25 October 2016, Volume 23 Issue 5

    

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Orignal Article
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  Analysis on anxiety and depression and their influence factors among elderly operative patients

  Zhang Chuanmeng, Zhang Gaohua, Wan Chonghua, Chen Mingyang, Wang Kangning, Li Jiahui

  journal1. 2016, 23(5): 321-324. https://doi.org/10.3969/j.issn.1006-5253.2016.05.001

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  Objective To understand anxiety and depression status and explore influence factors of anxiety and depression among elderly operative patients. Methods Two hundred and ninety-five elderly preoperative patients were investigated by self-rating anxiety scale (SAS), self-rating depression scale (SDS) and family APGAR index (APGAR). Results Among 295 elderly preoperative patients, the incidence rate of anxiety was 51.53%, and the incidence rate of depression was 33.22%. The correlation coefficient r of family function and preoperative anxiety was -0.336(P<0.01), while the correlation coefficient r of family function and depression was -0.272(P<0.01). In logistic regression analysis, age, occupation, income level, medical forms, drink, tumorous diseases and family function were found to affect anxiety and the regression coefficients (Odds ratio) were 0.260 (1.297), -0.681 (0.506), -0.583 (0.558), -0.643 (0.526), 0.544 (1.723), -0.628 (0.538) and -1.036(0.355). While sex, smoking, tumorous disease and family function were found to affect depression and the regression coefficients were 0.331(1.392),-0.939(0.391),-1.418(0.242) and -0.690(0.502). Conclusion There is a high incidence of anxiety and depression among elderly operative patients. The family function of elderly preoperative patients was related to anxiety and depression. In influence factors of anxiety, occupation, income level, medical forms, tumorous disease, and family function were protective factors, while age and drink were risk factors. In influence factors of depression, smoking, tumorous disease and family function were protective factors, while sex was a risk factor.
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  Distribution of epidemiology on nosocomial infection in a tertiary hospital

  Qiu Jingmei

  journal1. 2016, 23(5): 325-327. https://doi.org/10.3969/j.issn.1006-5253.2016.05.002

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  Objective To research the distribution of epidemiology of the nosocomial infection and to make reasonable suggestion in the nosocomial infection management system. Methods With retrospective study methods, data of 1099 patients with nosocomial infection in 2014 were drawn from HIS (Hospital Information System), and SPSS 16.0 software was used to analyze the three-dimension distribution characteristics. The main statistical methods included descriptive statistical analysis and χ² test. Results The nosocomial infection rate was 4.18%, and the ratio between male and female was 1.21∶1; the nosocomial infection rate of patients aged over 90 was 11.4%; respiratory tract infection patients accounted for 39.22% of the total; compared to other time, the highest nosocomial infection rate was in January (6.69%); compared to all patients, the average length of stay of nosocomial infection patients was more than 8days;the ratio between internal medicine and surgical department was 3.12∶1. Conclusion In future, administrators of nosocomial infection and medical workers should make great effort to supervise high-risk groups, high infection rate of departments and the susceptible position, to reduce the average length of stay, cut down the nosocomial infection rate, and save medical resources.
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  Analysis on present situation of self-management of tumor patients with PICC

  Jiang Naihu, Zhang Xiushi, Xie Mingfei

  journal1. 2016, 23(5): 328-331. https://doi.org/10.3969/j.issn.1006-5253.2016.05.003

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  Objective To analyze self-management ability of cancer patients and its influencing factors, and to put forward the improvement strategies to solve the problems. Methods A random sampling method was used to investigate and analyze 160 cancer patients receiving PICC treatment, and the PICC self-management scale was used to evaluate the cancer patients. Results In the survey of cancer patients, the total score of PICC was (152.16 + 17.26). Among them, 65% of patients in self-management capabilities were better, 23% of the patients were at the middle management level, and 12% of patients were with poor self-management skills. In the CPPSM questionnaire, the daily life management dimension scores were highest (32.18 ± 3.19), and the information obtained from the dimension scores was lowest (12.38 ± 3.42). Maintenance compliance management dimension was the highest score (4.78 ± 0.43), the lowest score of information access dimension (3.95 ± 1.24). Multiple linear stepwise regression analysis showed that gender and income level were the main factors influencing self-management ability of patients. Conclusion PICC cancer patients have better self-management behaviors, PICC catheter treatment of cancer patients must consider the patient′s psychological observation and other factors. And medical personnel and family members of patients should strengthen patient education and psychological care, improve patient self-PICC-management capabilities.
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  Logistic regression analysis on risk factors of hospitalized patients with hospital acquired infection in the department of gastroenterology

