantly reduce the incidence of VTE.


2021 ◽  
Vol 7 (6) ◽  
pp. 6395-6401
Author(s):  
XueQin Li ◽  
XiuYing Chen

Background VAP is a common complication of ventilator maintenance therapy. The occurrence of VAP is related to many factors such as long duration of breathing, invasive operation, pollution of respiratory tubes and instruments, and low immunity of patients. The prevention of VAP in critically ill patients I the primary problem for clinical medical staff. Avoiding exogenous bacteria invading the respiratory tract and endogenous bacterial infection is the main method. Objective To investigate the value of optimized cluster nursing intervention combined with targeted nursing measures in reducing the incidence of ventilator-associated pneumonia (VAP) in patients with mechanical ventilation in intensive care unit (ICU). Methods 200 patients with mechanical ventilation in ICU of our institute from January 2017 to June 2020 were selected and randomly divided into study group and control group, with 100 cases in each group. The study group was treated with cluster nursing intervention combined with targeted nursing measures optimized by muItL criteria decision analysis method, and the control group was treated with targeted nursing measures. The incidence of VAP, the detection rate of pathogenic bacteria in sputum specimens and the effect of nursing execution were compared between the two groups. 200 patients were divided into VAP group and non-VAP group according to whether VAP occurred. Multivariate Logistic regression model analysis was used to explore the risk factors of VAP in AECOPD patients. Results A total of 4 strains were detected in the study group and 18 strains were detected in the control group. The detection rate of pathogenic bacteria in the study group was higher than that in the control group (y2=10.010, P=0.002<0.05). The incidence of VAP in the study group was 4.00% lower than 17.00% in the control group, and the difference was statistically significant (P<0.05). Compared with VAP group and non-VAP group, the proportion of patients with serum albumin<30g/L, diabetes mellitus rate, APACHE II score>15 points, tracheotomy rate and mechanical ventilation time≥5 days in VAP group were significantly higher than those in non-VAP group, which had statistical significance (P<0.05). The results of logistic regression model snowed that serum albumin ≥30g/L and optimized cluster nursing could effectively reduce the risk of VAP in ICU patients with mechanical ventilation (P<0.05). The risk of VAP in ICU patients with mechanical ventilation was increased by the combination of diabetes rate. APACHE II score≥15 points, tracheotomy and mechanical ventilation time ≥ 5 days (P<0.05). Conclusion The risk of VAP in ICU patients with mechanical ventilation is high, and the optimized cluster nursing intervention combined with targeted nursing measures can effectively reduce the incidence of VAP.


Author(s):  
Jeyasudha Jambusayee ◽  
Kulur Mukhyaprana Sudha

Background: Alopecia areata is an autoimmune disorder causing patchy hair loss on scalp and other parts of the body and leading to poor self-esteem and anxiety in patients. Treatment with topical or systemic drugs like steroids or other immunosuppressants is associated with adverse effects. Hydroxychloroquine is an antimalarial drug, with T cell modulating function. This study was undertaken to assess the safety, efficacy and tolerability of Hydroxychloroquine in Alopecia areata compared to betamethasone oral mini pulse (OMP) therapy. Methods: 60 patients with alopecia areata were randomized into two groups of 30 each. Control group received tab. betamethasone 5 mg/day on two consecutive days of week for 12 weeks and Study group received tab. hydroxychloroquine 200 mg/day for 12 weeks. They were followed-up for further 12 weeks. Scale of alopecia tool, dermatology life quality index and global assessment at baseline, 12 weeks and 24 weeks were used to assess the outcome.Results: 94 patients were screened and 60 patients were included. All patients completed the study. At the end of 12 weeks, there was a statistically significant reduction in SALT and DLQI scores in both control and study groups. But at the end of 24 weeks, the study group showed an increase in the scores. Relapses were more in the study group. No significant difference in the incidence of adverse events was noted between the two groups.Conclusions: Hydroxychloroquine 200 mg/day is less efficacious in the management of alopecia areata in comparison to betamethasone oral mini pulse therapy.


2021 ◽  
Vol 7 (4) ◽  
pp. 392-399
Author(s):  
Jing Zhao ◽  
Lili Fu ◽  
Juan Zhu ◽  
Yan Liu ◽  
Xiaoqian Sun

To study and analyze the actual clinical effect of nursing intervention in stem cell therapy for stroke patients. A total of 9 stroke patients treated with stem cell therapy in our hospital from September 2018 to September 2019 were selected as the research and analysis objects. All patients were divided into observation group 5 stroke patients and control group 4 stroke patients by random number method. Both groups of patients were treated with stem cell therapy. Patients in the control group were treated with conventional nursing methods, and patients in the observation group were treated with nursing intervention methods. The treatment compliance, psychological status, quality of life and daily living ability before and after intervention were compared between the two groups. There were no significant differences in exercise training, disease monitoring and compliance with regular life between the two groups before intervention (P > 0.05), and the patients in observation group were significantly better than those in control group after intervention (P < 0.05), with significant differences. There was no significant difference in anxiety and depression scores between the two groups before intervention (P > 0.05), and after intervention, the patients in the observation group were significantly lower than those in the control group (P < 0.05), and the difference was statistically significant. There was no significant difference in quality of life and ability of daily living between the two groups before intervention (P > 0.05), and the patients in the observation group were significantly better than those in the control group after intervention (P < 0.05), the difference was statistically significant. The application of nursing intervention in stem cell therapy for stroke patients has a significant effect, which significantly improves the patient's compliance with the treatment, alleviates the negative emotions of patients, improves the psychological status of patients, improves the quality of life and daily living ability of patients, and is worthy of popularization and application in clinical nursing.


2021 ◽  
Vol 7 (6) ◽  
pp. 6445-6452
Author(s):  
Haijuan Hu ◽  
Yishu Zhao ◽  
Jianhua Ma

To analyze the clinical effect of nursing cooperation in transsphenoidal approach microscopic hypophysectomy. From January 2017 to January 2020, 80 patients who underwent transsphenoidal microscopic hypophysectomy in our hospital were selected to participate in the analysis and study. They were divided into two groups according to the randomized allocation, namely the observation group and the control group. Among them, 40 patients in the observation group and 40 patients in the control group were given routine nursing care for the patients in the control group, and comprehensive nursing intervention was adopted for the patients in the observation group, and the overall nursing effect of the two groups of patients was compared. After taking different nursing methods, the condition of patients in both groups was effectively controlled, and the effective rate of patients in the observation group with comprehensive nursing intervention was significantly better than that of patients in the control group with conventional nursing methods, and the difference had certain statistical significance (P < 0.05); The satisfaction degree of patients in the study group was significantly better than that of patients in the control group, and the difference was statistically significant (P < 0.05). The degree of negative emotions of patients in the study group was significantly better than that of patients in the control group after receiving comprehensive nursing intervention, and the difference was statistically significant (P < 0.05), and the difference in the incidence of adverse events between the two groups was not statistically significant (P > 0.05); The scores of each index of SF-36 questionnaire of patients in both groups were higher than those before nursing, and the scores of each index of patients in observation group were higher than those of patients in control group, and the difference was statistically significant (P > 0.05). With adequate preoperative preparation and mastery of the use of mechanical equipment, comprehensive nursing intervention can effectively improve the treatment effect of patients, make patients more satisfied with the nursing work, and can soothe patients’ negative psychological mood, eliminate panic, improve patients' life confidence, enhance intraoperative cooperation, and ensure that the operation can be completed smoothly.


2018 ◽  
Vol 8 (7) ◽  
pp. 125
Author(s):  
Ghada Ahmed Hassan ◽  
Hanady Shaaban Ibrahim

Background and objective: Cancer is a serious health problem. Children with cancer are in particular need of support and care due to its complications followed by chemotherapy. These children should be cared for at home by family caregivers, and this places great mental and physical burden on caregivers. Therefore, appropriate and effective nursing interventions are essential in order to decrease burden and improve their coping pattern. The aim of this study was to determine the effect of supportive nursing intervention on the burden of care and coping pattern in caregivers of children with cancer.Methods: Research design: A Quasi-study pre, immediately after, and 1 month after the intervention was used to test the study hypothesis and fulfill the aim of the study. Setting: The study was conducted at outpatient clinic in Specialized Pediatric Hospital at Benha City. Subjects: Sixty caregivers for children with cancer was chosen through convenient sampling method and divided by using table of random numbers into two groups, study and control group. Caregivers of the study group attended seven nursing intervention sessions. Tools: The tools used were (1) An inertviewing questionnaire which include two part; sociodemoghaphic date and medical history for child and thier caregivers (2) Zarit Burden Scale (3) Coping Health Inventory for caregivers parents (CHIP).Results: During the study period, burden decreased in the study group and increased in the control group. Mean burden of care score before, immediately after, and 1 month after the intervention was 42.2, 33.7, and 25.6, respectively, in the study group and 44.2, 46.1, and 48.5, respectively, in the control group. In addition, the mean burden score in the study group significantly decreased in comparison with the control group (p < .001). Also, coping strategies increased in the study group and decreased in the control group. Mean coping pattern score before, immediately after, and 1 month after the intervention was 32.8, 47.5, 53.6, respectively, in the study group and 34.7, 30.7 and 26.2, respectively, in the control group. In addition, the mean coping pattern score in the study group significantly improved in comparison with the control group (p < .001).Conclusions: The supportaive nursing intervention can decrease burden in caregivers of children with cancer and consequently improve their methods of coping.