  Shi Shan, Guo Yeli

  journal1. 2016, 23(5): 332-334. https://doi.org/10.3969/j.issn.1006-5253.2016.05.004

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  Objective To investigate the related risk factors of inpatients with hospital acquired infection (HAI) in the department of gastroenterology. Methods Five hundred and sixty-five inpatients from August 2014 to January 2016 were selected as the research objects. Relative risk factors of HAI in patients were analyzed with single factor chi-square test and the binary classification unconditional logistic regression equation. Results Eighty-five inpatients in the department of gastroenterology were with HAI and the infection rate was 15.0%. The most common part of infection was the lower respiratory tract (31.7%), followed by the upper respiratory tract (26.8%), and the urinary tract (18.3%). Multivariate Logistic regression analysis showed that age (OR=1.382,95%CI:1.167~4.154), diabetes mellitus (OR=1.454,95%CI:1.150~3.341), the digestive tract tumor (OR=1.382,95%CI:1.167~4.154), the combined use of antibiotics (OR=1.693,95%CI:1.253~4.541), serum albumin levels <40 (g/L) (OR=1.522,95%CI:1.311~2.651), the hs CRP acuity 10 mg/L (OR=1.304,95%CI:1.126~1.984), and invasive operation (OR=1.593,95%CI:1.242~5.761) were independent risk factors of HIA. Conclusion Inpatients in the department of gastroenterology have risks of hospital-acquired infection, and the risk factors were such as age, diabetes, antibiotics application way, the digestive tract tumor, serum albumin, hs-CRP level and the impact of invasive operation.
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  Effectiveness of chemotherapy alone versus radiation alone in endometrial cancer Meta analysis of randomized controlled trials

  Chen Qiaoying, Jiang Bengui

  journal1. 2016, 23(5): 335-339. https://doi.org/10.3969/j.issn.1006-5253.2016.05.005

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  Objective To review the effect and safety of chemotherapy alone or radiation alone in the treatment of endometrial cancer. Methods Databases of PubMed, Cochrane Library, Medline, Embase, Ovid, CBM, VIP, Wanfang, CNKI were searched, and randomized trials (RCT) of chemotherapy alone versus radiation alone for the treatment of endometrial cancer were gathered (from 2006 to 2016). Then the Meta-analysis was performed by using RevMan 5.2 software. Results Eight RCTs were included, involving 1 828 patients. Meta-analysis indicated that the differences of 5-year overall survival rate (RR＝0.92,95%CI (0.87,0.98), P=0.01), disease recurrence rate (RR＝1.15,95%CI (1.02,1.30), P=0.02), grade 3/4 thrombocytopenia (RR＝0.13,95%CI (0.07,0.27), P<0.000 01), grade 3/4 neutropenia (RR＝0.01,95%CI (0.00,0.03), P<0.000 01) between chemotherapy alone and radiation alone were significant. Conclusion Compared with postoperative radiotherapy, postoperative chemotherapy might improve the overall survival rate for patients with advanced stage endometrial cancer.
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  Analysis of the admission process satisfaction degree of patients in five 3A hospitals

  Li Ruibo, Zhang Qiao, Xiang Jing

  journal1. 2016, 23(5): 340-341. https://doi.org/10.3969/j.issn.1006-5253.2016.05.006

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  Objective Investigating the admission process satisfaction degree of patients from five 3A hospitals and analyzing the influencing factors for satisfaction degree in order to provide a reference for improving the quality of hospital service. Methods Questionnaires of admission process satisfaction degree were sent to patients from five 3A hospitals and collected; multiple linear regression was used to analyze the influencing factors for satisfaction degree. Results The overall score of satisfaction degree was 4.43±0.60; the satisfaction degree of patients from villages and towns was lower than that of patients from cities(β=-0.166 9); the satisfaction degree of readmission patients was lower than that of first admission patients(β=-0.101 9). Conclusion Hospitals need to extend the coverage of signs and guidance,provide one-stop service for admission procedures, strengthen admission education and pay more attention to sustainably improving the service quality before hospitalization.
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  Investigation analysis on correlated risk factors of acute upper gastrointestinal bleeding in the elder population

  Cai Zhefeng

  journal1. 2016, 23(5): 342-344. https://doi.org/10.3969/j.issn.1006-5253.2016.05.007

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  Objective To explore etiological and correlated risk factors of acute upper gastrointestinal bleeding in the elder population, then to provide basis for prevention and treatment of upper gastrointestinal bleeding. Methods Data of 190 patients possibly with upper gastrointestinal bleeding were retrospectively analyzed, and according to gastroscopy results, 190 cases were divided into hemorrhage group (n=65) and non-hemorrhage group (n=125). Then single factor and multiple factors analysis methods were used to analyze the risk factors of upper gastrointestinal bleeding. Results The incidence rate of upper gastrointestinal bleeding was 34.2% (65/190) in the elder. Multiple factors analysis results showed that the risk factors included age (OR=1.377), gastric ulcer history (OR=2.609), duodenal ulcer history (OR=3.203), acute gastric mucosa pathological changes (OR=2.560), helicobacter pylori infection (OR=3.511), and taking NSAIDs (OR=4.384) and ASA (OR=5.568) drugs. Conclusion The independent risk factors of acute upper gastrointestinal bleeding in the elderly population contain age, duodenal ulcer disease, helicobacter pylori infection and taking NSAIDs and ASA drugs. We should adopt protective measures for these high risk factors.
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  Effect of comprehensive psychological intervention on self-management and quality of life in patients with sleep apnea syndrome

  Liu Zhimei

  journal1. 2016, 23(5): 345-348. https://doi.org/10.3969/j.issn.1006-5253.2016.05.008

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  Objective To analyze the changes of self-management ability and quality of life of patients with sleep apnea syndrome after comprehensive psychological intervention, and to provide reference for clinical work. Methods From May 2013 to Jan 2014 in our hospital, 80 cases of sleep apnea syndrome patients were randomly divided into the observation group and the control group. Both groups of patients were treated with routine nursing intervention program including quitting smoking and drinking, reducing the impact of risk factors, keeping the lateral position during sleep. Besides, patients in the observation group received comprehensive psychological intervention. On the first hospitalized day and 9 months after treatment, self-management ability and the quality of life of patients were assessed with the use of self-management behavior questionnaire of patients with sleep apnea syndrome, Calgary quality of life questionnaire and Epworth Sleeping Scale (ESS). Polysomnography monitor was used to monitor the lowest nocturnal arterial oxygen saturation, the apnea hypopnea index, and the time proportion of oxygen saturation less than 90% of the total sleep time. Results After comprehensive psychological intervention, the increase values of total score values of treatment management, life management, management, knowledge management, and muscle self behavior management of the observation group were significantly higher than those of the control group (P<0.05). During the return visit, the increase values of total score values of patients′social situation, the daily life, the symptoms, and mood the observation group were significantly higher than those of the control group (P<0.05). After comprehensive psychological intervention, ESS score, AHI and decrease values of blood oxygen saturation < 90% of the observation group were higher than those of the control group (P<0.05), while the increase value of the lowest SpO₂ at night of the observation group was higher than that of the control group (P>0.05), with no statistical significance. Conclusion The comprehensive psychological intervention can significantly improve the self-management ability and the quality of life of patients with sleep apnea syndrome.