2017 ◽  
Vol 27 (06) ◽  
pp. 526-532 ◽  
Author(s):  
Selen Serel Arslan ◽  
Numan Demir ◽  
Sule Yalcın ◽  
Ayşe Karaduman ◽  
Ibrahim Karnak ◽  
...  

Aim The aim of this study was to evaluate the results of Swallowing Rehabilitation Protocol (SRP) on swallowing function (SF) of esophageal atresia and tracheoesophageal fistula (EA-TEF) patients with pharyngeal swallowing disorder. Materials and Methods In this study, 24 children with EA-TEF who had deglutitive and respiratory problems were grouped into either study (n = 12) or control group (n = 12) by basic randomization. Study group received the SRP including neuromuscular electrical stimulation, thermal tactile stimulation, and hyolaryngeal mobilization. The control group received nonnutritive stimulations. SF was evaluated with 3 mL liquid and pudding barium by videofluoroscopic swallowing study (VFSS) before and after 20 sessions of interventions. Results No statistical differences were found between groups in terms of descriptive characteristics including age, sex, weight, height, type of atresia, repair type, repair time, and start time of oral intake (p > 0.05). There were no statistical differences between groups in term of swallowing parameters (p > 0.05), except reflux (p = 0.004) according to VFSS findings. After 20 sessions of interventions, the study group showed improvement in penetration–aspiration scale scores, oral phase dysfunction, delay in swallowing reflex, and residue in valleculae and pyriform sinuses after pudding swallow. The control group showed improvement only in oral phase dysfunction. Conclusion SRP can be recommended to improve SF in patients with EA/TEF who have pharyngeal swallowing disorders.


2021 ◽  
Vol 12 ◽  
Author(s):  
Lida Zhong ◽  
Jinzhu Rao ◽  
Jing Wang ◽  
Fang Li ◽  
Yang Peng ◽  
...  

Background: The clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) protocols on patients with poststroke dysphagia is still unclear.Objective: This trial aimed to explore and analyze the effectiveness of 5 Hz rTMS on the unaffected hemisphere, affected hemisphere, and cerebellum in stroke patients with dysphagia.Methods: This observer-blind and randomized controlled trial included a total of 147 patients with stroke. Patients were divided into four treatment groups: the unaffected hemispheric group, the affected hemispheric group, the cerebellum group and the control group. Each group received traditional dysphagia treatment 5 days a week for 2 weeks. All recruited patients except for those in the control group underwent 10 consecutive rTMS sessions for 2 weeks. For the affected hemispheric group and unaffected hemispheric group, 5 Hz rTMS was applied to the affected mylohyoid cortical region or to the unaffected mylohyoid cortical region. For the cerebellum group, 5 Hz rTMS was applied to the mylohyoid cortical representation of the cerebellum (4.3 cm lateral and 2.4 cm below the inion). The Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), Penetration/Aspiration Scale (PAS), Gugging Swallowing Screen (GUSS), and Standardized Swallowing Assessment (SSA) were used to evaluate clinical swallowing function before the intervention (baseline), immediately after the intervention and 2 weeks after the intervention.Results: There were significant time and intervention interaction effects on the FEDSS, PAS, SSA, and GUSS scores (p &lt; 0.05). In a direct comparison of the swallowing parameters of the four groups, the changes in FEDSS, PAS, SSA, and GUSS scores showed a significantly greater improvement in the unaffected hemispheric group, the affected hemispheric group and cerebellum group than in the control group (p &lt; 0.05).Conclusions: Whether stimulating the unaffected hemisphere or the affected hemisphere, 5 Hz high-frequency rTMS on mylohyoid cortical tissue might have a positive effect on poststroke patients with dysphagia. In addition, cerebellar rTMS is a safe method that represents a potential treatment for poststroke dysphagia, and more clinical trials are needed to develop this technique further.Clinical Trial Registration:chictr.org.cn, identifier: ChiCTR2000032255.


2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Hongfang Jia ◽  
Jing Hao

Objective: To study and analyze the clinical effect of cluster intervention strategy in patients with stroke associated pneumonia. Methods: The time span of the study was from April 2018 to March 2019. 70 stroke patients were selected and divided into the study group and the control group according to the random number table model. The control group was treated with routine nursing, and the study group was treated with cluster intervention. The indicators of the two groups were compared and analyzed. Results: Compared with the incidence of aspiration and stroke associated pneumonia, the study group had more advantages (P< 0.05). Conclusion: Cluster intervention can significantly reduce the incidence of associated pneumonia in stroke patients, which is worthy of comprehensive promotion.


Sign in / Sign up

Export Citation Format

Share Document